Prevalence,features and risk factors for malaria co-infections amongst visceral leishmaniasis patients from Amudat hospital,Uganda

Background and methodology: due to geographic overlap of malaria and visceral leishmaniasis (vl),co-infections may exist but have been poorly investigated. to describe prevalence,features and risk factors for vl-malaria co-infections,a case-control analysis was conducted on data collected at amudat hospital,uganda (2000-2006) by médecins sans frontières. cases were identified as patients with laboratory-confirmed vl and malaria at hospital admission or during hospitalization; controls were vl patients with negative malaria smears. a logistic regression analysis was performed to study the association between patients' characteristics and the occurrence of the co-infection. results: of 2414 patients with confirmed vl,450 (19%) were positively diagnosed with concomitant malaria. most co-infected patients were males,residing in kenya (69%). while young age was identified by multivariate analysis as a risk factor for concurrent vl and malaria,particularly the age groups 0-4 (odds ratio (or): 2.44; 95% confidence interval (ci): 1.52-3.92) and 5-9 years (or: 2.23,95% ci: 1.45-3-45),mild (or: 0.53; 95% ci: 0.32-0.88) and moderate (or: 0.45; 95% ci: 0.27-0.77) anemia negatively correlated with the co-morbidity. vl patients harboring skin infections were nearly three times less likely to have the co-infection (or: 0.35; 95% ci: 0.17-0.72),as highlighted by the multivariate model. anorexia was slightly more frequent among co-infected patients (or: 1.71; 95% ci: 0.96-3.03). the in-hospital case-fatality rate did not significantly differ between cases and controls,being 2.7% and 3.1% respectively (or: 0.87; 95% ci: 0.46-1.63). conclusions: concurrent malaria represents a common condition among young vl patients living in the pokot region of kenya and uganda. although these co-morbidities did not result in a poorer prognosis,possibly due to early detection of malaria,a positive trend towards more severe symptoms was identified,indicating that routine screening of vl patients living in malaria endemic-areas and close monitoring of co-infected patients should be implemented. © 2012 van den bogaart et al.