Síntesis de evidencia y recomendaciones: directrices para el tratamiento de las leishmaniasis en la Región de las Américas

INTRODUCTION. Leishmaniasis continues to be a neglected infectious disease of great importance, mainly affecting the poorest people with the least access to health services. In the Americas, it is a public health problem due to its magnitude, wide geographical distribution, and levels of morbidity and mortality. OBJECTIVE. Summarize the recommendations included in Guideline for the Treatment of Leishmaniasis in the Region of the Americas, published by the Pan American Health Organization/World Health Organization, in order to provide adequate management of patients diagnosed with leishmaniasis, reduce clinical complications and deaths caused by drug toxicity, reduce the lethality of visceral leishmaniasis, and address key aspects of implementation of the guidelines. METHODS. The guideline and its recommendations were summarized and a systematic search was carried out in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature for other studies conducted in the Region of the Americas, in order to identify barriers, facilitators, and implementation strategies. RESULTS. Recommendations are presented, addressing the pharmacological treatment of patients diagnosed with cutaneous, mucosal, and visceral leishmaniasis in the Americas, as well as case management and secondary prophylaxis in patients coinfected with visceral leishmaniasis and HIV, and patients with other diseases that cause immunosuppression. CONCLUSIONS. The recommendations aim to provide the government entities and health professionals that care for leishmaniasis patients in the Americas with knowledge on management of the disease. Barriers are discussed (related to human resources, knowledge of guidelines, inputs, costs, access, and patient access), as well as facilitators and strategies to support implementation.