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1
Zijlstra EE, el-Hassan AM, 2001. Leishmaniasis in Sudan. Visceral leishmaniasis. Trans R Soc Trop Med Hyg 95 (Suppl 1):S27–S58.
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2
Seaman J, Mercer AJ, Sondorp E, 1996. The epidemic of visceral leishmaniasis in western Upper Nile, southern Sudan: course and impact from 1984 to 1994. Int J Epidemiol 25 :862–871.
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3
Guerin PJ, Olliaro P, Sundar S, Boelaert M, Croft SL, Desjeux P, Wasunna MK, Bryceson AD, 2002. Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda. Lancet Infect Dis 2 :494–501.
-
4
Ritmeijer K, Davidson RN, 2003. Royal Society of Tropical Medicine and Hygiene joint meeting with Medecins sans Frontieres at Manson House, London, 20 March 2003: field research in humanitarian medical programmes. Medecins sans Frontieres interventions against kala-azar in the Sudan, 1989– 2003. Trans R Soc Trop Med Hyg 97 :609–613.
-
5
Seaman J, Pryce D, Sondorp HE, Moody A, Bryceson AD, Davidson RN, 1993. Epidemic visceral leishmaniasis in Sudan: a randomized trial of aminosidine plus sodium stibogluconate versus sodium stibogluconate alone. J Infect Dis 168 :715–720.
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6
Chunge CN, Owate J, Pamba HO, Donno L, 1990. Treatment of visceral leishmaniasis in Kenya by aminosidine alone or combined with sodium stibogluconate. Trans R Soc Trop Med Hyg 84 :221–225.
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7
Scott JA, Davidson RN, Moody AH, Grant HR, Felmingham D, Scott GM, Olliaro P, Bryceson AD, 1992. Aminosidine (paromomycin) in the treatment of leishmaniasis imported into the United Kingdom. Trans R Soc Trop Med Hyg 86 :617–619.
-
8
Thakur CP, Olliaro P, Gothoskar S, Bhowmick S, Choudhury BK, Prasad S, Kumar M, Verma BB, 1992. Treatment of visceral leishmaniasis (kala-azar) with aminosidine (= paromomycin)-antimonial combinations, a pilot study in Bihar, India. Trans R Soc Trop Med Hyg 86 :615–616.
-
9
Thakur CP, Bhowmick S, Dolfi L, Olliaro P, 1995. Aminosidine plus sodium stibogluconate for the treatment of Indian kala-azar: a randomized dose-finding clinical trial. Trans R Soc Trop Med Hyg 89 :219–223.
-
10
Thakur CP, Kanyok TP, Pandey AK, Sinha GP, Zaniewski AE, Houlihan HH, Olliaro P, 2000. A prospective randomized, comparative, open-label trial of the safety and efficacy of paromomycin (aminosidine) plus sodium stibogluconate versus sodium stibogluconate alone for the treatment of visceral leishmaniasis. Trans R Soc Trop Med Hyg 94 :429–431.
-
11
Seaman J, Mercer AJ, Sondorp HE, Herwaldt BL, 1996. Epidemic visceral leishmaniasis in southern Sudan: treatment of severely debilitated patients under wartime conditions and with limited resources. Ann Intern Med 124 :664–672.
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12
World Health Organization, 1996. Manual on Visceral Leishmaniasis Control. Geneva: World Health Organization.
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13
Collin S, Davidson R, Ritmeijer K, Keus K, Melaku Y, Kipngetich S, Davies C, 2004. Conflict and kala-azar: determinants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis 38 :612–619.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 1094 | 982 | 383 |
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Treatment of Kala-Azar in Southern Sudan using a 17-Day Regimen of Sodium Stibogluconate Combined with Paromomycin: A Retrospective Comparison with 30-Day Sodium Stibogluconate Monotherapy
Yosef Melaku
Yosef Melaku
Médecins sans Frontières-Holland, Amsterdam, The Netherlands; Department of Social Medicine, University of Bristol, Bristol, United Kingdom; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom
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Simon M. Collin
Simon M. Collin
Médecins sans Frontières-Holland, Amsterdam, The Netherlands; Department of Social Medicine, University of Bristol, Bristol, United Kingdom; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom
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Kees Keus
Kees Keus
Médecins sans Frontières-Holland, Amsterdam, The Netherlands; Department of Social Medicine, University of Bristol, Bristol, United Kingdom; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom
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Francis Gatluak
Francis Gatluak
Médecins sans Frontières-Holland, Amsterdam, The Netherlands; Department of Social Medicine, University of Bristol, Bristol, United Kingdom; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom
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Koert Ritmeijer
Koert Ritmeijer
Médecins sans Frontières-Holland, Amsterdam, The Netherlands; Department of Social Medicine, University of Bristol, Bristol, United Kingdom; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom
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Robert N. Davidson
Robert N. Davidson
Médecins sans Frontières-Holland, Amsterdam, The Netherlands; Department of Social Medicine, University of Bristol, Bristol, United Kingdom; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom
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Médecins sans Frontières-Holland has treated > 67,000 patients with kala-azar (KA) in southern Sudan since 1989. In 2002, we replaced the standard regimen of 30 days of daily sodium stibogluconate (SSG) with a 17-day regimen of daily SSG combined with paromomycin (PM). We analyzed data for 4,263 primary KA patients treated between 2002 and 2005 in southern Sudan to determine the relative efficacy of the combination therapy regimen (PM/SSG). The initial cure rate among patients treated with PM/SSG was 97.0% compared with 92.4% among patients treated with SSG monotherapy. Relative efficacy of PM/SSG compared with SSG increased over the study period: odds of death in the PM/SSG group were 44% lower (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.37–0.84) in 2002, 78% lower (OR = 0.22, 95% CI = 0.10–0.50) in 2003, and 86% lower (OR = 0.14, 95% CI = 0.07–0.27) in 2004–2005. In remote field settings, 17 days of SSG combined with PM gives better survival and initial cure rates than 30 days of SSG monotherapy.
Author Notes
ProCite
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Reference Manager
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-
1
Zijlstra EE, el-Hassan AM, 2001. Leishmaniasis in Sudan. Visceral leishmaniasis. Trans R Soc Trop Med Hyg 95 (Suppl 1):S27–S58.
-
2
Seaman J, Mercer AJ, Sondorp E, 1996. The epidemic of visceral leishmaniasis in western Upper Nile, southern Sudan: course and impact from 1984 to 1994. Int J Epidemiol 25 :862–871.
-
3
Guerin PJ, Olliaro P, Sundar S, Boelaert M, Croft SL, Desjeux P, Wasunna MK, Bryceson AD, 2002. Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda. Lancet Infect Dis 2 :494–501.
-
4
Ritmeijer K, Davidson RN, 2003. Royal Society of Tropical Medicine and Hygiene joint meeting with Medecins sans Frontieres at Manson House, London, 20 March 2003: field research in humanitarian medical programmes. Medecins sans Frontieres interventions against kala-azar in the Sudan, 1989– 2003. Trans R Soc Trop Med Hyg 97 :609–613.
-
5
Seaman J, Pryce D, Sondorp HE, Moody A, Bryceson AD, Davidson RN, 1993. Epidemic visceral leishmaniasis in Sudan: a randomized trial of aminosidine plus sodium stibogluconate versus sodium stibogluconate alone. J Infect Dis 168 :715–720.
-
6
Chunge CN, Owate J, Pamba HO, Donno L, 1990. Treatment of visceral leishmaniasis in Kenya by aminosidine alone or combined with sodium stibogluconate. Trans R Soc Trop Med Hyg 84 :221–225.
-
7
Scott JA, Davidson RN, Moody AH, Grant HR, Felmingham D, Scott GM, Olliaro P, Bryceson AD, 1992. Aminosidine (paromomycin) in the treatment of leishmaniasis imported into the United Kingdom. Trans R Soc Trop Med Hyg 86 :617–619.
-
8
Thakur CP, Olliaro P, Gothoskar S, Bhowmick S, Choudhury BK, Prasad S, Kumar M, Verma BB, 1992. Treatment of visceral leishmaniasis (kala-azar) with aminosidine (= paromomycin)-antimonial combinations, a pilot study in Bihar, India. Trans R Soc Trop Med Hyg 86 :615–616.
-
9
Thakur CP, Bhowmick S, Dolfi L, Olliaro P, 1995. Aminosidine plus sodium stibogluconate for the treatment of Indian kala-azar: a randomized dose-finding clinical trial. Trans R Soc Trop Med Hyg 89 :219–223.
-
10
Thakur CP, Kanyok TP, Pandey AK, Sinha GP, Zaniewski AE, Houlihan HH, Olliaro P, 2000. A prospective randomized, comparative, open-label trial of the safety and efficacy of paromomycin (aminosidine) plus sodium stibogluconate versus sodium stibogluconate alone for the treatment of visceral leishmaniasis. Trans R Soc Trop Med Hyg 94 :429–431.
-
11
Seaman J, Mercer AJ, Sondorp HE, Herwaldt BL, 1996. Epidemic visceral leishmaniasis in southern Sudan: treatment of severely debilitated patients under wartime conditions and with limited resources. Ann Intern Med 124 :664–672.
-
12
World Health Organization, 1996. Manual on Visceral Leishmaniasis Control. Geneva: World Health Organization.
-
13
Collin S, Davidson R, Ritmeijer K, Keus K, Melaku Y, Kipngetich S, Davies C, 2004. Conflict and kala-azar: determinants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis 38 :612–619.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1094 | 982 | 383 |
| Full Text Views | 144 | 21 | 0 |
| PDF Downloads | 57 | 8 | 0 |