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


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