Major Co-Factors Associated with Adverse Outcome among Confirmed Lassa fever Patients with Acute Kidney Injury at a Tertiary Medical Center, South West Nigeria

Momoh AJ, Owhin SO, Olatunde LO, Ojo OE, Ojo OA, Adedosu AN, Ohwovwohwo RW, Abejegah C and Ahmed LA

Published on: 2020-09-17

Abstract

Lassa fever is a clinical illness associated with fever and bleeding diasthesis caused by a .virus belonging to the arenaviridae viridae family. Renal complication has been documented as one of the serious complication that determines the outcome of lassa fever. AKI has been found in 24% of confirmed Lassa fever cases in one study. No study to the best of our knowledge has clearly documented the major co-factors associated with adverse outcome of confirmed Lassa fever patients with AKI.

Aim: The aim of this study was to determine the prevalence of AKI, Haemodialysis and major co-factors associated with adverse outcome among patients with lassa fever complicated by AKI.

Methodology: This was a discriptive retrospective study that targets those individuals that were tested positive for lassa virus using PCR method and managed at the center from 2018-2019 of which 40 had AKI.

Result: There were 416 (232 males, 184 females) cases of confirmed lassa fever over a period of 22 months (January 2018-November 2019) with overall case fatality rate of 5.3%. The population of patients with AKI was 40 (30 males, 10 females) constituting 9.6%, presenting at various stages of AKI according to the KDIGO criteria. 25 (62.5%) presented in stage 3 AKI and needed urgent hemodialysis. The mean age of patients with Lassa fever complicated by AKI is 39.18±14.87 years with 37.4% of patients 30 years and below. The most affected age group is 20 -29 years. The followings were the major co-factors associated with adverse outcomes at p-value ? 0.05, advancing age (0.038), Neutrophilia (0.026), Lymphocytosis (0.041), Hypoalbuminaemia (0.036). The case fatality rate of those confirmed lassa fever complicated by AKI was 30.8% (12 patients = 10 males and 2 female) irrespective of the stage of AKI at presentation.

Conclusion: Among the population of confirmed Lassa fever patienst with AKI, we found that aside AKI being the major determinant of mortality other factors such as advancing age, neutrophilia, lymphocytosis and hypoalbuminaemia were major co-factors associated with adverse outcomes.