{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T19:18:59Z","timestamp":1772565539895,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014032","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000}}],"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100009054","name":"PEPFAR","doi-asserted-by":"crossref","award":["GH001353-01"],"award-info":[{"award-number":["GH001353-01"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Visceral leishmaniasis (VL), a neglected tropical disease (NTD)continues to affect several countries worldwide, including Uganda, where it remains a significant public health concern in the Karamoja Region. This region borders Kenya, where VL is endemic. Globally and within East Africa, VL persists due to a combination of ecological suitability for sandfly vectors, chronic underdiagnosis, limited access to care in remote and pastoralist communities, high levels of malnutrition and poverty, and cross-border population movement that sustains transmission. The World Health Organization (WHO) targets to eliminate VL as a public health problem by reducing case fatality to &lt;1%, but the current burden of VL is unknown. We described VL patients, their treatment outcomes, and identified factors associated with death in Uganda, from 2019\u20132024, to check progress towards meeting the country\u2019s targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational review of patient records from 2019\u20132024 at the main VL treatment center in Amudat District, Uganda, abstracting socio-demographic, clinical, treatment, and outcome dataWe used logistic regression to determine factors associated with death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 972 patients, 670 (69%) were male and 742 (76%) were age\u2009\u2264\u200918 years. Three hundred and seventy-three (38%) were from Kenya, while most, 434\/599 (72%) Ugandan patients were from Moroto District. The highest number of cases (322) was recorded in 2022, with Ugandans making up 80% of all patients that year(259\/322), unlike previous years (2019\u20132021) when Kenyan patients predominated. There was no identifiable seasonal pattern\/variation in the number of cases diagnosed. The commonest symptoms were fever (98%), night sweats (77%), and abdominal swelling (72%). The average duration of sickness was 2.6 months (standard deviation (SD)=0.3 months). Severe anemia was common (512\/972; 53%), and among the patients tested for co-infections, 175\/969 (18%) were co-infected with malaria and 185\/593 (31%) with Human Immunodeficiency Virus (HIV). For most patients, 898 (92%), this was their index episode of VL. Almost all patients [957 (98%)] were cured. and most [743 (76%)] patients were treated with the 1\n                      <jats:sup>st<\/jats:sup>\n                      - line regimen. The case fatality rate (CFR) declined from 2% in 2020 and 2021 to &lt;1% in 2023 and 2024. Being HIV positive was associated with death (Adjusted odds ratios (AOR) 10, 95% Confidence Intervals (CI) 2.2-50, p\u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study indicates progress towards the elimination of VL while highlighting the significance of cross-border transmission and the importance of screening\/treatment of co-infections, especially HIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014032","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:41:08Z","timestamp":1772131268000},"page":"e0014032","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics, treatment outcomes and factors associated with death among patients with Visceral Leishmaniasis, Uganda, 2019\u20132024"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0488-2891","authenticated-orcid":true,"given":"Benigna Gabriela","family":"Namara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Ankunda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Migisha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benon","family":"Kwesiga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilian","family":"Bulage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Nabatanzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex Riolexus","family":"Ario","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred","family":"Mubangizi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Kadobera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"issue":"10","key":"pntd.0014032.ref001","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms10101887","article-title":"Visceral Leishmaniasis: Epidemiology, Diagnosis, and Treatment Regimens in Different Geographical Areas with a Focus on Pediatrics","volume":"10","author":"S Scarpini","year":"2022","journal-title":"Microorganisms"},{"key":"pntd.0014032.ref002","year":"2015"},{"issue":"3","key":"pntd.0014032.ref003","doi-asserted-by":"crossref","first-page":"507","DOI":"10.3201\/eid1303.060706","article-title":"Kala-azar control, Uganda","volume":"13","author":"JH Kolaczinski","year":"2007","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"pntd.0014032.ref004","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0035-9203(00)90429-2","article-title":"Detection of antibodies to Leishmania donovani in animals in a kala-azar endemic region in eastern Sudan: a preliminary report","volume":"94","author":"MM Mukhtar","year":"2000","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"12","key":"pntd.0014032.ref005","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.micinf.2003.07.003","article-title":"Visceral leishmaniasis in eastern Sudan: parasite identification in humans and dogs; host-parasite relationships","volume":"5","author":"J Dereure","year":"2003","journal-title":"Microbes Infect"},{"key":"pntd.0014032.ref006","year":"2025"},{"issue":"2","key":"pntd.0014032.ref007","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jiph.2022.12.021","article-title":"Asymptomatic Leishmania infection in humans: A systematic review","volume":"16","author":"MMC Pederiva","year":"2023","journal-title":"J Infect Public Health"},{"issue":"1","key":"pntd.0014032.ref008","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4269\/ajtmh.13-0150","article-title":"Clinical epidemiology, diagnosis and treatment of visceral leishmaniasis in the Pokot endemic area of Uganda and Kenya","volume":"90","author":"YK Mueller","year":"2014","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pntd.0014032.ref009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0008253","article-title":"Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context","volume":"14","author":"R Molina","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014032.ref010","year":"2017"},{"key":"pntd.0014032.ref011"},{"key":"pntd.0014032.ref012","article-title":"Kala-Azar in the Upper Rift Valley of Kenya. 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