{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:42:55Z","timestamp":1789152175542,"version":"build-2803163510"},"reference-count":19,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Tropical Medicine"],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:p><jats:italic>Objectives<\/jats:italic>. To identify factors associated with death in visceral leishmaniasis (VL) cases.<jats:italic>Patients and Methodology<\/jats:italic>. We evaluated prognostic factors for death from VL in S\u00e3o Paulo state, Brazil, from 1999 to 2005. A prognostic study nested in a clinical cohort was carried out by data analysis of 376 medical files. A comparison between VL fatal cases and survivors was performed for clinical, laboratory, and biological features. Association between variables and death was assessed by univariate analysis, and the multiple logistic regression model was used to determine adjusted odds ratio for death, controlling confounding factors.<jats:italic>Results<\/jats:italic>. Data analysis identified 53 fatal cases out of 376 patients, between 1999 and 2005 in S\u00e3o Paulo state. Lethality was 14.1% (53\/376), being higher in patients older than fifty years. The main causes of death were sepsis, bleeding, liver failure, and cardiotoxicity due to treatment. Variables significantly associated with death were severe anemia, bleeding, heart failure, jaundice, diarrhea, fever for more than sixty days, age older than fifty years, and antibiotic use.<jats:italic>Conclusion<\/jats:italic>. Educational health measures are needed for the general population and continuing education programs for health professionals working in the affected areas with the purpose of identifying and treating early cases, thus preventing the disease evolution towards death.<\/jats:p>","DOI":"10.1155\/2012\/281572","type":"journal-article","created":{"date-parts":[[2012,9,14]],"date-time":"2012-09-14T18:02:10Z","timestamp":1347645730000},"page":"1-7","source":"Crossref","is-referenced-by-count":40,"title":["American Visceral Leishmaniasis: Factors Associated with Lethality in the State of S\u00e3o Paulo, Brazil"],"prefix":"10.1155","volume":"2012","author":[{"given":"Geraldine","family":"Madalosso","sequence":"first","affiliation":[{"name":"Centro de Vigil\u00e2ncia Epidemiol\u00f3gica \u201cProf. Alexandre Vranjac\u201d, Coordenadoria de Controle de Doen\u00e7as, SES, 01246-902 S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Magno","family":"Fortaleza","sequence":"additional","affiliation":[{"name":"Departamento de Doen\u00e7as Tropicais e Diagn\u00f3stico Por Imagem, Universidade Estadual Paulista J\u00falio de Mesquita Filho, 18618-970 Botucatu, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Freitas","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Centro de Vigil\u00e2ncia Epidemiol\u00f3gica \u201cProf. Alexandre Vranjac\u201d, Coordenadoria de Controle de Doen\u00e7as, SES, 01246-902 S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisete Lage","family":"Cruz","sequence":"additional","affiliation":[{"name":"Centro de Vigil\u00e2ncia Epidemiol\u00f3gica \u201cProf. Alexandre Vranjac\u201d, Coordenadoria de Controle de Doen\u00e7as, SES, 01246-902 S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ricles 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