Leishmaniasis is an infection caused by Leishmania parasites. In children, it can affect the skin or internal organs. Diagnosis may be delayed because the signs and symptoms can be similar to those of other conditions. Delayed diagnosis or treatment may lead to worse outcomes. Treatment approaches, especially for cutaneous leishmaniasis, may also vary across centers. This study aims to improve knowledge about pediatric leishmaniasis in Italy.
This is a multicenter observational study in children younger than 18 years of age with a diagnosis of human leishmaniasis according to World Health Organization criteria. The study includes both retrospective and prospective data from participating centers in Italy. Researchers will collect and analyze clinical, diagnostic, epidemiological, treatment, and outcome data from the baseline visit and from follow-up during the first year.
The main goal of the study is to describe the clinical and epidemiological features of pediatric leishmaniasis in Italy over the study period, with a particular focus on diagnostic and treatment delay and on patient outcomes. The study will also assess the frequency and severity of disease over time and compare outcomes associated with different treatment approaches, particularly in cutaneous leishmaniasis. Patients evaluated between January 1, 2013 and June 30, 2031 may be included.
Patients younger than 18 years of age at the time of diagnosis
Diagnosis of human leishmaniasis according to World Health Organization (WHO) criteria
Written informed consent signed by parents or legal guardians; patient assent when applicable
Patients who do not meet the diagnostic criteria for confirmed human leishmaniasis
Lack of informed consent signed by parents or legal guardians, when required
Children and adolescents younger than 18 years of age with confirmed human leishmaniasis (visceral, cutaneous, or mucocutaneous) diagnosed according to WHO criteria and evaluated as inpatients or outpatients at participating Italian pediatric centers during the study period. Both retrospectively and prospectively identified patients may be included.
Cohort
Other
Not listed
Recovery rate according to therapeutic and diagnostic delay
Association between recovery rate and diagnostic and therapeutic delay, based on the time intervals from symptom onset to diagnosis and from diagnosis to treatment initiation.
Death rate according to therapeutic and diagnostic delay
Association between death rate and diagnostic and therapeutic delay, based on the time intervals from symptom onset to diagnosis and from diagnosis to treatment initiation.
Relapse rate according to therapeutic and diagnostic delay
Association between relapse rate and diagnostic and therapeutic delay, based on the time intervals from symptom onset to diagnosis and from diagnosis to treatment initiation.
Severity of pediatric leishmaniasis
Severity of disease at presentation. For visceral leishmaniasis, severity will be assessed using duration of fever, hematologic abnormalities/cytopenias, duration of hospitalization, and occurrence of complications such as macrophage activation syndrome. For cutaneous and mucocutaneous leishmaniasis, severity will be assessed according to number and size of lesions and classification as simple or complicated forms.
Risk factors for complicated forms of leishmaniasis
Association of age, area of origin, Leishmania species typing when available, and other clinical characteristics with the development of complicated visceral, cutaneous, or mucocutaneous leishmaniasis.
Risk factors for relapse of leishmaniasis
Association of demographic, microbiologic, and clinical factors with relapse after initial clinical improvement.
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