Table 3. Predictors and odds ratios for initial parasitological failure in visceral leishmaniasis and HIV co-infected patients treated with a combination of liposomal amphotericin B (AmBisome) and miltefosine by MSF in Ethiopia from January 2011 to August 2014 (N = 151).
| Predictors | n/N (%) | Crude OR (95% CI) | P | Adjusted OR (95% CI) | P |
|---|---|---|---|---|---|
| Age (years) | |||||
| - 18–40 | 4/128 (3.1) | 1.0 | 0.23a | – | – |
| - >40 | 2/23 (8.7) | 2.95 (0.51–17.15) | – | ||
| Spleen size ≥11 cm | |||||
| - No | 5/127 (3.9) | 1.0 | 1.00a | – | – |
| - Yes | 1/21 (4.8) | 1.22 (0.14–11.00) | – | ||
| Body mass index <16 kg/m2 | |||||
| - No | 3/88 (3.4) | 1.0 | 1.00a | – | – |
| - Yes | 2/57 (3.5) | 1.03 (0.17–6.37) | – | ||
| Tuberculosis | |||||
| - No | 2/116 (1.7) | 1.0 | 0.02a | 1.0 | 0.02 |
| - Yes | 4/32 (12.5) | 8.14 (1.42–46.72) | 8.14 (1.42–46.72) | ||
| Primary VL | |||||
| - No | 5/85 (5.9) | 1.0 | 0.23a | – | – |
| - Yes | 1/66 (1.5) | 0.25 (0.03–2.16) | – | ||
| Advanced HIVb | |||||
| - Noc | 0/34 (0.0) | 1.0 | 0.33a | – | – |
| - Yes | 5/98 (5.1) | – | – | ||
| Parasite grade | |||||
| - <6+ | 1/74 (1.4) | 1.0 | 0.04a | – | – |
| - 6+ | 5/50 (10.0) | 8.11 (0.92–71.68) | – | ||
| - Serological/clinical diagnosisc | 0/24 (0.0) | – | – | ||
| ART initiated before VL episode | |||||
| - Yesd | 6/95 (6.3) | 1.0 | 0.09a | – | – |
| - Noc | 0/50 (0.0) | – | – |
Abbreviations: ART, antiretroviral therapy; CI, confidence interval; OR, odds ratio; VL, visceral leishmaniasis.
a Fisher’s exact test.
b WHO stage IV or CD4 <50 cells/μL.
c No patient with parasitological failure in these subgroups.
d Of the 6 patients with parasitological failure out of the 95 patients that started ART before the VL episode: 3/44 started tenofovir based regimen, 3/41 started non-tenofovir based regimen, and in 10 patients the ART regimen was missing. The prediction of parasitological failure by the variable “ART initiated before VL episode (in ART categories)” are similar to those presented.