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Jajarmi H, Tavakoli Sani SB, Pourtaheri A, Gholian-Aval M, Esmaily H, Hosseini SH, Rajabzadeh R, Tehrani H. A community based intervention to modify preventive behaviors of cutaneous leishmaniasis in children: a randomized controlled trial based on PRECEDE PROCEED model. BMC Public Health 2024; 24:1304. [PMID: 38741099 DOI: 10.1186/s12889-024-18810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 05/09/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES Iran ranks among the top six countries globally with a significant incidence of Cutaneous Leishmaniasis (CL). Using planning models is one community-based intervention to promote preventive behaviors. The purpose of our study was to evaluate the effectiveness of the PRECEDE-PROCEED model (PPM) in modifying preventive behaviors related to CL in children through mother training in a community intervention. METHODS A randomized controlled trial based on the PPM model was conducted on 168 mothers (intervention (n = 84) and control group (n = 84) with 10 years old children in the rural areas of Iran. Mothers from 7 village areas were randomly allocated to the intervention (2 village) and control groups (5 village). The intervention group received a program comprising eight 90-minute training sessions and environmental interventions. In this study, we utilized the PPM as a framework to design the questionnaires on Leishmaniosis prevention behavior. Participants in both groups completed the questionnaires at baseline (before the intervention), immediately after the intervention, and at the 2-month follow-up. Analysis of the data was conducted utilizing SPSS20, with statistical significance set at p < 0.05. RESULTS Compared to the control group, the intervention group showed significant increases in knowledge, enabling factors, reinforcing factors, attitude, and preventive behaviors related to Cutaneous Leishmaniasis over time from baseline to follow-up (P < 0.001). No significant differences (P > 0.05) were observed in the alterations of the PPM construct, knowledge, and preventive behaviors within the control group from pre-intervention to follow-up. CONCLUSIONS Community (education and environmental) intervention based on PPM is feasible and acceptable to modify preventive behaviors of Cutaneous Leishmaniasis in children by increasing a mother's knowledge and attitude as well as changing enabling and reinforcing factors. TRIAL REGISTRATION IRCT20160619028529N8.
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Affiliation(s)
- Hossein Jajarmi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Belin Tavakoli Sani
- Department of Health, Safety, and environment, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asma Pourtaheri
- Instructor of Health Education, School of Public Health, Bam University of Medical Sciences, Bam, Iran
| | - Mahdi Gholian-Aval
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Hamid Hosseini
- Health Education and Promotion, Vector-borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Rezvan Rajabzadeh
- Epidemiology, Vector-borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hadi Tehrani
- Department of Health, Safety, and environment, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health research center, Mashhad University of Medical Sciences, Mashhad, Iran.
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De los Santos MB, Loyola S, Perez-Velez ES, Santos RDP, Ramírez IM, Valdivia HO. Sampling is decisive to determination of Leishmania (Viannia) species. PLoS Negl Trop Dis 2024; 18:e0012113. [PMID: 38662642 PMCID: PMC11045131 DOI: 10.1371/journal.pntd.0012113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Accuracy of molecular tools for the identification of parasites that cause human cutaneous leishmaniasis (CL) could largely depend on the sampling method. Non-invasive or less-invasive sampling methods such as filter paper imprints and cotton swabs are preferred over punch biopsies and lancet scrapings for detection methods of Leishmania based on polymerase chain reaction (PCR) because they are painless, simple, and inexpensive, and of benefit to military and civilian patients to ensure timely treatment. However, different types of samples can generate false negatives and there is a clear need to demonstrate which sample is more proper for molecular assays. METHODOLOGY Here, we compared the sensitivity of molecular identification of different Leishmania (Viannia) species from Peru, using three types of sampling: punch biopsy, filter paper imprint and lancet scraping. Different composite reference standards and latent class models allowed to evaluate the accuracy of the molecular tools. Additionally, a quantitative PCR assessed variations in the results and parasite load in each type of sample. PRINCIPAL FINDINGS Different composite reference standards and latent class models determined higher sensitivity when lancet scrapings were used for sampling in the identification and determination of Leishmania (Viannia) species through PCR-based assays. This was consistent for genus identification through kinetoplastid DNA-PCR and for the determination of species using FRET probes-based Nested Real-Time PCR. Lack of species identification in some samples correlated with the low intensity of the PCR electrophoretic band, which reflects the low parasite load in samples. CONCLUSIONS The type of clinical sample can directly influence the detection and identification of Leishmania (Viannia) species. Here, we demonstrated that lancet scraping samples consistently allowed the identification of more leishmaniasis cases compared to filter paper imprints or biopsies. This procedure is inexpensive, painless, and easy to implement at the point of care and avoids the need for anesthesia, surgery, and hospitalization and therefore could be used in resource limited settings for both military and civilian populations.
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Affiliation(s)
- Maxy B. De los Santos
- Department of Parasitology, U.S. Naval Medical Research Unit SOUTH (NAMRU SOUTH), Bellavista, Lima, Peru
| | - Steev Loyola
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Erika S. Perez-Velez
- Departamento Académico de Medicina Humana, Universidad Andina del Cusco, Cusco, Peru
| | | | - Ivonne Melissa Ramírez
- Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, Cercado de Lima, Lima, Peru
| | - Hugo O. Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit SOUTH (NAMRU SOUTH), Bellavista, Lima, Peru
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Abedin S, Adeleke OA. State of the art in pediatric nanomedicines. Drug Deliv Transl Res 2024:10.1007/s13346-024-01532-x. [PMID: 38324166 DOI: 10.1007/s13346-024-01532-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
In recent years, the continuous development of innovative nanopharmaceuticals is expanding their biomedical and clinical applications. Nanomedicines are being revolutionized to circumvent the limitations of unbound therapeutic agents as well as overcome barriers posed by biological interfaces at the cellular, organ, system, and microenvironment levels. In many ways, the use of nanoconfigured delivery systems has eased challenges associated with patient differences, and in our opinion, this forms the foundation for their potential usefulness in developing innovative medicines and diagnostics for special patient populations. Here, we present a comprehensive review of nanomedicines specifically designed and evaluated for disease management in the pediatric population. Typically, the pediatric population has distinguishing needs relative to those of adults majorly because of their constantly growing bodies and age-related physiological changes, which often need specialized drug formulation interventions to provide desirable therapeutic effects and outcomes. Besides, child-centric drug carriers have unique delivery routes, dosing flexibility, organoleptic properties (e.g., taste, flavor), and caregiver requirements that are often not met by traditional formulations and can impact adherence to therapy. Engineering pediatric medicines as nanoconfigured structures can potentially resolve these limitations stemming from traditional drug carriers because of their unique capabilities. Consequently, researchers from different specialties relentlessly and creatively investigate the usefulness of nanomedicines for pediatric disease management as extensively captured in this compilation. Some examples of nanomedicines covered include nanoparticles, liposomes, and nanomicelles for cancer; solid lipid and lipid-based nanostructured carriers for hypertension; self-nanoemulsifying lipid-based systems and niosomes for infections; and nanocapsules for asthma pharmacotherapy.
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Affiliation(s)
- Saba Abedin
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Oluwatoyin A Adeleke
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
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Silverberg SL, Kahane A, Kazmi K. A Nonhealing Ulcerating Lip Lesion. J Pediatr 2023; 262:113397. [PMID: 37004958 DOI: 10.1016/j.jpeds.2023.113397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 04/04/2023]
Affiliation(s)
- Sarah L Silverberg
- Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alyssa Kahane
- Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kescha Kazmi
- Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
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Heleine M, Elenga N, Njuieyon F, Martin E, Piat C, Pansart C, Couppie P, Hernandez M, Demar M, Blaizot R. Using pentamidine to treat cutaneous leishmaniasis in children: a 10-year study in French Guiana. Clin Exp Dermatol 2023; 48:913-915. [PMID: 37075241 DOI: 10.1093/ced/llad146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 04/21/2023]
Abstract
There are little data on pentamidine as a treatment for paediatric cutaneous leishmaniasis (CL). The objective of this study was to describe the effectiveness and safety of pentamidine over a 10-year period. Every child seen in French Guiana between 2010 and 2020 with proven CL and treated with pentamidine was included. In total, 55 children met the inclusion criteria - 23 girls and 32 boys. There were 38 patients (38/55, 69%) with a > 50% improvement at 1 month after pentamidine treatment and a complete cure at 3 months; 16 children had a < 50% improvement at 1 month and were given a second dose. Of these 16, 8 showed a complete cure at 3 months, 5 were lost to follow-up and 3 showed therapeutic failure at 3 months. The overall cure rate was 84% (46/55) after one or two doses. In terms of the safety of pentamidine, no severe adverse events (grade ≥ 3) were reported.
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Affiliation(s)
| | | | | | | | | | | | - Pierre Couppie
- Dermatology Department
- UMR TBIP 1019 Tropical Biomes and Immunophysiopathology, University of French Guiana, Cayenne, French Guiana
- National Reference Centre for Leishmania, Cayenne, French Guiana
| | - Miguel Hernandez
- National Reference Centre for Leishmania, Cayenne, French Guiana
| | - Magalie Demar
- UMR TBIP 1019 Tropical Biomes and Immunophysiopathology, University of French Guiana, Cayenne, French Guiana
- National Reference Centre for Leishmania, Cayenne, French Guiana
- Parasitology Laboratory, Cayenne Hospital Centre, Cayenne, French Guiana
| | - Romain Blaizot
- Dermatology Department
- UMR TBIP 1019 Tropical Biomes and Immunophysiopathology, University of French Guiana, Cayenne, French Guiana
- National Reference Centre for Leishmania, Cayenne, French Guiana
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Khan A, Madke B, Saoji V, Rusia K, Jaiswal S, Meghe S. Lupoid leishmaniasis successfully treated with oral fluconazole in a child. Med J Armed Forces India 2023. [DOI: 10.1016/j.mjafi.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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7
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Castro MDM, Rode J, Machado PRL, Llanos-Cuentas A, Hueb M, Cota G, Rojas IV, Orobio Y, Oviedo Sarmiento O, Rojas E, Quintero J, Pimentel MIF, Soto J, Suprien C, Alvarez F, Ramos AP, Arantes RBDS, da Silva RE, Arenas CM, Vélez ID, Lyra MR, Saravia NG, Arana B, Alexander N. Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study. PLoS Negl Trop Dis 2023; 17:e0011029. [PMID: 36689465 PMCID: PMC9894540 DOI: 10.1371/journal.pntd.0011029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 02/02/2023] [Accepted: 12/16/2022] [Indexed: 01/24/2023] Open
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.
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Affiliation(s)
- Maria del Mar Castro
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Joelle Rode
- Drugs for Neglected Diseases initiative (DNDi), Rio de Janeiro, Brazil
| | - Paulo R. L. Machado
- Servico de Imunologia, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Alejandro Llanos-Cuentas
- Unidad de Leishmaniasis y Malaria, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, and Hospital Cayetano Heredia, Lima, Perú
| | - Marcia Hueb
- Universidade Federal de Mato Grosso, Hospital Universitário Júlio Müller (HUJM), Cuiabá, Mato Grosso, Brazil
| | - Gláucia Cota
- Instituto René Rachou, Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Yenifer Orobio
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Oscar Oviedo Sarmiento
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Ernesto Rojas
- Centro Universitario de Medicina Tropical–Universidad Mayor de San Simón (CUMT), Cochabamba, Bolivia
| | - Juliana Quintero
- PECET—Programa de Estudio y Control de Enfermedades Tropicales, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Jaime Soto
- FUNDERMA (Fundación Nacional de Dermatología), Santa Cruz de la Sierra, Bolivia
| | - Carvel Suprien
- Servico de Imunologia, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Fiorela Alvarez
- Unidad de Leishmaniasis y Malaria, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, and Hospital Cayetano Heredia, Lima, Perú
| | - Ana Pilar Ramos
- Unidad de Leishmaniasis y Malaria, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, and Hospital Cayetano Heredia, Lima, Perú
| | | | | | | | - Ivan Darío Vélez
- PECET—Programa de Estudio y Control de Enfermedades Tropicales, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Marcelo Rosandiski Lyra
- Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Nancy Gore Saravia
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Byron Arana
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
| | - Neal Alexander
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
- * E-mail:
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Ness TE, Martin-Blais R, Weatherhead JE. How I Approach Leishmaniasis: Diagnosis and Treatment in the United States. J Pediatric Infect Dis Soc 2022; 11:525-532. [PMID: 36043874 PMCID: PMC9720369 DOI: 10.1093/jpids/piac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/09/2022] [Indexed: 12/15/2022]
Abstract
Leishmaniasis is a vector-borne disease caused by over 20 species of obligate intracellular protozoa belonging to the genus Leishmania. Leishmaniasis has a global distribution, including in the United States, and can cause a spectrum of clinical syndromes, including cutaneous, mucosal, and visceral diseases depending on host factors and the infecting Leishmania spp. Accurate diagnosis, including Leishmania species identification, is an important step to guide the most appropriate therapeutic intervention. Antileishmanial therapy is dependent on the Leishmania spp. identified, the clinical syndrome, and the child's immune system. However, many treatment regimens for children have been extrapolated from adult clinical trials, which may lead to underdosing and subsequent poor outcomes in infected children. Additional research is urgently needed to help guide therapy for children and determine appropriate antileishmanial agents, doses, and treatment courses for children with leishmaniasis.
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Affiliation(s)
- Tara E Ness
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Rachel Martin-Blais
- Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jill E Weatherhead
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Division of Pediatric Tropical Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
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Barba P, Morgado-Carrasco D, Quera A. [Translated article] Miltefosine to Treat Childhood Cutaneous Leishmaniasis. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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10
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Barba P, Morgado-Carrasco D, Quera A. Tratamiento de leishmaniasis cutánea infantil con miltefosina. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:827-831. [DOI: 10.1016/j.ad.2020.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/15/2020] [Accepted: 11/22/2020] [Indexed: 11/27/2022] Open
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Moya-Salazar J, Contreras-Pulache H, Pasco IA, Cañari B. Cutaneous Leishmaniasis Associated With the Level of Poverty of the Andean Rural Population: A Five-Year Single-Center Study. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2021. [DOI: 10.29333/ejgm/11335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Akuffo R, Sanchez C, Chicharro C, Carrillo E, Attram N, Mosore MT, Yeboah C, Kotey NK, Boakye D, Ruiz-Postigo JA, Moreno J, Wilson M, Sarfo B, Anto F. Detection of cutaneous leishmaniasis in three communities of Oti Region, Ghana. PLoS Negl Trop Dis 2021; 15:e0009416. [PMID: 34029326 PMCID: PMC8177633 DOI: 10.1371/journal.pntd.0009416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/04/2021] [Accepted: 04/27/2021] [Indexed: 11/19/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL) is the most common type of leishmaniasis, a neglected tropical disease caused by parasites of the genus Leishmania. In Ghana, some studies in the Volta region have detected Leishmania parasites among persons with skin ulcers. Methodology/Principal findings Using a cross-sectional study design, the prevalence of CL in three communities of the Oti Region of Ghana was investigated. Demographic and epidemiological data were obtained by a structured interviewer administered questionnaire. A total of 426 (12.4%) out of 3,440 participants screened had at least one skin ulcer. Of 595 skin ulcers sampled and tested by PCR for Leishmania infection, 150 (25.2%) ulcers from 136 individuals tested positive, accounting for an overall CL prevalence of 31.9% among persons with skin ulcers. Individual community CL prevalence of 23.2%, 29.8%, and 36.8% was observed in Ashiabre, Keri, and Sibi Hilltop respectively among persons with skin ulcers. Conclusions/Significance Confirmation of CL in the study area suggests an active cycle of transmission of Leishmania infection. The observation of skin ulcers which tested negative to Leishmania infection suggests a need to test for additional causes of skin ulcers such as Treponema pallidum pertenue and Mycobacterium ulcerans in the study area. Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by parasites of the genus Leishmania and is transmitted by various species of female sandflies. CL usually begins as painless nodules and is usually characterized by skin ulcers which may be single or multiple. Although ulcers due to CL are often self-healing, they may become painful and result in scarring after healing. Typically, CL occurs on exposed parts of the body such as the neck, limbs, and face, which may be easily accessible to sandflies. Although cases of CL had previously been reported in some parts of the Volta region of Ghana, no previous case of CL had been reported in the Oti region. This study was initiated following reports of skin ulcers which were suggestive of CL in some communities of the Oti region. This study confirmed Leishmania infection in 150(25.5%) out of 595 skin ulcer samples obtained from 426 study participants. Given that 445(74,8%) of the skin ulcers tested negative for Leishmania parasite suggests a need for investigation of additional causes of skin ulcers such as yaws and Buruli ulcer in the study area.
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Affiliation(s)
- Richard Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- School of Public Health, University of Ghana, Accra, Ghana
| | - Carmen Sanchez
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Chicharro
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Eugenia Carrillo
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Naiki Attram
- U.S. Naval Medical Research Unit No. 3, Ghana Detachment, Accra, Ghana
| | | | - Clara Yeboah
- U.S. Naval Medical Research Unit No. 3, Ghana Detachment, Accra, Ghana
| | | | - Daniel Boakye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Jose-Antonio Ruiz-Postigo
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Javier Moreno
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Michael Wilson
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Bismark Sarfo
- School of Public Health, University of Ghana, Accra, Ghana
| | - Francis Anto
- School of Public Health, University of Ghana, Accra, Ghana
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Lodi G, Sannino M, Caterino P, Cannarozzo G, Bennardo L, Nisticò SP. Fractional CO 2 laser-assisted topical rifamycin drug delivery in the treatment of pediatric cutaneous leishmaniasis. Pediatr Dermatol 2021; 38:717-720. [PMID: 33899264 DOI: 10.1111/pde.14608] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cutaneous leishmaniasis is challenging to treat. Various drugs have been proposed to manage this condition, with variable results. In this case report, we describe laser-assisted delivery of rifamycin to treat this infection. Two sessions of fractional CO2 laser were performed one month apart. Each was followed by a topical application of rifamycin for three days. Resolution with minimal scarring was obtained, suggesting this technique might be safe and effective in treating cutaneous leishmaniasis.
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Affiliation(s)
- Giuseppe Lodi
- Laser Unit, University of Rome Tor Vergata, Rome, Italy
| | - Mario Sannino
- Laser Unit, University of Rome Tor Vergata, Rome, Italy
| | | | | | - Luigi Bennardo
- Department of Health Sciences, University of Magna Graecia, Catanzaro, Italy
| | - Steven Paul Nisticò
- Department of Health Sciences, University of Magna Graecia, Catanzaro, Italy
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Vila-Payeras A, Mañes AL, Lladó CN. Erythematous Nodule With Central Crust on the Nail Fold in an Infant. JAMA Dermatol 2021; 156:1016-1017. [PMID: 32756889 DOI: 10.1001/jamadermatol.2020.2406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Aina Vila-Payeras
- Department of Dermatology, Son Llàtzer Hospital, Palma de Mallorca, Mallorca, Spain
| | - Alex Llambrich Mañes
- Department of Dermatology, Son Llàtzer Hospital, Palma de Mallorca, Mallorca, Spain
| | - Cristina Nadal Lladó
- Department of Dermatology, Son Llàtzer Hospital, Palma de Mallorca, Mallorca, Spain
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Hussein NR, Naqid IA, Abdullah AS, M. Saleem ZS, Majed HS, Salih HM, Abdi BA, Rashad BH. Successful treatment of cutaneous leishmaniasis with intralesional sodium stibogluconate in internally displaced school age children in Iraq. Dermatol Ther 2020. [DOI: 10.1111/dth.14107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nawfal R. Hussein
- Infectious Disease Unit, Azadi Teaching Hospital Duhok Kurdistan Region Iraq
- Department of Biomedical Sciences College of Medicine, University of Zakho Duhok Kurdistan Region Iraq
| | - Ibrahim A. Naqid
- Department of Biomedical Sciences College of Medicine, University of Zakho Duhok Kurdistan Region Iraq
| | | | - Zana Sidiq M. Saleem
- Kidney Transplant Center Duhok Kurdistan Region Iraq
- Department of Internal Medicine College of Medicine, University of Duhok Duhok Kurdistan Region Iraq
| | - Halat S. Majed
- Infectious Disease Unit, Azadi Teaching Hospital Duhok Kurdistan Region Iraq
| | - Haval M. Salih
- Department of Biomedical Sciences College of Medicine, University of Zakho Duhok Kurdistan Region Iraq
| | - Basheer A. Abdi
- Department of Biomedical Sciences College of Medicine, University of Zakho Duhok Kurdistan Region Iraq
| | - Brisik H. Rashad
- Department of Biomedical Sciences College of Medicine, University of Zakho Duhok Kurdistan Region Iraq
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16
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Ware JM, O'Connell EM, Brown T, Wetzler L, Talaat KR, Nutman TB, Nash TE. Efficacy and Tolerability of Miltefosine in the Treatment of Cutaneous Leishmaniasis. Clin Infect Dis 2020; 73:e2457-e2562. [PMID: 33124666 DOI: 10.1093/cid/ciaa1238] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/13/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a neglected tropical disease causing an estimated 1 million new cases annually. While antimonial compounds are the standard of care worldwide, they are associated with significant adverse effects. Miltefosine, an oral medication, is United States (US) Food and Drug Administration approved to treat CL caused by Leishmania braziliensis, Leishmania guyanensis, and Leishmania panamensis. Evidence of efficacy in other species and side-effect profiles in CL has been limited. METHODS Twenty-six patients with CL were treated with miltefosine at the US National Institutes of Health. Species included L. braziliensis (n = 7), L. panamensis (n = 5), Leishmania mexicana (n = 1), Leishmania infantum (n = 3), Leishmania aethiopica (n = 4), Leishmania tropica (n = 2), Leishmania major (n = 1), and unspeciated (n = 3). Demographic and clinic characteristics of the participants, response to treatment, and associated adverse events were analyzed. RESULTS Treatment with miltefosine resulted in cure in 77 % (20/26) of cases, with cures among all species. Common adverse events included nausea/vomiting (97%) and lack of appetite (54%). Clinical management or dose reduction was required in a third of cases. Gout occurred in 3 individuals with a prior history of gout. Most laboratory abnormalities, including elevated creatinine and aminotransferases, were mild and normalized after treatment. CONCLUSIONS Our data suggest that miltefosine has good but imperfect efficacy to a wide variety of Leishmania species. While side effects were common and mostly mild to moderate, some resulted in discontinuation of therapy. Due to oral administration, broad efficacy, and manageable toxicities, miltefosine is a viable alternative treatment option for CL, though cost and lack of local availability may limit its widespread use.
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Affiliation(s)
- JeanAnne M Ware
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Elise M O'Connell
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Thomas Brown
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Lauren Wetzler
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Kawsar R Talaat
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Theodore E Nash
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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17
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Ducharme O, Simon S, Ginouves M, Prévot G, Couppie P, Demar M, Blaizot R. Leishmania naiffi and lainsoni in French Guiana: Clinical features and phylogenetic variability. PLoS Negl Trop Dis 2020; 14:e0008380. [PMID: 32797078 PMCID: PMC7449503 DOI: 10.1371/journal.pntd.0008380] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 08/26/2020] [Accepted: 05/11/2020] [Indexed: 11/19/2022] Open
Abstract
In French Guiana, five species are associated with Cutaneous Leishmaniasis (CL). Though infections with Leishmania guyanensis, L. (V.) braziliensis and L. (L.) amazonensis have been extensively described, there are few available clinical and genetic data on L. (V.) lainsoni and L. (V.) naiffi. We determined the clinical and epidemiological features of all cases of CL due to L. (V.) naiffi and L. (V.) lainsoni diagnosed in French Guiana between 2003 and 2019. Phylogenetic analysis was performed by sequencing a portion of HSP70 and cyt b genes. Five cases of L. naiffi and 25 cases of L. lainsoni were reported. Patients infected by L. (V.) lainsoni were usually infected on gold camps, mostly along the Maroni river (60%), while L. naiffi was observed in French patients infected on the coast (100%). A high number of pediatric cases (n = 5; 20%) was observed for L. (V.) lainsoni. A mild clinical course was observed for all cases of L. (V.) naiffi. HSP70 and cyt b partial nucleotide sequence analysis revealed different geographical clusters within L. (V.) naiffi and L. (V.) lainsoni but no association were found between phylogenetic and clinical features. Our data suggest distinct socio-epidemiological features for these two Leishmania species. Patients seem to get infected with L. (V.) naiffi during leisure activities in anthropized coastal areas, while L. (V.) lainsoni shares common features with L. (V.) guyanensis and braziliensis and seems to be acquired during professional activities in primary forest regions. Phylogenetic analysis has provided information on the intraspecific genetic variability of L. (V.) naiffi and L. (V.) lainsoni and how these genotypes are distributed at the geographic level.
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Affiliation(s)
- Océane Ducharme
- Service de Dermatologie, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - Stéphane Simon
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
| | - Marine Ginouves
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
| | - Ghislaine Prévot
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
| | - Pierre Couppie
- Service de Dermatologie, Hôpital Andrée Rosemon, Cayenne, French Guiana
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
- Centre National de Référence des Leishmanioses, laboratoire associé, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - Magalie Demar
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
- Centre National de Référence des Leishmanioses, laboratoire associé, Hôpital Andrée Rosemon, Cayenne, French Guiana
- Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - Romain Blaizot
- Service de Dermatologie, Hôpital Andrée Rosemon, Cayenne, French Guiana
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
- Centre National de Référence des Leishmanioses, laboratoire associé, Hôpital Andrée Rosemon, Cayenne, French Guiana
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18
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Suprien C, Rocha PN, Teixeira M, Carvalho LP, Guimarães LH, Bonvoisin T, Machado PRL, Carvalho EM. Clinical Presentation and Response to Therapy in Children with Cutaneous Leishmaniasis. Am J Trop Med Hyg 2020; 102:777-781. [PMID: 32043440 DOI: 10.4269/ajtmh.19-0531] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis (CL) caused by Leishmania braziliensis occurs predominantly in adult males. Herein, we compare the clinical presentation and the response to antimony therapy of CL in children versus adults. Participants included 571 patients with CL; of these, 129 were children (age ≤ 12 years). Cure was defined as the complete healing of ulcer in the absence of raised borders at day 90 after initiation of therapy. Failure was defined by the presence of an active ulcer or a scar with elevated borders at day 90. In comparison with adults, children had shorter duration of illness, more lesions in the head, and smaller ulcers. Risk factors for therapeutic failure were younger age, shorter duration of disease, higher number of lesions, and larger size of the biggest ulcer. When age was categorized in ≤ 12-year-olds (children versus adults), it predicted therapeutic failure with statistical significance at day 60 but not at day 90. In conclusion, our data indicate that there are significant differences in the clinical presentation of CL between children and adults. Physicians caring for children with CL should be aware that lesions may take longer to heal and remain alert for the possibility of higher odds of therapeutic failure in this group.
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Affiliation(s)
- Carvel Suprien
- Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Brazil
| | - Paulo N Rocha
- Serviço de Imunologia do Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Brazil
| | | | - Lucas P Carvalho
- Instituto de Ciências da Saúde da Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Brazil.,Serviço de Imunologia do Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Instituto Gonçalo Moniz (IGM), FIOCRUZ-BA, Salvador, Brazil.,National Institutes of Science and Technology in Tropical Diseases, Ministry of Science and Technology, Salvador, Brazil
| | - Luiz H Guimarães
- Universidade Federal do Sul da Bahia, Ilhéus, Brazil.,National Institutes of Science and Technology in Tropical Diseases, Ministry of Science and Technology, Salvador, Brazil
| | | | - Paulo R L Machado
- National Institutes of Science and Technology in Tropical Diseases, Ministry of Science and Technology, Salvador, Brazil.,Serviço de Imunologia do Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Edgar M Carvalho
- Serviço de Imunologia do Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,National Institutes of Science and Technology in Tropical Diseases, Ministry of Science and Technology, Salvador, Brazil.,Instituto Gonçalo Moniz (IGM), FIOCRUZ-BA, Salvador, Brazil
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19
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Baghad B, Riyad M, Razanapinaritra R, Maksouri H, Ben Errais H, Chiheb S. [Pediatric cutaneous leishmaniasis in Morocco: Clinical and epidemiological features]. Ann Dermatol Venereol 2019; 147:106-112. [PMID: 31843225 DOI: 10.1016/j.annder.2019.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/03/2019] [Accepted: 10/01/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Cutaneous leishmaniasis (CL) is a parasitic disease caused by a flagellate protozoa of the genus Leishmania and is a public health problem throughout the world. In Morocco, CL may be sporadic or endemic depending on the species of Leishmania and the region involved. Casablanca is a non-endemic city but many children with CL come from elsewhere in the country. The aim of our study is to describe the clinical and epidemiological particularities of CL diagnosed in children at the Casablanca University Hospital. MATERIALS AND METHODS A cross-sectional study was conducted between 2010 and 2016. All patients with one or more skin lesions suggestive of CL underwent parasitological and molecular investigation. Epidemiological and clinical data from patients with positive genotyping were collected and analyzed. A comparative study was made of epidemiological and clinical variables between children and adults and between different species found in children. RESULTS One hundred and six cases of CL were diagnosed, of which 40 in children (37.7%): 29 due to L. tropica (72.5%), 7 due to L. major (17.5%), and 4 due to L. infantum (10%). CL caused by L. tropica was significantly associated with children (P=0.009) and was distinguished by the predominance of the nodular form (P=0.04) and a facial location (P=0.007). Compared to adults, childhood CL lesions were characterized by their small size (P=0.001) and facial location (P=0.003). Children were treated mainly with pentavalent antimonials, with good safety and clinical response. CONCLUSION In our series, CL due to L. tropica was predominant in children, reflecting the epidemic nature and wide geographical distribution of this species in Morocco. CL due to L. tropica was significantly associated with facial location and nodular form in children.
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Affiliation(s)
- B Baghad
- Service de dermatologie et vénéréologie, CHU Ibn Rochd, Casablanca, Maroc; Équipe de recherche, immunopathologie des maladies infectieuses et de système, faculté de médecine et de pharmacie, université Hassan II de Casablanca, Maroc.
| | - M Riyad
- Équipe de recherche, immunopathologie des maladies infectieuses et de système, faculté de médecine et de pharmacie, université Hassan II de Casablanca, Maroc; Laboratoire de parasitologie, faculté de médecine et pharmacie, université Hassan II de Casablanca, Maroc
| | - R Razanapinaritra
- Service de dermatologie et vénéréologie, CHU Ibn Rochd, Casablanca, Maroc; Équipe de recherche, immunopathologie des maladies infectieuses et de système, faculté de médecine et de pharmacie, université Hassan II de Casablanca, Maroc
| | - H Maksouri
- Équipe de recherche, immunopathologie des maladies infectieuses et de système, faculté de médecine et de pharmacie, université Hassan II de Casablanca, Maroc; Laboratoire de parasitologie, faculté de médecine et pharmacie, université Hassan II de Casablanca, Maroc
| | - H Ben Errais
- Équipe de recherche, immunopathologie des maladies infectieuses et de système, faculté de médecine et de pharmacie, université Hassan II de Casablanca, Maroc
| | - S Chiheb
- Service de dermatologie et vénéréologie, CHU Ibn Rochd, Casablanca, Maroc; Équipe de recherche, immunopathologie des maladies infectieuses et de système, faculté de médecine et de pharmacie, université Hassan II de Casablanca, Maroc
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20
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Cutaneous Leishmaniasis: The Complexity of Host's Effective Immune Response against a Polymorphic Parasitic Disease. J Immunol Res 2019; 2019:2603730. [PMID: 31871953 PMCID: PMC6913332 DOI: 10.1155/2019/2603730] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 10/05/2019] [Accepted: 10/22/2019] [Indexed: 12/14/2022] Open
Abstract
This review is aimed at providing a comprehensive outline of the immune response displayed against cutaneous leishmaniasis (CL), the more common zoonotic infection caused by protozoan parasites of the genus Leishmania. Although of polymorphic clinical presentation, classically CL is characterized by leishmaniotic lesions on the face and extremities of the patients, which can be ulcerative, and even after healing can lead to permanent injuries and disfigurement, affecting significantly their psychological, social, and economic well-being. According a report released by the World Health Organization, the disability-adjusted life years (DALYs) lost due to leishmaniasis are close to 2.4 million, annually there are 1.0–1.5 million new cases of CL, and a numerous population is at risk in the endemic areas. Despite its increasing worldwide incidence, it is one of the so-called neglected tropical diseases. Furthermore, this review provides an overview of the existing knowledge of the host innate and acquired immune response to cutaneous species of Leishmania. The use of animal models and of in vitro studies has improved the understanding of parasite-host interplay and the complexity of immune mechanisms involved. The importance of diagnosis accuracy associated with effective patient management in CL reduction is highlighted. However, the multiple factors involved in CL epizoology associated with the unavailability of vaccines or drugs to prevent infection make difficult to formulate an effective strategy for CL control.
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21
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Hussein NR. A Clinicoepidemiological Study of Pediatric Cutaneous Leishmaniasis in Sinjar Province, Iraq. Am J Trop Med Hyg 2019; 101:1111-1113. [PMID: 31516113 DOI: 10.4269/ajtmh.19-0508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a major health problem worldwide. Although CL is a common disease among children, treatment regimens for the pediatric age group are based on extrapolation of efficacy data in adults. The present study aimed to evaluate the treatment outcome of CL in preschool-age children and the factors influencing the outcome. Two hundred ninety-four children were diagnosed with CL between December 2018 and March 2019 in Sinjar Province, Iraq. All patients were treated with intralesional injections of sodium stibogluconate and followed up for 3 months after the completion of treatment. The treatment success rate was 99% (291/294). A statistically significant association was found between the number of doses per lesion and the number of lesions (P = 0.002; CI = 0.066-0.2875). No association was found between the number of lesions, age, gender, or the presence of livestock and the treatment outcome. In conclusion, treatment success rate was high with the use of intralesional injection of sodium stibogluconate. A significant association was found between the number of lesions and the number of doses. Further studies are required to assess the treatment outcome indicators, including the genotype of leishmania.
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Affiliation(s)
- Nawfal R Hussein
- Infectious Disease Unit, Azadi Teaching Hospital and College of Medicine, University of Zakho, Duhok, Iraq
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22
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De Annunzio SR, Costa NCS, Mezzina RD, Graminha MAS, Fontana CR. Chlorin, Phthalocyanine, and Porphyrin Types Derivatives in Phototreatment of Cutaneous Manifestations: A Review. Int J Mol Sci 2019; 20:ijms20163861. [PMID: 31398812 PMCID: PMC6719085 DOI: 10.3390/ijms20163861] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/13/2019] [Accepted: 06/18/2019] [Indexed: 12/13/2022] Open
Abstract
Recent scientific research has shown the use of chlorin, phthalocyanines, and porphyrins derivatives as photosensitizers in photodynamic therapy in the treatment of various pathologies, including some of the major skin diseases. Thus, the main goal of this critical review is to catalog the papers that used these photosensitizers in the treatment of acne vulgaris, psoriasis, papillomavirus infections, cutaneous leishmaniasis, and skin rejuvenation, and to explore the photodynamic therapy mechanisms against these conditions alongside their clinical benefits.
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Affiliation(s)
- Sarah Raquel De Annunzio
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Natalia Caroline Silva Costa
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Rafaela Dalbello Mezzina
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Márcia A S Graminha
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Carla Raquel Fontana
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil.
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