Early Clinical Manifestations Associated with Death from Visceral Leishmaniasis 英文参考文献.docVIP

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Early Clinical Manifestations Associated with Death from Visceral Leishmaniasis 英文参考文献.doc

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Early Clinical Manifestations Associated with Death from Visceral Leishmaniasis 英文参考文献

EarlyClinicalManifestationsAssociatedwithDeathfrom VisceralLeishmaniasis ValdelaineEtelvinaMirandadeArau′jo1,2,MariaHelenaFrancoMorais1,2,IlkaAfonsoReis3 ,Ana Rabello4,Maria?ngelaCarneiro1,5* 1Laborato′riodeEpidemiologiadeDoenc?as InfecciosaseParasita′rias, Po′s-graduac?a?o emParasitologia,DepartamentodeParasitologia,InstitutodeCie?nciasBiolo′gicas, UniversidadeFederaldeMinasGerais,BeloHorizonte,MinasGerais,Brazil,2SecretariaMunicipaldeSau′de,PrefeituradeBeloHorizonte,BeloHorizonte,MinasGerais, Brazil, 3Departamento de Estat?′stica, Instituto de Cie?ncias Exatas, Belo Horizonte, Minas Gerais, Brazil, 4Laborato′rio de Pesquisas Cl?′nicas, Centro de Pesquisas Rene′ Rachou,Fundac?a?o OswaldoCruz,BeloHorizonte,MinasGerais,Brazil,5Po′s-graduac?a?o emCie?ncias daSau′de,InfectologiaeMedicinaTropical,FaculdadedeMedicina, UniversidadeFederaldeMinasGerais,BeloHorizonte,MinasGerais,Brazil Abstract Background:InBrazil,lethalityfromvisceralleishmaniasis(VL)ishighandfewstudieshaveaddressedprognosticfactors. ThishistoricalcohortstudywasdesignedtoinvestigatetheprognosticfactorsfordeathfromVLinBeloHorizonte(Brazil). Methodology:TheanalysiswasbasedondataoftheReportableDiseaseInformationSystem-SINAN(BrazilianMinistryof Health) relating to the clinical manifestations of the disease. During the study period (2002–2009), the SINAN changed platform from a Windows to a Net-version that differed with respect to some of the parameters collected. Multivariate logisticregressionmodelswereperformedtoidentifyvariablesassociatedwithdeathfromVL,andthesewereincludedin prognosticscore. PrincipalFindings:Model1(period2002–2009;111deathsfromVLand777curedpatients)includedthevariablespresent inbothSINANversions,whereasModel2(period2007–2009;49deathsfromVLand327curedpatients)includedvariables common to both SINAN versions plus the additional variables included in the Net version. In Model 1, the variables significantly associated with a greater risk of death from VL were weakness (OR 2.9; 95%CI