1921
Volume 101, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Cutaneous leishmaniasis (CL) is a major health problem worldwide. Although CL is a common disease among children, treatment regimens for the pediatric age group are based on extrapolation of efficacy data in adults. The present study aimed to evaluate the treatment outcome of CL in preschool-age children and the factors influencing the outcome. Two hundred ninety-four children were diagnosed with CL between December 2018 and March 2019 in Sinjar Province, Iraq. All patients were treated with intralesional injections of sodium stibogluconate and followed up for 3 months after the completion of treatment. The treatment success rate was 99% (291/294). A statistically significant association was found between the number of doses per lesion and the number of lesions ( = 0.002; CI = 0.066–0.2875). No association was found between the number of lesions, age, gender, or the presence of livestock and the treatment outcome. In conclusion, treatment success rate was high with the use of intralesional injection of sodium stibogluconate. A significant association was found between the number of lesions and the number of doses. Further studies are required to assess the treatment outcome indicators, including the genotype of leishmania.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.19-0508
2019-09-16
2020-09-26
Loading full text...

Full text loading...

/deliver/fulltext/14761645/101/5/tpmd190508.html?itemId=/content/journals/10.4269/ajtmh.19-0508&mimeType=html&fmt=ahah

References

  1. Alvar J, Yactayo S, Bern C, 2006. Leishmaniasis and poverty. Trends Parasitol 22: 552557.
    [Google Scholar]
  2. Hotez PJ, Remme JHF, Buss P, George G, Morel C, Breman JG, 2004. Combating tropical infectious diseases: report of the disease control priorities in developing countries project. Clin Infect Dis 38: 871878.
    [Google Scholar]
  3. Reithinger R, Dujardin J-C, Louzir H, Pirmez C, Alexander B, Brooker S, 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7: 581596.
    [Google Scholar]
  4. Salam N, Al-Shaqha WM, Azzi A, 2014. Leishmaniasis in the middle east: incidence and epidemiology. PLoS Negl Trop Dis 8: 18.
    [Google Scholar]
  5. Hussein NR et al., 2019. A clinical study of cutaneous leishmaniasis in a new focus in the Kurdistan Region, Iraq. PLoS One 14: e0217683.
    [Google Scholar]
  6. Uribe-Restrepo A, Cossio A, Desai MM, Davalos D, Castro MDM, 2018. Interventions to treat cutaneous leishmaniasis in children: a systematic review. PLoS Negl Trop Dis 12: e0006986.
    [Google Scholar]
  7. WHO, 2002. Guidelines for the Treatment and Prevention of Cutaneous Leishmaniasis in Pakistan. Ministry of Health, The World Health Organization, Health Net International. Available at: http://www.who.int/leishmaniasis/burden/Guidelines_for_the_treatment_and_prevention_of_CL_in_Pakistan.pdf/content/1/5/18. Accessed November 5, 2018.
    [Google Scholar]
  8. Chrusciak-Talhari A, Dietze R, Chrusciak Talhari C, da Silva RM, Gadelha Yamashita EP, de Oliveira Penna G, Lima Machado PR, Talhari S, 2011. Randomized controlled clinical trial to access efficacy and safety of miltefosine in the treatment of cutaneous leishmaniasis caused by Leishmania (Viannia) guyanensis in Manaus, Brazil. Am J Trop Med Hyg 84: 255260.
    [Google Scholar]
  9. Machado PR, Ampuero J, Guimares LH, Villasboas L, Rocha AT, Schriefer A, Sousa RS, Talhari A, Penna G, Carvalho EM, 2010. Miltefosine in the treatment of cutaneous leishmaniasis caused by Leishmania braziliensis in Brazil: a randomized and controlled trial. PLoS Negl Trop Dis 4: e912.
    [Google Scholar]
  10. Rubiano LC et al., 2012. Noninferiority of miltefosine versus meglumine antimoniate for cutaneous leishmaniasis in children. J Infect Dis 205: 684692.
    [Google Scholar]
  11. Layegh P, Rahsepar S, Rahsepar AA, 2011. Systemic meglumine antimoniate in acute cutaneous leishmaniasis: children versus adults. Am J Trop Med Hyg 84: 539542.
    [Google Scholar]
  12. Castro MD, Gomez MA, Kip AE, Cossio A, Ortiz E, Navas A, Dorlo TP, Saravia NG, 2017. Pharmacokinetics of miltefosine in children and adults with cutaneous leishmaniasis. Antimicrob Agents Chemother 61: e02198-16.
    [Google Scholar]
  13. Agrawal S, Khandelwal K, Bumb RA, Oghumu S, Salotra P, Satoskar AR, 2014. Short report: pediatric cutaneous leishmaniasis in an endemic region in India. Am J Trop Med Hyg 91: 901904.
    [Google Scholar]
  14. Llanos-Cuentas A et al., 2008. Clinical and parasite species risk factors for pentavalent antimonial treatment failure in cutaneous leishmaniasis in Peru. Clin Infect Dis 46: 223231.
    [Google Scholar]
  15. Al-Bajalan MMM, Al-Jaf SMA, Niranji SS, Abdulkareem DR, Al-Kayali KK, Kato H, 2018. An outbreak of Leishmania major from an endemic to a non-endemic region posed a public health threat in Iraq from 2014–2017: epidemiological, molecular and phylogenetic studies. PLoS Negl Trop Dis 12: e0006255.
    [Google Scholar]
  16. Brito NC, Rabello A, Cota GF, 2017. Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: a systematic review. PLoS One 12: e0184777.
    [Google Scholar]
  17. Layegh P, Pezeshkpoor F, Soruri AH, Naviafar P, Moghiman T, 2009. Efficacy of cryotherapy versus intralesional meglumine antimoniate (Glucantime) for treatment of cutaneous leishmaniasis in children. Am J Trop Med Hyg 80: 172175.
    [Google Scholar]
  18. Salmanpour R, Razmavar MR, Abtahi N, 2006. Comparison of intralesional meglumine antimoniate, cryotherapy and their combination in the treatment of cutaneous leishmaniasis. Int J Dermatol 45: 11151116.
    [Google Scholar]
  19. Aksoy M, Doni N, Ozkul HU, Yesilova Y, Ardic N, Yesilova A, Ahn-Jarvis J, Oghumu S, Terrazas C, Satoskar AR, 2016. Pediatric cutaneous leishmaniasis in an endemic region in Turkey: a retrospective analysis of 8786 cases during 1998–2014. PLoS Negl Trop Dis 10: e0004835.
    [Google Scholar]
  20. Castro MDM, Cossio A, Velasco C, Osorio L, 2017. Risk factors for therapeutic failure to meglumine antimoniate and miltefosine in adults and children with cutaneous leishmaniasis in Colombia: a cohort study. PLoS Negl Trop Dis 11: e0005515.
    [Google Scholar]
  21. Palacios R, Osorio LE, Grajalew LF, Ochoa MT, 2001. Treatment failure in children in a randomized clinical trial with 10 and 20 days of meglumine antimonate for cutaneous leishmaniasis due to Leishmania viannia species. Am J Trop Med Hyg 64: 187193.
    [Google Scholar]
  22. Machado P, Arajo C, da Silva AT, Almeida RP, D’Oliveira JA, Bittencourt A, Carvalho EM, 2002. Failure of early treatment of cutaneous leishmaniasis in preventing the development of an ulcer. Clin Infect Dis 34: e69e73.
    [Google Scholar]
  23. Hashiguchi Y, Gomez EAL, Cáceres AG, Velez LN, Villegas NV, Hashiguchi K, Mimori T, Uezato H, Kato H, 2018. Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the causative Leishmania parasites and clinico-epidemiological features. Acta Tropica 177: 135145.
    [Google Scholar]
  24. Norouzinezhad F, Ghaffari F, Norouzinejad A, Kaveh F, Gouya MM, 2016. Cutaneous leishmaniasis in Iran: results from an epidemiological study in urban and rural provinces. Asian Pac J Trop Biomed 6: 614619.
    [Google Scholar]
  25. Fakoorziba MR, Eghbal F, Eghbal H, 2012. Surrey on some epidemiological factors of cutaneous leishmaniasis in Fars Province of Iran. Int J Infect Dis 16: e158e159.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.19-0508
Loading
/content/journals/10.4269/ajtmh.19-0508
Loading

Data & Media loading...

  • Received : 06 Jul 2019
  • Accepted : 07 Aug 2019
  • Published online : 16 Sep 2019
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error