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Prediction score for antimony treatment failure in patients with ulcerative leishmaniasis lesions

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dc.contributor.author Valencia, C.
dc.contributor.author Arévalo Zelada, Jorge Luis
dc.contributor.author Dujardin, J.C.
dc.contributor.author Llanos Cuentas, Elmer Alejandro
dc.contributor.author Chappuis, F.
dc.contributor.author Zimic-Peralta, Mirko Juan
dc.date.accessioned 2022-01-18T19:34:38Z
dc.date.available 2022-01-18T19:34:38Z
dc.date.issued 2012
dc.identifier.uri https://hdl.handle.net/20.500.12866/11077
dc.description.abstract Background: Increased rates for failure in leishmaniasis antimony treatment have been recently recognized worldwide. Although several risk factors have been identified there is no clinical score to predict antimony therapy failure of cutaneous leishmaniasis. Methods: A case control study was conducted in Peru from 2001 to 2004. 171 patients were treated with pentavalent antimony and followed up to at least 6 months to determine cure or failure. Only patients with ulcerative cutaneous leishmaniasis (N = 87) were considered for data analysis. Epidemiological, demographical, clinical and laboratory data were analyzed to identify risk factors for treatment failure. Two prognostic scores for antimonial treatment failure were tested for sensitivity and specificity to predict antimony therapy failure by comparison with treatment outcome. Results: Among 87 antimony-treated patients, 18 (21%) failed the treatment and 69 (79%) were cured. A novel risk factor for treatment failure was identified: presence of concomitant distant lesions. Patients presenting concomitant-distant lesions showed a 30.5-fold increase in the risk of treatment failure compared to other patients. The best prognostic score for antimonial treatment failure showed a sensitivity of 77.78% and specificity of 95.52% to predict antimony therapy failure. Conclusions: A prognostic score including a novel risk factor was able to predict antimonial treatment failure in cutaneous leishmaniasis with high specificity and sensitivity. This prognostic score presents practical advantages as it relies on clinical and epidemiological characteristics, easily obtained by physicians or health workers, and makes it a promising clinical tool that needs to be validated before their use for developing countries. 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 Humans en_US
dc.subject Peru en_US
dc.subject risk factor en_US
dc.subject major clinical study en_US
dc.subject pathology en_US
dc.subject disease severity en_US
dc.subject prognosis en_US
dc.subject methodology en_US
dc.subject evaluation en_US
dc.subject follow up en_US
dc.subject Leishmania braziliensis en_US
dc.subject Leishmaniasis, Cutaneous en_US
dc.subject skin leishmaniasis en_US
dc.subject Sensitivity and Specificity en_US
dc.subject treatment outcome en_US
dc.subject disease duration en_US
dc.subject Skin Ulcer en_US
dc.subject stibogluconate sodium en_US
dc.subject drug treatment failure en_US
dc.subject amphotericin B en_US
dc.subject Antiprotozoal Agents en_US
dc.subject receiver operating characteristic en_US
dc.subject Treatment Failure en_US
dc.subject Drug Monitoring en_US
dc.subject antiprotozoal agent en_US
dc.subject treatment failure en_US
dc.subject Antimony en_US
dc.subject concurrent infection en_US
dc.subject imiquimod en_US
dc.title Prediction score for antimony treatment failure in patients with ulcerative leishmaniasis lesions en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pntd.0001656
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1935-2735


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