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Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia

The standard of care for cutaneous leishmaniasis includes the intramuscular/intravenous administration of pentavalent antimonials that are toxic and poorly tolerated. Primary health care usually lacks trained health staff for the diagnosis and treatment of leishmaniasis in Cochabamba Bolivia. Taking...

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Autores principales: Rojas Cabrera, Ernesto, Verduguez-Orellana, Aleida, Tordoya-Titichoca, Igberto J., Sejas, Ccoya, Ledezma, Rebeca, Álvarez, Ingrid, Limachi-Choque, Jhonny, Ortuño-Gutiérrez, Nimer, Córdova Rojas, Marisol, Guzman-Rivero, Miguel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9607986/
https://www.ncbi.nlm.nih.gov/pubmed/36288028
http://dx.doi.org/10.3390/tropicalmed7100286
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author Rojas Cabrera, Ernesto
Verduguez-Orellana, Aleida
Tordoya-Titichoca, Igberto J.
Sejas, Ccoya
Ledezma, Rebeca
Álvarez, Ingrid
Limachi-Choque, Jhonny
Ortuño-Gutiérrez, Nimer
Córdova Rojas, Marisol
Guzman-Rivero, Miguel
author_facet Rojas Cabrera, Ernesto
Verduguez-Orellana, Aleida
Tordoya-Titichoca, Igberto J.
Sejas, Ccoya
Ledezma, Rebeca
Álvarez, Ingrid
Limachi-Choque, Jhonny
Ortuño-Gutiérrez, Nimer
Córdova Rojas, Marisol
Guzman-Rivero, Miguel
author_sort Rojas Cabrera, Ernesto
collection PubMed
description The standard of care for cutaneous leishmaniasis includes the intramuscular/intravenous administration of pentavalent antimonials that are toxic and poorly tolerated. Primary health care usually lacks trained health staff for the diagnosis and treatment of leishmaniasis in Cochabamba Bolivia. Taking these aspects into account, a Bolivian consortium set out to explore the intralesional administration of meglumine antimoniate to treat cutaneous leishmaniasis during primary care under programmatic conditions. A four-step strategy consisting of clinical training for intralesional treatment and the promotion and periodic follow-up of health staff was carried out. The training process was applied in situ to personnel of nine primary health care centres. The intralesional treatment was applied five times every other day. Clinical follow-up after six-months of treatment showed a 77% healing proportion and 5% of therapeutic failure among 152 enrolled patients. The drug volume used in the intralesional procedure was on average 1.7 mL/ulcer treated. In conclusion, the strategy used was successful and effective, accomplishing a healing proportion similar to the long standardized treatment with a reduced time of administration, no severe side effects, and it is feasible to conduct by trained health staff. Our study supports the current PAHO/WHO recommendation for the intralesional administration of pentavalent antimonials for the treatment of cutaneous leishmaniasis.
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spelling pubmed-96079862022-10-28 Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia Rojas Cabrera, Ernesto Verduguez-Orellana, Aleida Tordoya-Titichoca, Igberto J. Sejas, Ccoya Ledezma, Rebeca Álvarez, Ingrid Limachi-Choque, Jhonny Ortuño-Gutiérrez, Nimer Córdova Rojas, Marisol Guzman-Rivero, Miguel Trop Med Infect Dis Article The standard of care for cutaneous leishmaniasis includes the intramuscular/intravenous administration of pentavalent antimonials that are toxic and poorly tolerated. Primary health care usually lacks trained health staff for the diagnosis and treatment of leishmaniasis in Cochabamba Bolivia. Taking these aspects into account, a Bolivian consortium set out to explore the intralesional administration of meglumine antimoniate to treat cutaneous leishmaniasis during primary care under programmatic conditions. A four-step strategy consisting of clinical training for intralesional treatment and the promotion and periodic follow-up of health staff was carried out. The training process was applied in situ to personnel of nine primary health care centres. The intralesional treatment was applied five times every other day. Clinical follow-up after six-months of treatment showed a 77% healing proportion and 5% of therapeutic failure among 152 enrolled patients. The drug volume used in the intralesional procedure was on average 1.7 mL/ulcer treated. In conclusion, the strategy used was successful and effective, accomplishing a healing proportion similar to the long standardized treatment with a reduced time of administration, no severe side effects, and it is feasible to conduct by trained health staff. Our study supports the current PAHO/WHO recommendation for the intralesional administration of pentavalent antimonials for the treatment of cutaneous leishmaniasis. MDPI 2022-10-07 /pmc/articles/PMC9607986/ /pubmed/36288028 http://dx.doi.org/10.3390/tropicalmed7100286 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rojas Cabrera, Ernesto
Verduguez-Orellana, Aleida
Tordoya-Titichoca, Igberto J.
Sejas, Ccoya
Ledezma, Rebeca
Álvarez, Ingrid
Limachi-Choque, Jhonny
Ortuño-Gutiérrez, Nimer
Córdova Rojas, Marisol
Guzman-Rivero, Miguel
Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia
title Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia
title_full Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia
title_fullStr Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia
title_full_unstemmed Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia
title_short Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia
title_sort intralesional meglumine antimoniate: safe, feasible and effective therapy for cutaneous leishmaniasis in bolivia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9607986/
https://www.ncbi.nlm.nih.gov/pubmed/36288028
http://dx.doi.org/10.3390/tropicalmed7100286
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