Clinical Profiles and Outcomes of rK39-Confirmed Paediatric Visceral Leishmaniasis at a General Hospital in Massawa, Eritrea: A Retrospective Study

Nahom Asmerom Yohannes,1 Sirak Afewerki Teweldemedhin,2 Luam Ghebreab,3 Robel Ghirmay Ghebreigziabher,4 Samuel Tekle Mengistu5 1Medical Department, Glas Central Military Hospital, Glas, Eritrea; 2Medical Department, Massawa Hospital, Massawa, Eritrea; 3Medical Department, Orotta National Referral Hospital, Asmara, Eritrea; 4Department of Ophthalmic, Haz-Haz Hospital, Asmara, Eritrea; 5Medical Department, Nakfa Hospital, Nakfa, EritreaCorrespondence: Robel Ghirmay Ghebreigziabher, Department of Ophthalmic, Haz-Haz Hospital, Asmara, Eritrea, Tel +291-1-7586067, Email [email protected]: Although timely diagnostic and treatment modalities exist worldwide for the disease Visceral leishmaniasis (VL), still a sporadic outbreak cases are reported especially in the high burden of Sub-Saharan countries.Purpose: The purpose is to identify the characteristics, distribution of the clinical parameters and treatment outcomes of VL among affected children younger than five years old.Patients and Methods: A retrospective cohort study design was used by involving all patients admitted with the rk-39 serology diagnosed patients in the VL treatment center from 15th December 2021 until 7th February 2023 in Massawa. It evaluated a patients’ hospital stay, progressive changes and finally assessing treatment outcome as favorable and unfavorable.Results: Our study found 97 rk-39 confirmed VL cases. Out of these, most cases were males 53.6%, median age with IQR of 32 (15– 66) months, and most were from Ghelalo (62%) and Foro (35.1%) of the Northern Red Sea region of Eritrea. The mortality rate was 14.4% which is 14 out of 97 cases. The younger cases were found to have higher mortality rate. Children who recovered or those with favorable outcome were found to have better baseline hematologic parameters, without concomitant infection and few blood products given. Pre and post treatment anthropometric and hematologic comparisons showed a significant positive shift with p < 0.001 paired sample T-test. Finally, a time-to-event analysis revealed a 1729 days of follow-up period with overall mortality of 6.3 per 1000 child-days.Conclusion: Along with the implementation of updated diagnostic and treatment guidelines, our study discovered the need for region-specific approach of the disease, a holistic treatment approach including their nutritional status and focusing on specific socio-demographic factors, which strongly affect the outcome of the patients.Keywords: visceral leishmaniasis, kinesin-related (rk-39), Massawa, Eritrea