Visceral leishmaniasis treatment outcome and associated factors among pediatric patients in Northwest Ethiopia: a seven-year retrospective cohort data analysis (2013–2019)

BackgroundVisceral leishmaniasis (VL) remains a major public health challenge in East Africa, particularly in Ethiopia, where poor treatment outcomes contribute to high mortality rates in resource-limited settings. This study aimed to evaluate treatment outcomes and to identify factors associated with these outcomes among pediatric patients with VL at the University of Gondar Comprehensive Specialized Hospital.MethodsA retrospective study was conducted among pediatric patients with VL admitted to the pediatric hospital ward between September 2013 and August 2019. Patient records were reviewed to collect data on demographics, clinical presentations, treatment regimens, and outcomes. Data were entered into Epi-Info version 7.2 and subsequently analyzed using SPSS version 20. Logistic regression was employed to identify factors associated with treatment outcomes, with a statistical significance threshold set at p< 0.05.ResultsOf the 222 pediatric admissions for VL, 200 complete records were included in the analysis. A clinical cure was achieved in 77.5% of patients. Poor treatment outcomes were observed in 22.5% of cases, which included a partial response in 15%, death in 5%, and relapse in 2.5%. Children under 5 years of age had an 80% lower likelihood of clinical cure compared to those aged 11–15 years (AOR 0.2; 95% CI: 0.04–0.6). Additionally, patients from rural areas exhibited a cure rate four times higher than their urban counterparts (AOR, 4; 95% CI: 2–11). Those hospitalized for 11–20 days had a four-fold increased chance of cure compared to those hospitalized for more than 21 days (AOR, 4; 95% CI: 1–16). Immunocompetent children were three times more likely to be cured than immunocompromised children (AOR, 3; 95% CI: 1–9). Furthermore, adherence to international treatment guidelines correlated with a 26-fold increase in cure rates compared to local guidelines (AOR, 26; 95% CI: 8–82).ConclusionThe findings indicate a high rate of clinical cure among pediatric patients with VL, underscoring the importance of understanding the factors that influence treatment success. Targeted healthcare interventions addressing these determinants may enhance cure rates and improve the overall management of pediatric patients with VL.