Visceral leishmaniasis and HIV in Tigray, Ethiopia


Suzi Lyons, Department of Public Health and Epidemiology, University College Dublin, Earlsfort Terrace, National University of Ireland, Dublin 2, Ireland. Tel.: +353 1 716 5550; Fax: +353 1 716 7407; E-mail: (corresponding author).
Dr Hans Veeken, Medical Department, Médecins Sans Frontières, Max Euweplein 40, 1001 EA, Amsterdam, The Netherlands. E-mail:
Dr Jean Long, Department of Community Health and General Practice, Trinity Centre for Health Sciences, The Adelaide and Meath Hospital Incorporating The National Children's Hospital, Tallaght, Dublin 24, Ireland. Tel.: +353 1 608 1087; E-mail:


Objectives To identify characteristics that increased the risk of mortality in Ethiopian visceral leishmaniasis patients in a treatment programme managed by Médecins sans Frontières, in Tigray, Northern Ethiopia.

Methods Retrospective review of a cohort of 791 patients treated for visceral leishmaniasis.

Results The cohort displayed all the classical signs and symptoms of the disease. The case fatality rate was 18.5% (146) (95% CI: 15.8–21.3%). Logistic regression showed that individuals who experienced at least one episode of vomiting or haemorrhage were more likely to die than those who did not. A subcohort of individuals who tested human immunodeficiency virus (HIV)-positive were more than four times more likely to die than those who tested HIV-negative (OR 4.5, 95% CI: 1.8–11.4).

Conclusion This study identifies characteristics associated with death in this population and highlights the devastating effect of co-infection with visceral leishmaniasis and HIV in the African context.