Cutaneous Leishmaniasis in Guatemala: Comparison of Diagnostic Methods

Navin, Thomas R.; Arana, Flora E.; Mérida, A M de; Arana, Byron; Castillo, A.; Silvers, David N.

doi:10.4269/ajtmh.1990.42.36

Cited by 74 publications

(63 citation statements)

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“…Confirmation of the CL infection was based on either observation of amastigotes in thin smears obtained from the edge of the ulcer and stained with Giemsa stain, or by culture of promastigotes from aspirates taken through the skin adjacent to the ulcer, following previously described methods. 14 Only patients with positive cultures or clearly distinguishable amastigotes entered the study. As reported in previous studies, most of the patients (75%) we studied are infected with L. braziliensis, and the rest (25%) are infected with L. mexicana [15][16][17] ; therefore, no characterization of Leishmania parasites was performed.…”

Section: Patientsmentioning

confidence: 99%

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Arana¹,

Mendoza²,

Rizzo³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

114

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Abstract. A double-blind, randomized trial was undertaken in Guatemala to determine the therapeutic efficacy of an ointment for the treatment of cutaneous leishmaniasis that contained 15% paromomycin and 12% methylbenzethonium chloride and that was applied twice a day for 20 days. The treatment group included 35 patients, and the placebo group included 33 patients. The initial clinical response rate (13 weeks after completing the treatment) was 91.4% in the treatment group and 39.4% in the placebo group. The final clinical response rate at the 12-month followup examination was 85.7% (31 of 35) in the treatment group and 39.4% (13 of 33) in the placebo group (P Յ 0.001). In general, the treatment was well tolerated and was never interrupted because of adverse effects. The number of adverse effects reported in the placebo group was lower than in the treatment group (16 events versus 30 events). All adverse effects reported by patients disappeared within 1 week of completing the treatment. Our findings show that the combination of paromomycin with methylbenzethonium chloride for 20 days is a good alternative for antimonial treatments of cutaneous leishmaniasis in Guatemala.

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Section: Patientsmentioning

confidence: 99%

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Arana¹,

Mendoza²,

Rizzo³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

114

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“…3 The parasitologic methods have always been considered first-choice procedures for the diagnosis of leishmaniasis due to their specificity of 100%, although with variable sensitivities. [4][5][6] However, in some instances it is very difficult to demonstrate the presence of parasites 7,8 and immunodiagnosis then becomes an important alternative for demonstrating the presence of the parasite. 9,10 The main line of defense against infection in ATL is the cell immune response.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of antigens from various Leishmania species in a Western blot for diagnosis of American tegumentary leishmaniasis.

Gonçalves¹,

Reiche²,

Filho³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. A Western blot method that uses antigens from culture promastigote forms of Leishmania (Viannia) braziliensis, L. (Leishmania) amazonensis, L. (Leishmania) tropica, and a trypanosomatid (strain 268T) isolated from naturally infected tomatoes was evaluated for laboratory diagnosis of American tegumentary leishmaniasis (ATL). Serum samples were obtained from 108 patients with ATL (group I), 23 chagasic patients (group II), 32 patients with other diseases (group III), and 78 healthy individuals (group IV). The overall analysis showed a sensitivity of 76.90%, 90.40%, 78.50%, and 87.90%, a specificity of 100%, 93.80%, 87.80%, and 77.10%, a positive predictive value of 100%, 94.00%, 89.50%, and 72.50%, a negative predictive value of 75.70%, 90.00%, 75.40%, and 90.20%, and a concordance coefficient kappa of 0.7358, 0.8400, 0.6491, and 0.6287 for L.(L.) tropica, and strain 268T antigens, respectively. The antigenic profile recognized by serum samples from patients with ATL and with Chagas' disease permits serologic distinction between these infections.

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“…The sensitivity of the smear varies in different reports, depending on the lesions duration and appearance, parasite strain and localities, even within the same region (Weigle et al 2002). Positive diagnosis of CL by the smear also varies greatly with the number of amastigotes in aspirate materials and sometimes requires an incubation period of up to 15-30 days (Navin et al 1990;Weigle et al 1987). In contrast, the IMC is much less susceptible to these parameters and provides a fast reading.…”

Section: Discussionmentioning

confidence: 99%

An improved microculture method for diagnosis of cutaneous leishmaniasis

et al. 2013

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This study evaluated the performance of three diagnostic methods for cutaneous leishmaniasis (CL). Patients who came to the Health Center Laboratory of Gonbad-e-Qabus in Golestan Province, Iran, were enrolled in the study. Skin scraping smear, improved microculture (IMC) and polymerase chain reaction (PCR) were performed. A total of 303 subjects were recruited, among whom 273 subjects fulfilled the criteria for CL. Sensitivity and specificity were 88.8 % (95 % CI = 84.2-92.2 %) and 100.0 % for smears, 98.4 % (95 % CI = 96.1-99.1 %) and 100.0 % for IMC, both of them 100.0 % for PCR. Although, PCR was relatively more sensitive than the IMC, the high correlation (agreement = 96 %, Kappa = 0.82) between IMC and PCR along with the advantages of simplicity, rapidity, adequate sensitivity and as a needle free method, offers the IMC as a valuable alternative diagnostic method for PCR in diagnosis of CL.

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Cutaneous Leishmaniasis in Guatemala: Comparison of Diagnostic Methods

Cited by 74 publications

References 0 publications

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Evaluation of antigens from various Leishmania species in a Western blot for diagnosis of American tegumentary leishmaniasis.

An improved microculture method for diagnosis of cutaneous leishmaniasis

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