Universidad Peruana Cayetano Heredia
Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study.
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| dc.contributor.author | Castro, Maria Del Mar | |
| dc.contributor.author | Rode, Joelle | |
| dc.contributor.author | Machado, Paulo R L | |
| dc.contributor.author | Llanos Cuentas, Elmer Alejandro | |
| dc.contributor.author | Hueb, Marcia | |
| dc.contributor.author | Cota, Glaucia | |
| dc.contributor.author | Rojas, Isis Valentina | |
| dc.contributor.author | Orobio, Yenifer | |
| dc.contributor.author | Oviedo Sarmiento, Oscar | |
| dc.contributor.author | Rojas, Ernesto | |
| dc.contributor.author | Quintero, Juliana | |
| dc.contributor.author | Pimentel, Maria Ines Fernandes | |
| dc.contributor.author | Soto, Jaime | |
| dc.contributor.author | Suprien, Carvel | |
| dc.contributor.author | Alvarez Romero, Fiorela Yuli | |
| dc.contributor.author | Ramos Ttito, Ana Pilar | |
| dc.contributor.author | Arantes, Rayssa Basilio Dos Santos | |
| dc.contributor.author | da Silva, Rosiana Estefane | |
| dc.contributor.author | Arenas, Claudia Marcela | |
| dc.contributor.author | Vélez, Ivan Dario | |
| dc.contributor.author | Lyra, Marcelo Rosandiski | |
| dc.contributor.author | Saravia, Nancy Gore | |
| dc.contributor.author | Arana, Byron | |
| dc.contributor.author | Alexander, Neal | |
| dc.coverage.spatial | Centro Universitario de Medicina Tropical, Universidad Mayor de San Simón | |
| dc.coverage.spatial | Fundación Nacional de Dermatología, Santa Cruz de la Sierra, Bolivia | |
| dc.coverage.spatial | Centro de Pesquisas René Rachou | |
| dc.coverage.spatial | Hospital Universitário Júlio Müller | |
| dc.coverage.spatial | Instituto Nacional de Infectologia Evandro Chagas | |
| dc.coverage.spatial | Centro Dermatológico Federico Lleras Acosta | |
| dc.coverage.spatial | Centro Internacional de Entrenamiento e Investigaciones Médicas | |
| dc.coverage.spatial | Programa de Estudio y Control de Enfermedades Tropicales | |
| dc.coverage.spatial | Universidad Peruana Cayetano Heredia | |
| dc.date.accessioned | 2023-02-20T13:28:08Z | |
| dc.date.available | 2023-02-20T13:28:08Z | |
| dc.date.issued | 2023 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.12866/13116 | |
| dc.description.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 |
| dc.language.iso | eng | |
| dc.publisher | Public Library of Science | |
| dc.relation.ispartofseries | PLoS Neglected Tropical Diseases | |
| dc.rights | info:eu-repo/semantics/restrictedAccess | |
| dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es | |
| dc.subject | Adverse reactions | en_US |
| dc.subject | Pediatrics | en_US |
| dc.subject | Lesions | en_US |
| dc.subject | Elderly | en_US |
| dc.subject | Amphotericin | en_US |
| dc.subject | Drug therapy | en_US |
| dc.subject | Brazil | en_US |
| dc.subject | Children | en_US |
| dc.subject.mesh | Drug-Related Side Effects and Adverse Reactions | |
| dc.subject.mesh | Pediatrics | |
| dc.subject.mesh | Aged | |
| dc.subject.mesh | Amphotericin B | |
| dc.subject.mesh | Drug Therapy | |
| dc.subject.mesh | Brazil | |
| dc.subject.mesh | Child | |
| dc.title | Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study. | en_US |
| dc.type | info:eu-repo/semantics/article | |
| dc.identifier.doi | https://doi.org/10.1371/journal.pntd.0011029 | |
| dc.relation.issn | 1935-2735 |
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