Estudo comparativo entre casos novos e recidivas dos pacientes pediátricos acometidos por leishmaniose visceral atendidos no hospital de doenças tropicais do Tocantins entre os anos de 2017 a 2019

Abstract

Visceral Leishmaniasis is a parasitic infectious disease considered endemic in 38 countries and is among the six priority endemics in the world. In Brazil, the disease has a wide geographic distribution, with cases reported in at least 19 states, distributed among the five regions of the federation, with an increasing number of occurrences, mainly in the North and Northeast regions. In view of this, the objective of the present study was to identify the clinical and epidemiological profile of pediatric patients, from 0 to 12, affected by VL, attended at the Hospital de Doenças Tropicais (HDT/UFT) between the years 2017 to 2019, located in the municipality of Araguaína, in the state of Tocantins, considered an endemic region for the disease. The methodology used in the present study was based on a retrospective documentary research with a qualitative and quantitative approach, carried out by analyzing the medical records of children aged 0 to 12 years old with a diagnosis of Visceral Leishmaniasis. The following information was collected: age, gender, ethnicity, place of residence, clinical signs and symptoms, physical examination, laboratory tests, preexisting diseases, type of diet, past history, hydration and nutrition conditions. Data were categorized in Microsoft Office Excel 2010, in order to create the composition of frequencies and percentages, in the analysis of descriptive statistics. Analytical statistics used the chi-square and Fisher's test as significance tests. Data were processed using the EpiInfo software, version 7.2.4.0, with a significance level of 95% (p ≤0.05). The present study was carried out with the approval of the Research Ethics Committee of the Hospital for Tropical Diseases of the Federal University of Tocantins, under number 3,987,059. Between 2017 and 2019, 147 cases (new and recurrent) of VL confirmed in the HDT were registered, with 70% occurring in children between 0 and 2 years old, evidencing a susceptibility of this age group to developing the disease. Of the evaluated patients, 81.6% were brown, which may be an indication of exposure related to social class, which affects the low-income population, mostly composed of black and brown people. Most occurrences of the disease were recorded in urban areas, representing 89.7% of cases. Regarding laboratory tests, several alterations due to hematological disorders were observed, in addition to fever, splenomegaly, hepatomegaly and pallor. However, the treatment was capable of significantly reversing the hematological parameters (p < 0.01), including the platelet alteration, which can cause severe bleeding, both in new cases and in patients with relapses. The present study was of great importance, as it brought information about the reality of pediatric patients affected by VL, to help the scientific community, serving as a guideline for future studies. In addition, it brought to light information that can be used by the hospital community to improve its conduct in the care of these cases.