Drug Resistance in Leishmaniasis

Sundar, Shyam; Chakravarty, Jaya

doi:10.1007/978-3-319-47266-9_29

Cited by 2 publications

(3 citation statements)

References 182 publications

(78 reference statements)

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“…Leishmaniases is a group of diseases which includes several clinical forms. To understand and counter the emerging drug resistance, it is essential to investigate into the different disease forms based on their clinical and serological features, to enable prompt diagnosis and effective management (Table 4) [30][31][32][33][34][35][36][37][38][39][40][41][42].…”

Section: Discussionmentioning

confidence: 99%

“…• Africa: Papular rash is more common, spontaneously heal and treatment is indicated only for chronic or severe cases Serological diagnosis • rk39, DAT, ELISA are usually positive but is of limited value in diagnosis due to remaining serological response due to VL • Serology is helpful in differentiating from other diseases such as leprosy [30,31,40] (Continued )…”

Section: Plos Onementioning

confidence: 99%

“…8 Misuse of the antimony drugs [30]. Practices such as inadequate dose, inappropriate regimes, free availability, management of patients by unqualified persons and not completing treatment have led to development of subtherapeutic levels of antimony in blood causing development of parasite tolerance to antimony.…”

Section: Mechanism Commentmentioning

confidence: 99%

See 2 more Smart Citations

Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination

Silva

Liyanage²,

Deerasinghe³

et al. 2021

PLoS ONE

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The first-line treatment for Leishmania donovani-induced cutaneous leishmaniasis (CL) in Sri Lanka is intra-lesional sodium stibogluconate (IL-SSG). Antimony failures in leishmaniasis is a challenge both at regional and global level, threatening the ongoing disease control efforts. There is a dearth of information on treatment failures to routine therapy in Sri Lanka, which hinders policy changes in therapeutics. Laboratory-confirmed CL patients (n = 201) who attended the District General Hospital Hambantota and Base Hospital Tangalle in southern Sri Lanka between 2016 and 2018 were included in a descriptive cohort study and followed up for three months to assess the treatment response of their lesions to IL-SSG. Treatment failure (TF) of total study population was 75.1% and the majority of them were >20 years (127/151,84%). Highest TF was seen in lesions on the trunk (16/18, 89%) while those on head and neck showed the least (31/44, 70%). Nodules were least responsive to therapy (27/31, 87.1%) unlike papules (28/44, 63.6%). Susceptibility to antimony therapy seemed age-dependant with treatment failure associated with factors such as time elapsed since onset to seeking treatment, number and site of the lesions. This is the first detailed study on characteristics of CL treatment failures in Sri Lanka. The findings highlight the need for in depth investigations on pathogenesis of TF and importance of reviewing existing treatment protocols to introduce more effective strategies. Such interventions would enable containment of the rapid spread of L.donovani infections in Sri Lanka that threatens the ongoing regional elimination drive.

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