<b>Retrospective analysis of visceral leishmaniasis in Eastern Sudan: Clinical presentation and treatment outcomes</b>

Background: Visceral leishmaniasis (VL) is a neglected tropical disease common in Sudan. Treatment outcomes are affected by factors such as drug resistance. Despite the accessibility of antileishmanial drugs, outcomes vary regionally. Identification of epidemiology, clinicopathology, and contributing factors is important for informed treatment decision-making. Aim: This retrospective study aimed to investigate the clinical manifestations of VL and evaluate first- and secondline treatment outcomes. Methods: The study included 363 patients with VL treated at Al Qadarif Hospital between 2019 and 2020. Venous blood samples were tested for anti-rK39 antibodies to confirm VL diagnosis. Patients received either first-line or second-line therapy; however, some treatment data were inaccessible. Descriptive statistics and bivariate logistic regression were used to analyze factors associated with clinical characteristics and treatment outcomes. Results: Of the 363 patients, 70.6% were working age (20–50 years), predominantly male (83.5%), living in ruralareas (85.1%), and without formal education (90.1%). Shared symptoms included fever alone (27.3%) and cough (6.3%). Less than 5% had coinfections, whereas 68.9% had none. Anemia and cough were noted, but 52.6% of the patients reported no additional issues. Treatment outcomes showed that 12.1% received first-line therapy, 22.0% received second-line therapy, and 65.8% did not disclose their treatment. Mortality was 3.6%, with no specific clinical or demographic predictors identified. Conclusion: The mortality rate of 3.6% is alarming but not related to symptoms or demographics. First- and secondline therapies were successful in 65.8% of cases. Improving VL detection and treatment success is essential.