Simao et al reported predictors of relapse for a patient with visceral leishmaniasis. These can help to identify a patient who may benefit from close follow-up. The authors are from Sao Paulo State University in Botucatu, Brazil.
Patient selection: status post successful treatment of viscera leishmaniasis
Relapse: recurrence of signs and symptoms <= 24 months after completing successful therapy
Risk of relapse: about 7% with median period of 6 months
Predictors during index admission:
(1) HIV infection (HR 7.5)
(2) lower limb edema (HR 6.1), interpreted as a sign of malnutrition
(3) low platelet count on admission (HR 0.99 per 1,000)
(4) secondary pneumonia (HR 5.5)
Additional factors:
(1) age 10 to 19 years (see Figure 2)
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