Table 2.
Baseline socio-demographic and clinical characteristics of visceral leishmaniasis (VL) patient by timing of antiretroviral treatment (ART) initiation at Abdurafi Health Center, Ethiopia, 2008–2015
| ART before current VL episode, n (%) | ART within 4 weeks, n (%) | ART after 4 weeks, n (%) | RRR (95% CI)b | p-value | |
|---|---|---|---|---|---|
| Total | 89 | 46 | 78 | ||
| Age | |||||
| Mean, years (SD) | 35 (8) | 32 (7) | 31 (8) | 33c (32–4) | NS |
| Gender | |||||
| Male | 84 (94) | 45 (98) | 74 (95) | 1 | |
| Female | 5 (6) | 1 (3) | 4 (5) | 0.9 (.5–1.9) | NS |
| Residence status in West Armachiho | |||||
| Resident | 64 (72) | 20 (44) | 32 (41) | 1 | |
| Migrant worker | 25 (28) | 26 (57) | 46 (59) | 1.9 (1.4–2.6) | 0.000 |
| Category of leishmaniasis | |||||
| Primary VL | 59 (66) | 37 (80) | 66 (85) | 1 | |
| Relapse VL | 29 (33) | 8 (17) | 12 (15) | 0.6 (0.4–0 .9) | 0.000 |
| PKDL | 1 (1) | 1 (<1) | 0 | NA | NA |
| Malnutrition status (BMI) | |||||
| Normal (>18), (n=39) | 14 (16) | 11 (24) | 14 (18) | 1 | |
| Mild (16.0–17.9), (n=78) | 30 (34) | 14 (30) | 34 (44) | 1.1 (0.7–1.6) | NS |
| Moderate (14.0–15.9), (n=77) | 35 (39) | 17 (37) | 25 (32) | 0.8 (0.5–1.3) | NS |
| Severe (<14.0), (n=19) | 10 (11) | 4 (9) | 5 (6) | 0.7 (0.4–1.3) | NS |
| Active TBa | |||||
| Yes | 23 (26) | 12 (26) | 18 (23) | 1.1 (0.8–1.5) | NS |
| Edema or ascitesa | |||||
| Yes | 4 (4) | 5 (11) | 3 (4) | 0.9 (0.5–1.8) | NS |
| Jaundicea | |||||
| Yes | 1 (1) | 1 (2) | 4 (5) | 2.2 (0.8–6.5) | NS |
| Unrecorded | 10 (11) | 5 (11) | 8 (10) | NA | |
| Palpable spleena | |||||
| Yes | 78 (88) | 39 (85) | 69 (89) | 0.9 (0.6–1.5) | NS |
| Unrecorded | 2 (2) | 1 (3) | 0 | NA | |
| CD4 count (cell/ml) | |||||
| <200 | 9 (10) | 10 (22) | 22 (28) | 1 | |
| >200 | 5 (6) | 8 (17) | 8 (10) | 0.8 (0.4–1.5) | NS |
| Unrecorded | 75 (84) | 28 (61) | 48 (62) | NA | |
| Hemoglobin (g/dL) | |||||
| >9 | 26 (29) | 20 (44) | 35 (45) | 1 | |
| 5–9 | 53 (60) | 24 (52) | 38 (49) | 0.7 (0.5–1.0) | NS |
| <5 | 7 (8) | 1 (3) | 5 (6) | 0.7 (0.4–1.4) | NS |
| Unrecorded | 3 (3) | 1 (3) | 0 | NA | |
| Pentamidine secondary prophylaxis (PSP) PSP | |||||
| PSP received before or in 1 year (n=20) | 11 (12) | 3 (7) | 6 (8) | 0.8 (0.4–1.3) | NS |
| Leishmaniasis treatment regimen | |||||
| SSG (n=6) | 2 (2) | 2 (4) | 2 (3) | 1 | NS |
| L-AmB (n=108) | 38 (43) | 26 (57) | 44 (56) | 1.1 (0.4–2.7) | NS |
| L-AmB with MF (n=98) | 48 (54) | 18 (39) | 32 (42) | 0.8 (0.3–2.1) | NS |
| dMF (n=1) | 1 (1) | 0 | 0 | NA | |
| Starting antiretroviral regimens | |||||
| AZT-3TC-NVP (n=19) | 12 (14) | 3 (6) | 4 (5) | ||
| AZT-3TC-EFV (n=1) | 0 | 0 | 1 (1) | NA | |
| D4T-3TC-NVP (n=67) | 35 (39) | 15 (33) | 17 (22) | 1.3 (0.7–2.4) | NS |
| D4T-3TC-EFV (n=6) | 3 (3) | 0 | 3 (4) | 1.8 (0.6–5.3) | NS |
| TDF-3TC-NVP (n=2) | 2 (2) | 0 | 0 (0) | NA | |
| TDF-3TC-EFV (n=118) | 37 (42) | 28 (61) | 53 (68) | 2.1 (1.2–3.9) | 0.014 |
3TC: lamivudine; AZT: zidovudine; BMI: body mass index; D4T: stavudine; EFV: efavirenz; L-AmB: liposomal amphotericin B; MF: miltefosine; NA: not applicable; NS: not significant; NVP: nevirapine; PKDL: post-kala azar dermal leishmaniasis (excluded for RR calculation); RRR: relative risk ratio; SSG: sodium stibogluconate; TDF: tenofovir disoprosil fumarate.
a Comparison is done with non missing values.
b Derived from multiple logistic regression model and it is estimated for each delay in ART start from ‘before current VL episode’ to ‘within 4 weeks’ and to ‘after 4 weeks’ categories.
c Mean (95% CI) stated instead of RR.
d Excluded from comparison.