Nodular Lymphangitis (NL) is a common epidemiological feature and clinical complication for Localized Cutaneous Leishmaniosis (LCL). Secondary local infection has been reported associated with this complication. However, it is not clear the causes for NL in many cases of leishmaniosis, specially in children and old adults, and when lesions are located in some specific anatomic locations. The purpose of this research was to learn more about the association of secondary infection and NL. A “case-control study” was conducted on a case-series of patents with LCL. LCL cases with NL were compared to LCL controls without NL regarding selected intrinsic and extrinsic factors. A total of 457 LCL patients were included in the study, being 43.3% (198) cases with NL and 56.7% (259) controls without NL. Mean difference and crude and logistic regression adjusted odds ratio were used as measures of association. Patients with NL had 2.3 times more likelihood of having history of secondary infection (95% CI 1.6, 3.5). Aging and anatomic location of the lesions were also found associated with NL (p < 0.0001). Altitude of the household was associated with NL as well (p=0.05). The association between NL and secondary infection was found to be confounded by age and anatomic location. Conclusions: secondary infection is probably the most important factor in the development of NL and this association is independent from age and anatomic location.
Learning Objectives: At the end of the presentation the participant will be able to 1. Describe the basic epidemiology of leishmaniosis. 2. Identify nodular lymphangitis as a complication of leishmaniosis. 3. Recognize local infection as an important cause for nodular lymphagitis in patients with leishmaniosis. 4. Understand the relationship of age and anatomic location with nodular lymphangitis and secondary local infection. 5. Appreciate how to use a case-control study in a case-series to investigate prognosis in tropical diseases.
Keywords: Risk Factors, Epidemiology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.