Incidence of Mortality and Its Predictors Among Adult Visceral Leishmaniasis Patients at the University of Gondar Hospital: A Retrospective Cohort Study

Figures & data

Table 1 Sociodemographic and Baseline Clinical Characteristics of VL Patients at the University of Gondar Hospital, 2019 (n=586)

Variables	Frequency	Percentage
Age	Median= 27 years
Sex
Male	584	99.7
Female	2	0.3
Migration Status
Migrant worker	470	80.2
Resident	116	19.8
VL Type
Primary VL	561	95.7
Relapse VL	25	4.3
Toxicity During Treatment
No	545	93.0
Yes	41	7.0
Concomitant Disease at Admission
No	417	71.2
Yes	169	28.8
Diarrhea at Admission
No	535	91.3
Yes	51	8.7
Nasal Bleeding
No	497	84.8
Yes	89	15.2
Jaundice
No	505	86.2
Yes	81	13.8
Duration of Illness (days)
≤30	328	56,0
>30	258	44.0
Leukopenia
No	50	8.5
Yes	536	91.5
Thrombocytopenia
No	86	14.7
Yes	500	85.3
Condition of Patient at Admission
Ambulatory	483	82.4
Bedridden	103	17.6
Parasite Load
Low	519	88.6
High	67	11.4
Treatment Type
Sodium stibogluconate	83	14.2
Sodium stibogluconate and paromomycin	425	72.5
Ambisome	78	13.3

Figure 1 Kaplan–Meier failure curves for some of the variables among the cohort of VL patients at the University of Gondar Hospital, 2019.

Figure 2 Proportional hazard plot for some of the variables among the cohort of VL patients at the University of Gondar Hospital, 2019.

Table 2 Proportional Hazard Assumption Test for the Study on Incidence of Mortality and Its Predictors Among VL Patients at the University of Gondar Hospital, 2019

Variables	Rho	Chi^2	df	Prob>chi^2
Residence	−0.29213	6,20	1	0.0127
Edema	−0.19109	2.73	1	0.0983
Diarrhea	0.06225	0.28	1	0.5940
Comorbidity	0.16637	2.29	1	0.1305
VL episode	−0.15490	1.77	1	0.1831
Toxicity	−0.01293	0.01	1	0.9055
Hemoglobin	−0.10120	0.78	1	0.3781
Nasal bleeding	0.06777	0.38	1	0.5398
Jaundice	−0.05067	0.19	1	0.6626
Illness duration	0.14165	1.61	1	0.2039
Patient condition at admission	−0.11546	1.22	1	0.2688
Parasite level	0.13763	1.63	1	0.2011
Creatinine level	0.02843	0.06	1	0.8060
Treatment type	0.04827	0.17	1	0.6793
Global test		15.30	14	0.4299

Table 3 Multivariable Stratified Cox Regression Analysis for Incidence of Mortality Among VL Patients at the University of Gondar Hospital, 2019

Variables	Death		Hazard Ratio (95% CI)
	No N (%)	Yes N (%)	CHR	AHR
Age	Median= 27		1.04 (1.01–1.07)	0.99 (0.95–1.04)
VL episode
Primary	504 (89.8)	57 (10.2)	1	1
Relapse	17 (68)	8 (32)	3.98 (1.89–8.36)	3.03 (1.25–7.35)*
Hemoglobin (mg/dl)
0–7.9	218 (85.5)	37 (14.5)	1.59 (0.71–3.57)	1.42 (0.59–3.42)
8–10.9	232 (91.7)	21 (8.3)	0.87 (0.37–2.05)	1.06 (0.42–2.56)
≥11	71 (91.0)	7 (8.9)	1	1
Illness Duration (days)
≤30	300 (91.5)	28 (8.5)	1	1
>30	221 (85.7)	37 (14.3)	1.64 (1.01–2.69)	0.92 (0.51–1.64)
Treatment Toxicity
No	507 (93)	38 (7)	1	1
Yes	14 (34.1)	27 (65.9)	13.99 (8.48–23.10)	5.87 (3.3–10.44)*
Comorbidity
No	395 (94.7)	22 (5.3)	1	1
Yes	126 (74.6)	43 (25.4)	5.57 (3.33–9.32)	2.29 (1.27–4.11)*
Diarrhea
No	482 (90.1)	53 (9.9)	1	1
Yes	39 (76.5)	12 (23.5)	2.61 (1.39–4.89)	1.73 (0.88–3.78)
Nasal Bleeding
No	459 (92.3)	38 (7.7)	1	1
Yes	62 (69.7)	27 (30.3)	4.51 (2.75–7.39)	2.58 (1.48–4.51)*
Edema
No	443 (90.8)	45 (9.2)	1	1
Yes	78 (79.6)	20 (20.4)	2.34 (1.38 −3.97)	1.45 (0.78–2.66)
Jaundice
No	465 (92.0)	40 (8.0)	1	1
Yes	56 (69.1)	25 (30.9)	4.62 (2.79–7.62)	2.84 (1.57–5.16)*
Creatinine Level (mg/dl)
<1.5	455 (91.0)	45 (9.0)	1	1
≥1.5	66 (76.7)	20 (27.3)	2.88 (1.70–4.88)	1.33 (0.70–2.54)
Condition of Patient
Ambulatory	456 (94.4)	27 (5.6)	1	1
Bedridden	65 (63.1)	38 (36.9)	8.29 (5.05–13.59)	3.26 (1.86–5.73)*
Parasite Load
Low	469 (90.4)	50 (9.6)	1	1
High	52 (77.6)	15 (22.4)	2.29 (1.28–4.10)	1.94 (0.97–3.89)
Treatment Type
SSG and PM	398 (93.7)	27 (6.3)	1	1
SSG	69 (83.1)	14 (16.9)	2.16 (1.07–4.34)	0.81 (0.37–1.78)
Ambisome	54 (69.2)	24 (30.8)	7.82 (4.39–13.89)	1.79 (0.91–3.54)

Note: *p<0.05.

Abbreviations: SSG, sodium stibogluconate; PM, paromomycin.