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.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.03.06 |
|
dc.relation.issn |
1935-2735 |
|