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Photo: Julio Pantoja / World Bank
The systematic review, Prognostic models predicting clinical outcomes in patients diagnosed with visceral leishmaniasis: a systematic review, has been published in BMJ Public Health.
Visceral leishmaniasis is a neglected tropical disease that is transmitted by female sandflies. The disease affects impoverished regions in the Indian sub-continent, East Africa, the Mediterranean basin and South America. It is the most severe of the three forms of leishmaniasis and is almost always fatal without treatment.
IDDO’s researchers identified eight studies, published between 2003 and 2021, which together described 12 prognostic models that were developed in the context of Brazil or East Africa, that are used to predict the clinical outcomes for VL patients.
This review is the first comprehensive overview of these existing models and can support policymakers in evaluating and incorporating prognostic tools into patient management, as well as help clinicians assess their relevance to their own patient populations. It can also be used to identify key evidence gaps and to determine whether the available data are better suited to developing new models or to externally validating and updating existing ones.
However, the authors also highlight limitations of these models, which were judged to have a high risk of bias. This means that all model predictions and performance measures should be interpreted with caution.
The study’s first author Dr James Wilson said: “None of the models we found were developed for populations in the Indian sub-continent, even though this region historically carried the highest global burden of visceral leishmaniasis.
“As elimination programmes continue in the Indian sub-continent and East Africa, these gaps highlight where new model development should be prioritised. Our findings can help clinicians and policymakers assess whether existing models are applicable to their own settings.”
Find out more about IDDO work in visceral leishmaniasis