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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9607986 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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