Visceral leishmaniasis in northern Ethiopia.

Abstract:  BACKGROUND: Visceral leishmaniasis (VL) has been well documented by the Medecins sans Frontieres (MSF) VL treatment programmeme in the Tigray region of Ethiopia, but reports are limited from other facilities in this region where this disease continues to cause substantial morbidity and mortality. OBJECTIVE: To describe the clinical manifestations and treatment outcomes of VL in a government hospital in Axum, Ethiopia. DESIGN: Retrospective analysis of 111 patients treated for visceral leishmaniasis. SETTING: Saint Mary's Hospital, Axum, Ethiopia. SUBJECTS: One hundred and Eleven patients treated for visceral leishmaniasis in a government hospital in Axum, Ethiopia. RESULTS: All patients were male and most reported travel history to Humera, a known endemic area. Patients presented with classic signs and symptoms, including fever, weight loss, splenomegaly and anaemia. Almost one third (15/53) of patients who underwent HIV testing had a positive result. Crude death rate at six months was 13.5 per 100 patients (95% CI: 6.7 - 20.3 per 100 patients). Presence of HIV and other co-infections were associated with increased risk of death. CONCLUSIONS: Clinical manifestations and treatment outcomes in this setting were comparable to that of the MSF programmeme in Tigray, Ethiopia and highlight the importance of HIV testing for patients presenting with visceral leishmaniasis.