Epidemiological Changes in Leishmaniasis in Spain According to Hospitalization-Based Records, 1997-2011: Raising Awareness towards Leishmaniasis in Non-HIV Patients

Hdl Handle:
http://hdl.handle.net/10144/347033
Title:
Epidemiological Changes in Leishmaniasis in Spain According to Hospitalization-Based Records, 1997-2011: Raising Awareness towards Leishmaniasis in Non-HIV Patients
Authors:
Herrador, Zaida; Gherasim, Alin; Jimenez, B Carolina; Granados, Marisol; San Martín, Juan Victor; Aparicio, Pilar
Journal:
PLoS Neglected Tropical Diseases
Abstract:
In Spain, Leishmania infantum is endemic, human visceral and cutaneous leishmaniasis cases occurring both in the Peninsula, as well as in the Balearic Islands. We aimed to describe the clinical characteristics of leishmaniasis patients and the changes in the disease evolution after the introduction of antiretroviral therapy in 1997. In this descriptive study, we used Spanish Centralized Hospital Discharge Database for the hospitalized leishmaniasis cases between 1997 and 2011. We included in the analysis only the records having leishmaniasis as the first registered diagnosis and calculated the hospitalization rates. Disease trend was described taking into account the HIV status. Adjusted odds-ratio was used to estimate the association between clinical and socio-demographic factors and HIV co-infection. Of the total 8010 Leishmaniasis hospitalizations records, 3442 had leishmaniasis as first diagnosis; 2545/3442 (75.6%) were males and 2240/3442 (65.1%) aged between 14-65 years. Regarding disease forms, 2844/3442 (82.6%) of hospitalizations were due to visceral leishmaniasis (VL), while 118/3442 (3.4%) hospitalizations were cutaneous leishmaniasis (CL). Overall, 1737/2844 of VL (61.1%) were HIV negatives. An overall increasing trend was observed for the records with leishmaniasis as first diagnosis (p=0.113). Non-HIV leishmaniasis increased during this time period (p=0.021) while leishmaniasis-HIV co-infection hospitalization revealed a slight descending trend (p=0.717). Leishmaniasis-HIV co-infection was significantly associated with male sex (aOR=1.6; 95% CI: 1.25-2.04), 16-64 years age group (aOR=17.4; 95%CI: 2.1-143.3), visceral leishmaniasis aOR=6.1 (95%CI: 3.27-11.28) and solid neoplasms 4.5 (95% CI: 1.65-12.04). The absence of HIV co-infection was associated with lymph/hematopoietic neoplasms (aOR=0.3; 95%CI:0.14-0.57), other immunodeficiency (aOR=0.04; 95% CI:0.01-0.32) and transplant (aOR=0.01; 95%CI:0.00-0.07). Our findings suggest a significant increase of hospitalization in the absence of HIV co-infection, with a predomination of VL. We consider that clinicians in Spain should be aware of leishmaniasis not only in the HIV population but also in non HIV patients, especially for those having immunosuppression as an associate condition.
Publisher:
Public Library of Science
Issue Date:
10-Mar-2015
URI:
http://hdl.handle.net/10144/347033
DOI:
10.1371/journal.pntd.0003594
PubMed ID:
25756785
Language:
en
ISSN:
1935-2735
Appears in Collections:
Leishmaniasis/Kala Azar

Full metadata record

DC FieldValue Language
dc.contributor.authorHerrador, Zaidaen_GB
dc.contributor.authorGherasim, Alinen_GB
dc.contributor.authorJimenez, B Carolinaen_GB
dc.contributor.authorGranados, Marisolen_GB
dc.contributor.authorSan Martín, Juan Victoren_GB
dc.contributor.authorAparicio, Pilaren_GB
dc.date.accessioned2015-03-23T20:31:40Z-
dc.date.available2015-03-23T20:31:40Z-
dc.date.issued2015-03-10-
dc.identifier.citationEpidemiological Changes in Leishmaniasis in Spain According to Hospitalization-Based Records, 1997-2011: Raising Awareness towards Leishmaniasis in Non-HIV Patients. 2015, 9 (3):e0003594 PLoS Negl Trop Disen_GB
dc.identifier.issn1935-2735-
dc.identifier.pmid25756785-
dc.identifier.doi10.1371/journal.pntd.0003594-
dc.identifier.urihttp://hdl.handle.net/10144/347033-
dc.description.abstractIn Spain, Leishmania infantum is endemic, human visceral and cutaneous leishmaniasis cases occurring both in the Peninsula, as well as in the Balearic Islands. We aimed to describe the clinical characteristics of leishmaniasis patients and the changes in the disease evolution after the introduction of antiretroviral therapy in 1997. In this descriptive study, we used Spanish Centralized Hospital Discharge Database for the hospitalized leishmaniasis cases between 1997 and 2011. We included in the analysis only the records having leishmaniasis as the first registered diagnosis and calculated the hospitalization rates. Disease trend was described taking into account the HIV status. Adjusted odds-ratio was used to estimate the association between clinical and socio-demographic factors and HIV co-infection. Of the total 8010 Leishmaniasis hospitalizations records, 3442 had leishmaniasis as first diagnosis; 2545/3442 (75.6%) were males and 2240/3442 (65.1%) aged between 14-65 years. Regarding disease forms, 2844/3442 (82.6%) of hospitalizations were due to visceral leishmaniasis (VL), while 118/3442 (3.4%) hospitalizations were cutaneous leishmaniasis (CL). Overall, 1737/2844 of VL (61.1%) were HIV negatives. An overall increasing trend was observed for the records with leishmaniasis as first diagnosis (p=0.113). Non-HIV leishmaniasis increased during this time period (p=0.021) while leishmaniasis-HIV co-infection hospitalization revealed a slight descending trend (p=0.717). Leishmaniasis-HIV co-infection was significantly associated with male sex (aOR=1.6; 95% CI: 1.25-2.04), 16-64 years age group (aOR=17.4; 95%CI: 2.1-143.3), visceral leishmaniasis aOR=6.1 (95%CI: 3.27-11.28) and solid neoplasms 4.5 (95% CI: 1.65-12.04). The absence of HIV co-infection was associated with lymph/hematopoietic neoplasms (aOR=0.3; 95%CI:0.14-0.57), other immunodeficiency (aOR=0.04; 95% CI:0.01-0.32) and transplant (aOR=0.01; 95%CI:0.00-0.07). Our findings suggest a significant increase of hospitalization in the absence of HIV co-infection, with a predomination of VL. We consider that clinicians in Spain should be aware of leishmaniasis not only in the HIV population but also in non HIV patients, especially for those having immunosuppression as an associate condition.en_GB
dc.language.isoenen
dc.publisherPublic Library of Scienceen_GB
dc.rightsArchived with thanks to PLoS Neglected Tropical Diseasesen_GB
dc.titleEpidemiological Changes in Leishmaniasis in Spain According to Hospitalization-Based Records, 1997-2011: Raising Awareness towards Leishmaniasis in Non-HIV Patientsen
dc.identifier.journalPLoS Neglected Tropical Diseasesen_GB

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