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Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina
Background. To date, there is no specific literature available on the determinants for therapeutic failure (TF) with meglumine antimoniate (MA) in Northwestern-Argentina. This study aimed to identify epidemiological, clinical, and treatment-related factors that could be involved in TF. Methodology/P...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864468/ https://www.ncbi.nlm.nih.gov/pubmed/33497376 http://dx.doi.org/10.1371/journal.pntd.0009003 |
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author | García-Bustos, María F. González-Prieto, Gabriela Paniz-Mondolfi, Alberto E. Parodi, Cecilia Beckar, Josefina Monroig, Sibila Ramos, Federico Mora, María C. Delgado-Noguera, Lourdes A. Hashiguchi, Yoshihisa Jaime, Daniela Moreno, Sonia Ruiz-Morales, Luisa Lemir, César G. Barrio, Alejandra |
author_facet | García-Bustos, María F. González-Prieto, Gabriela Paniz-Mondolfi, Alberto E. Parodi, Cecilia Beckar, Josefina Monroig, Sibila Ramos, Federico Mora, María C. Delgado-Noguera, Lourdes A. Hashiguchi, Yoshihisa Jaime, Daniela Moreno, Sonia Ruiz-Morales, Luisa Lemir, César G. Barrio, Alejandra |
author_sort | García-Bustos, María F. |
collection | PubMed |
description | Background. To date, there is no specific literature available on the determinants for therapeutic failure (TF) with meglumine antimoniate (MA) in Northwestern-Argentina. This study aimed to identify epidemiological, clinical, and treatment-related factors that could be involved in TF. Methodology/Principal Findings. We performed a case-control study. Cases were represented by patients who showed TF after administration of the first course of MA treatment, whereas, controls were determined as patients who evolved towards healing after the first MA cycle received. Crude Odds Ratios and their corresponding 90% confidence intervals (CI) were calculated, and risk factors were then tested by multivariate analysis using logistic binary regression. Three hundred and eighty-four patients with a presumptive diagnosis of ACL were recruited, and 153 with a positive diagnosis were selected. We included in the study 71 patients, who underwent specific treatment with MA, presented complete data on response to treatment, and had a minimum post-treatment follow-up of 6 months in cutaneous leishmaniasis, and 12 months in mucosal leishmaniasis. Of these, 34 (47.9%) presented TF. In the initial analysis, TF was significantly associated with the geographical area of disease acquisition (p = 0.036), the presence of mucosal lesions (p = 0.042), the presence of concomitant skin and mucosal lesions (p = 0.002), and lesion age ≥ 6 months (p = 0.018). Risk factors influencing TF in the final multivariate model included the geographical area where the disease was acquired (adjusted Odd Ratio 8.062; 95% CI 1.914–33.959; p = 0.004), and lesion age ≥ 6 months (adjusted Odd Ratio 10.037; 95% CI 1.383–72.843; p = 0.023). Conclusions/Significance. The results of the present study suggest the existence of some risk factors linked to TF in Northwestern-Argentina, which deserve further investigation. Herein we recorded a high percentage of TF and we described clinical and epidemiological characteristics associated with TF that could be taken into account improving the clinical management of patients. |
format | Online Article Text |
id | pubmed-7864468 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-78644682021-02-12 Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina García-Bustos, María F. González-Prieto, Gabriela Paniz-Mondolfi, Alberto E. Parodi, Cecilia Beckar, Josefina Monroig, Sibila Ramos, Federico Mora, María C. Delgado-Noguera, Lourdes A. Hashiguchi, Yoshihisa Jaime, Daniela Moreno, Sonia Ruiz-Morales, Luisa Lemir, César G. Barrio, Alejandra PLoS Negl Trop Dis Research Article Background. To date, there is no specific literature available on the determinants for therapeutic failure (TF) with meglumine antimoniate (MA) in Northwestern-Argentina. This study aimed to identify epidemiological, clinical, and treatment-related factors that could be involved in TF. Methodology/Principal Findings. We performed a case-control study. Cases were represented by patients who showed TF after administration of the first course of MA treatment, whereas, controls were determined as patients who evolved towards healing after the first MA cycle received. Crude Odds Ratios and their corresponding 90% confidence intervals (CI) were calculated, and risk factors were then tested by multivariate analysis using logistic binary regression. Three hundred and eighty-four patients with a presumptive diagnosis of ACL were recruited, and 153 with a positive diagnosis were selected. We included in the study 71 patients, who underwent specific treatment with MA, presented complete data on response to treatment, and had a minimum post-treatment follow-up of 6 months in cutaneous leishmaniasis, and 12 months in mucosal leishmaniasis. Of these, 34 (47.9%) presented TF. In the initial analysis, TF was significantly associated with the geographical area of disease acquisition (p = 0.036), the presence of mucosal lesions (p = 0.042), the presence of concomitant skin and mucosal lesions (p = 0.002), and lesion age ≥ 6 months (p = 0.018). Risk factors influencing TF in the final multivariate model included the geographical area where the disease was acquired (adjusted Odd Ratio 8.062; 95% CI 1.914–33.959; p = 0.004), and lesion age ≥ 6 months (adjusted Odd Ratio 10.037; 95% CI 1.383–72.843; p = 0.023). Conclusions/Significance. The results of the present study suggest the existence of some risk factors linked to TF in Northwestern-Argentina, which deserve further investigation. Herein we recorded a high percentage of TF and we described clinical and epidemiological characteristics associated with TF that could be taken into account improving the clinical management of patients. Public Library of Science 2021-01-26 /pmc/articles/PMC7864468/ /pubmed/33497376 http://dx.doi.org/10.1371/journal.pntd.0009003 Text en © 2021 García-Bustos et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article García-Bustos, María F. González-Prieto, Gabriela Paniz-Mondolfi, Alberto E. Parodi, Cecilia Beckar, Josefina Monroig, Sibila Ramos, Federico Mora, María C. Delgado-Noguera, Lourdes A. Hashiguchi, Yoshihisa Jaime, Daniela Moreno, Sonia Ruiz-Morales, Luisa Lemir, César G. Barrio, Alejandra Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina |
title | Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina |
title_full | Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina |
title_fullStr | Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina |
title_full_unstemmed | Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina |
title_short | Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina |
title_sort | risk factors for antimony treatment failure in american cutaneous leishmaniasis in northwestern-argentina |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864468/ https://www.ncbi.nlm.nih.gov/pubmed/33497376 http://dx.doi.org/10.1371/journal.pntd.0009003 |
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