Author | Castro, Maria Del Mar | |
Author | Rode, Joelle | |
Author | Machado, Paulo R. L. | |
Author | Llanos-Cuentas, Alejandro | |
Author | Hueb, Marcia | |
Author | Cota, Gláucia Fernandes | |
Author | Rojas, Isis Valentina | |
Author | Orobio, Yenifer | |
Author | Sarmiento, Oscar Oviedo | |
Author | Rojas, Ernesto | |
Author | Quintero, Juliana | |
Author | Pimentel, Maria Inês Fernandes | |
Author | Soto, Jaime | |
Author | Suprien, Carvel | |
Author | Alvarez, Fiorela | |
Author | Ramos, Ana Pilar | |
Author | Arantes, Rayssa Basílio dos Santos | |
Author | Silva, Rosiana Estéfane da | |
Author | Arenas, Claudia Marcela | |
Author | Vélez, Ivan Darío | |
Author | Lyra, Marcelo Rosandiski | |
Author | Saravia, Nancy Gore | |
Author | Arana, Byron | |
Author | Alexander, Neal | |
Access date | 2023-02-13T17:39:04Z | |
Available date | 2023-02-13T17:39:04Z | |
Document date | 2023 | |
Citation | CASTRO, Maria Del Mar et al. Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study. PLOS Neglected Tropical Diseases, v. 17, n. 1, p. 1-21, Jan 2023. | en_US |
ISSN | 1935-2735 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/57045 | |
Language | eng | en_US |
Publisher | Public Library of Science | en_US |
Rights | open access | en_US |
Title | Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study | en_US |
Type | Article | en_US |
DOI | 10.1371/journal.pntd.0011029 | |
Abstract | Background: Treatment guidance for children and older adult patients affected by cutaneous leishmaniasis (CL) is unclear due to limited representation of these groups in clinical trials. Methods: We conducted a collaborative retrospective study to describe the effectiveness and safety of antileishmanial treatments in children ≤ 10 and adults ≥ 60 years of age, treated between 2014 and 2018 in ten CL referral centers in Latin America.
Results: 2,037 clinical records were assessed for eligibility. Of them, the main reason for non-inclusion was lack of data on treatment follow-up and therapeutic response (182/242, 75% of children and 179/468, 38% of adults). Data on 1,325 eligible CL patients (736 children and 589 older adults) were analyzed. In both age groups, disease presentation was mild, with a median number of lesions of one (IQR: 1-2) and median lesion diameter of less than 3 cm. Less than 50% of the patients had data for two or more follow-up visits post-treatment (being only 28% in pediatric patients). Systemic antimonials were the most common monotherapy regimen in both age groups (590/736, 80.2% of children and 308/589, 52.3% of older adults) with overall cure rates of 54.6% (95% CI: 50.5-58.6%) and 68.2% (95% CI: 62.6-73.4%), respectively. Other treatments used include miltefosine, amphotericin B, intralesional antimonials, and pentamidine. Adverse reactions related to the main treatment were experienced in 11.9% (86/722) of children versus 38.4% (206/537) of older adults. Most adverse reactions were of mild intensity. Conclusion: Our findings support the need for greater availability and use of alternatives to systemic antimonials, particularly local therapies, and development of strategies to improve patient follow-up across the region, with special attention to pediatric populations. | en_US |
Affilliation | Centro Internacional de Entrenamiento e Investigaciones Médicas. Cali, Colombia / Universidad Icesi. Cali, Colombia. | en_US |
Affilliation | Drugs for Neglected Diseases initiative. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Universidade Federal da Bahia. Hospital Universitário Prof. Edgar Santos. Servico de Imunologia. Salvador, BA, Brazil. | en_US |
Affilliation | Unidad de Leishmaniasis y Malaria. Instituto de Medicina Tropical Alexander von Humboldt. Universidad Peruana Cayetano Heredia. Lima, Perú / Hospital Cayetano Heredia. Lima, Perú. | en_US |
Affilliation | Universidade Federal de Mato Grosso. Hospital Universitário Júlio Müller. Cuiabá, MT, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brazil. | en_US |
Affilliation | Centro Dermatológico Federico Lleras Acosta. Bogotá, Colombia. | en_US |
Affilliation | Centro Internacional de Entrenamiento e Investigaciones Médicas. Cali, Colombia / Universidad Icesi. Cali, Colombia. | en_US |
Affilliation | Centro Internacional de Entrenamiento e Investigaciones Médicas. Cali, Colombia / Universidad Icesi. Cali, Colombia. | en_US |
Affilliation | Centro Universitario de Medicina Tropical. Universidad Mayor de San Simón. Cochabamba, Bolivia. | en_US |
Affilliation | Programa de Estudio y Control de Enfermedades Tropicales. Facultad de Medicina. Universidad de Antioquia. Medellín, Colombia. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundación Nacional de Dermatología. Santa Cruz de la Sierra, Bolivia. | en_US |
Affilliation | Universidade Federal da Bahia. Hospital Universitário Prof. Edgar Santos. Servico de Imunologia. Salvador, BA, Brazil. | en_US |
Affilliation | Unidad de Leishmaniasis y Malaria. Instituto de Medicina Tropical Alexander von Humboldt. Universidad Peruana Cayetano Heredia. Lima, Perú / Hospital Cayetano Heredia. Lima, Perú. | en_US |
Affilliation | Unidad de Leishmaniasis y Malaria. Instituto de Medicina Tropical Alexander von Humboldt. Universidad Peruana Cayetano Heredia. Lima, Perú / Hospital Cayetano Heredia. Lima, Perú. | en_US |
Affilliation | Universidade Federal de Mato Grosso. Hospital Universitário Júlio Müller. Cuiabá, MT, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brazil. | en_US |
Affilliation | Centro Dermatológico Federico Lleras Acosta. Bogotá, Colombia. | en_US |
Affilliation | Programa de Estudio y Control de Enfermedades Tropicales. Facultad de Medicina. Universidad de Antioquia. Medellín, Colombia. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Centro Internacional de Entrenamiento e Investigaciones Médicas. Cali, Colombia / Universidad Icesi. Cali, Colombia. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Centro Internacional de Entrenamiento e Investigaciones Médicas. Cali, Colombia / Universidad Icesi. Cali, Colombia. | en_US |
Subject | Cutaneous Leishmaniasis Treatment | |
Subject | Cutaneous Leishmaniasis | |
Subject | Patients | |
Subject | Clinical records | |