Treatment Outcome of the Drug-resistant Zoonotic Cutaneous Leishmaniasis by Glucantime

Soleimanifard, Simindokht; Arjmand, Reza; Saberi, Sedigheh; Salehi, Mansoor; Hejazi, Seyed Hossein

doi:10.4103/2277-9175.201329

Cited by 8 publications

(4 citation statements)

References 28 publications

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“…Another second-line medication, mainly in combination with MA, was used on a special occasion. The overall efficacy of MA against ACL was 89% in a cohort study with a significant focus in southeastern Iran (51); however, in routine practice, variable ranges of treatment failures have been reported for ACL (80)(81)(82) and ZCL throughout the country (82,83).…”

Section: Treatment Of Patientsmentioning

confidence: 98%

Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Sharifi

Khosravi

Aflatoonian

et al. 2023

Front. Public Health

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Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989–2020. However, we emphasized the current trends, 2013–2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported.

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Section: Treatment Of Patientsmentioning

confidence: 98%

Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Sharifi

Khosravi

Aflatoonian

et al. 2023

Front. Public Health

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“…In a time of restriction and contraindication for choice drug therapy, other drugs such as lipid formulations of amphotericin B (AmBisome ® ), paromomycin, miltefosine, ketoconazole, itraconazole, and fluconazole and also multiple therapies as a combination, could be used [31]. In general efficacy of MA against ACL, is high; however, cases of treatment failures (unresponsiveness) have been reported [25,[32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

Mutual Role of Patients and the Healthcare System in the Control of Cutaneous Leishmaniasis

Bamorovat,

Sharifi,

Agha Kuchak Afshari

et al. 2023

Transboundary and Emerging Diseases

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Leishmaniasis is a neglected and old emerging/reemerging disease that has extremely increased and expanded in the different geographical areas. Cutaneous leishmaniasis (CL) is a common global public health concern in the tropics and subtropics reported from the Eastern Mediterranean Region, Africa, Latin America, and the Indian subcontinent. The presence of numerous epidemiological and clinical characteristics of the disease present a challenge in managing and controlling it. Despite wonderful efforts to control the disease in endemic areas, it appears that the burden of CL is still high. There is no comprehensive survey considering the interactive role of patients and medical services in the international CL control system. In the present study, the effective and mutual responsibility of the patients and the healthcare management in controlling the CL are reviewed, described, and discussed. Some patient-related factors that have a remarkable impact on the proper treatment and control strategies are low-socioeconomic condition, lack of sufficient knowledge about the disease, absence of personal protection, disregarding adherence to treatment, culture and incorrect beliefs about disease and therapy, depression, and lack of appropriate support from the family. On the other hand, some healthcare system-related factors that have an important effect on the suitable therapy and management of the disease are the economic burden of healthcare and drug preparation, unsuitable follow-up assessments, health education, early detection, and the right treatment, handling of unresponsive cases, active case detection, and monitoring/evaluation. Improving the socioeconomic conditions and living standards supports longstanding elimination approaches, and facilitates the wide-ranging control of the disease. Trained health staff and experienced clinicians should strengthen the building capacity for appropriate control programs throughout the healthcare system. These measures need sustained encouragement and appropriate multifunctional activities through all government segments including policymakers, the health system, clinical physicians, researchers, and also the private sector. In a suitable strategy, it is essential to understand precisely all the aspects of control strategies to respond correctly to the requests. Nevertheless, due to the complexity of the causative agent, major challenges/gaps remain, and vigorous conservative control plans should be continued until novel tools become available.

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“…However, over the past few years, there has been increasing concern about the resistance of parasites to Glucantime® ( 6 ). Anti- Leishmania resistance and treatment failure is a major challenge in new and old-world countries ( 7 – 9 ). Resistance of L. tropica to Glucantime® was first reported in Iran in 2006 ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment Failure in Cutaneous Leishmaniasis Patients Referred to the School of Public Health, Tehran University of Medical Sciences During 2008–2017

Kakooei¹,

Hajjaran²,

Akhoundi³

et al. 2021

JAD

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Background: Cutaneous leishmaniasis (CL) is a vector borne disease predominantly found in tropical and subtropical countries, including Iran. For more than 6 decades, pentavalent antimonials have been used successfully worldwide for the treatment of leishmaniasis, but over the past few years, clinical resistance to these medications has increased. In this study, we evaluated CL patients who did not show any desirable responses to the anti-leishmanial treatment within a 10- year period (2008 to 2017). Methods: All patients from different parts of Iran suspected of having cutaneous leishmaniasis, who were referred to the laboratory of leishmaniosis in Tehran University of Medical Sciences from 2008–2017 were parasitological examined. Results: During this period, a total of 1480 suspected CL patients were referred to the laboratory of leishmaniosis. Samples from 655 patients (70.8%) suspected of having CL were positive microscopically. The failure rate in patients treated with anti-leishmaniasis medications for a minimum of three complete treatment periods was 1.83% (12 cases). There was no association between the number and size of skin lesions and patient characteristics. Also, the route of drug administration had no significant effect on the number and size of lesions. Conclusion: In the present study, treatment failure was found in some confirmed CL patients treated with meglumine antimoniate. Over the past few years, it seems that had been increased in resistance to these medications. So, a review of the correct implementation of the treatment protocol and/or a combination therapy may be helpful in preventing an increase in the rate of treatment failure.

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Treatment Outcome of the Drug-resistant Zoonotic Cutaneous Leishmaniasis by Glucantime

Cited by 8 publications

References 28 publications

Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Mutual Role of Patients and the Healthcare System in the Control of Cutaneous Leishmaniasis

Treatment Failure in Cutaneous Leishmaniasis Patients Referred to the School of Public Health, Tehran University of Medical Sciences During 2008–2017

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