scholarly journals Efficacy and Safety of Paromomycin in Treatment of Post-Kala-Azar Dermal Leishmaniasis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Shyam Sundar ◽  
Anup Singh ◽  
Anurag Tiwari ◽  
Saurabh Shukla ◽  
Jaya Chakravarty ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Protocol Analysis ◽  
Complete Disappearance ◽  
Efficacy And Safety ◽  
Multidrug Therapy ◽  
Cure Rate ◽  
Duration Of Treatment ◽  
Treatment Regimens ◽  
Kala Azar ◽  
One Year

Background. Post-kala-azar dermal leishmaniasis (PKDL) plays an important role in maintaining endemicity of visceral leishmaniasis and its transmission. Treatment regimens for PKDL are toxic and require 3-4 months of hospitalization. These long and arduous regimens result in extensive noncompliance. There is an urgent need to develop a safe, effective, and acceptable regimen for the treatment of PKDL. Paromomycin (PM) has been recently approved in India for treatment of visceral leishmaniasis (VL); hence we tested its efficacy in patients with PKDL. Methods. In this exploratory study, 31 patients with PKDL aged 10 years and above were administered PM 11 mg/kg daily intramuscularly for 45  days and followed up for one year. Results. Out of 31 patients, 7 patients were lost to followup at 1  year and 9 (37.5%) got cured with complete disappearance of lesion, while 15 (62.5%) showed no improvement by per protocol analysis. Conclusion. Cure rate with 45 intramuscular injections of PM was unacceptably low though there was no serious side effect of the drug. Whether paromomycin can be used in multidrug therapy to shorten the duration of treatment should be the next logical step for investigation.

scholarly journals Efficacy and Safety of Miltefosine in Treatment of Post-Kala-Azar Dermal Leishmaniasis

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Shyam Sundar ◽  
Anup Singh ◽  
Jaya Chakravarty ◽  
Madhukar Rai
Keyword(s):  
Adverse Effect ◽  
Visceral Leishmaniasis ◽  
Exploratory Study ◽  
Protocol Analysis ◽  
Complete Disappearance ◽  
Efficacy And Safety ◽  
Kala Azar ◽  
One Year

Background. Long regimens for the treatment of post-kala-azar dermal leishmaniasis (PKDL) result in noncompliance. A safe, effective, and acceptable regimen for the treatment of PKDL is still to be developed. Miltefosine has been found to be effective in the treatment of Visceral Leishmaniasis (VL). Hence, its efficacy was tested in patients of PKDL.Methods. In this exploratory study, 33 patients with PKDL aged 10 years and above were administered miltefosine (50 mg for those weighing <25 kg or 100 mg in divided doses for those ≥25 kg and 2.5 mg per kg for children) for 12 weeks and followed up for one year to find out the efficacy.Results. Out of 33 patients, 3 patients withdrew consent. Treatment was stopped due to adverse effect in 1 patient. 28 (96.6%) got cured with complete disappearance of lesion while 1 patient (3.4%) failed treatment by protocol analysis.Conclusion. Miltefosine was found to be effective and safe in the treatment of PKDL.

scholarly journals Comparison of KAtex, Bone Marrow Aspiration and DAT for the Diagnosis of Visceral Leishmaniasis

2019 ◽  
Vol 6 (1) ◽  
pp. 12-15
Author(s):  
Ishrat Sharmin ◽  
AKM Quamruzzaman ◽  
Rezina Parveen ◽  
M Abdulah Yusuf ◽  
Rashida Akter Khanam
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Bone Marrow Aspiration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Kala Azar ◽  
History Of ◽  
One Year

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar. Objectives: The aim of the present study was to compare KAtex, Bone marrow aspiration and DAT to diagnose VL. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the Department of Parasitology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala-azar (VL) cases of different age and sex attending IEDCR, Dhaka from different Kala-azar endemic areas of Bangladesh were selected for this study. Patients having fever for more than 2 weeks, with or without splenomegaly, having history of loss of body weight following onset of fever were clinically suspected as Kala-azar cases. Microscopy and culture was performed in bone marrow (BM). KAtex was performed with urine sample. Agglutination of sensitized latex indicated presence of Leishmania donovani antigen in urine and thereby visceral leishmaniasis. No agglutination indicates absence of antigen in urine. DAT was done with serums of all cases. Result: Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60(46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex and DAT. Among 60 BM negative cases, 15 were positive by KAtex and 23 were positive by DAT. The sensitivity of KAtex was 100.0% and specificity was 75.0%. The sensitivity of DAT was 100.0% and specificity is 61.6%. Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL in comparison with DAT. Bangladesh Journal of Infectious Diseases, June 2019;6(1):12-15

scholarly journals Efficacy and Safety of Paromomycin for Visceral Leishmaniasis: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Pashupati Pokharel ◽  
Rakesh Ghimire ◽  
Pratik Lamichhane
Keyword(s):  
Systematic Review ◽  
Drug Resistance ◽  
Visceral Leishmaniasis ◽  
South America ◽  
South Asia ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases ◽  
Efficacy And Safety ◽  
Kala Azar ◽  
Resource Limited

Visceral leishmaniasis, also known as kala-azar is one of the most commonly neglected tropical diseases affecting a large number of rural and resource-limited people in South Asia, Africa, and South America. Paromomycin, an aminoglycoside drug, is frequently used for the treatment of visceral leishmaniasis. Despite limited therapies for visceral leishmaniasis and emerging drug resistance, a proper review on the action of paromomycin for kala-azar is lacking. This systematic review aims to look for the efficacy and safety aspects of paromomycin for the treatment of visceral leishmaniasis.

scholarly journals Clinical and haematological parameters associated with patients of visceral leishmaniasis in a district of North Bihar

2017 ◽  
Vol 4 (6) ◽  
pp. 1957
Author(s):  
Kumar Saurabh ◽  
Shilpi Ranjan ◽  
Rajeev Ranjan Prasad
Keyword(s):  
Visceral Leishmaniasis ◽  
Blood Parameters ◽  
Haematological Parameters ◽  
Poor Control ◽  
Medical College ◽  
Kala Azar ◽  
Retrospective Data Collection ◽  
Bleeding Manifestation ◽  
Common Sign ◽  
One Year

Background: Visceral leishmaniasis is highly endemic in West Champaran district of Bihar. This endemicity is supposed to be due to poor hygiene and sanitation and poor control of vectors. This study was done to study clinical and haematological parameters of Kala-azar patients in this area.Methods: A retrospective data collection was done in a medical college of north Bihar. Study duration was one year from January 2016 to December 2016. 43 cases, rk-39 positive from 13 blocks of W. Champaran admitted at medical college were studied for clinical and haematological parameters.Results: Bhitha was the highest affected block (25.58%) followed by Manjhaulia (23.25%) Fever was the commonest presentation whereas splenomegaly was the most common sign. Pallor was seen in 90 % cases and hepatomegaly in 60 % cases. Patients presented with bleeding manifestation in 9.3% cases and lymphadenopathy in 6.9% cases. Among blood parameters anaemia was seen in 93% cases and thrombocytopenia in 83%. Microcytic hypochromic blood picture was the most common peripheral blood picture.Conclusions: Extensive epidemiological investigation is needed to find out hidden cases in this area. 

scholarly journals Long-term incidence of relapse and post-kala-azar dermal leishmaniasis after three different visceral leishmaniasis treatment regimens in Bihar, India

2020 ◽  
Vol 14 (7) ◽  
pp. e0008429
Author(s):  
Vishal Goyal ◽  
Vidya Nand Rabi Das ◽  
Shambhu Nath Singh ◽  
Ravi Shankar Singh ◽  
Krishna Pandey ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Treatment Regimens ◽  
Kala Azar

scholarly journals Case Report: Post Kala-Azar Dermal Leishmaniasis with History of Visceral Leishmaniasis

2021 ◽  
Vol 8 (5) ◽  
pp. 69-72
Author(s):  
Pavankumar Narapaka ◽  
Kalpana Katikala
Keyword(s):  
Visceral Leishmaniasis ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Liposomal Amphotericin B ◽  
First Line ◽  
Treatment Regimens ◽  
First Line Therapy ◽  
Kala Azar ◽  
History Of

The complication of visceral leishmaniasis is post-kala-azar dermal leishmaniasis (PKDL). PKDL typically occurs as a result of treatment failure or parasite resistance to treatment regimens, as well as poor patient follow-up. In the treatment of visceral leishmaniasis and post-kala-azar dermal leishmaniasis, Liposomal Amphotericin B is considering as first-line therapy. We're going to show you a case where Liposomal Amphotericin B was used to treat it. Keywords: visceral leishmaniasis, post-kala-azar dermal leishmaniasis, PKDL, kala-azar

scholarly journals Predictors of an unsatisfactory response to pentavalent antimony in the treatment of American visceral leishmaniasis

2002 ◽  
Vol 35 (6) ◽  
pp. 629-633 ◽  
Author(s):  
Mácia A. Santos ◽  
Raynério C. Marques ◽  
Carolinne A. Farias ◽  
Danielle M. Vasconcelos ◽  
Jay M. Stewart ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Amphotericin B ◽  
Control Group ◽  
Inadequate Response ◽  
Second Line ◽  
Cure Rate ◽  
Small Children ◽  
Pentavalent Antimony ◽  
Bacterial Coinfection ◽  
One Year

Although treatment of visceral leishmaniasis with pentavalent antimony is usually successful, some patients require second-line drug therapy, most commonly with amphotericin B. To identify the clinical characteristics that predict an inadequate response to pentavalent antimony, a case-control study was undertaken in Teresina, Piaui, Brazil. Over a two-year period, there were 19 cases of VL in which the staff physicians of a hospital prescribed second-line therapy with amphotericin B after determining that treatment with pentavalent antimony had failed. The control group consisted of 97 patients that were successfully treated with pentavalent antimony. A chart review using univariate and multivariate analysis was performed. The cure rate was 90% with amphotericin B. The odds ratio for the prescription of amphotericin B was 10.2 for children less than one year old, compared with individuals aged over 10 years. Patients who presented coinfection had an OR of 7.1 while those on antibiotics had an OR of 2.8. These data support either undertaking a longer course of therapy with pentavalent antimony for children or using amphotericin B as a first-line agent for children and individuals with coinfections. It also suggests that chemoprophylaxis directed toward bacterial coinfection in small children with VL may be indicated.

scholarly journals Chemotherapeutics of visceral leishmaniasis: present and future developments

Parasitology ◽  
2017 ◽  
Vol 145 (4) ◽  
pp. 481-489 ◽  
Author(s):  
SHYAM SUNDAR ◽  
ANUP SINGH
Keyword(s):  
Visceral Leishmaniasis ◽  
Treatment Options ◽  
Secondary Prophylaxis ◽  
Multidrug Therapy ◽  
Duration Of Treatment ◽  
Future Developments ◽  
Recommended Treatment ◽  
Preclinical Phase ◽  
Long Duration ◽  
Further Development

SUMMARYTreatment of Visceral Leishmaniasis (VL), a neglected tropical disease, is very challenging with few treatment options. Long duration of treatment and drug toxicity further limit the target of achieving VL elimination. Chemotherapy remains the treatment of choice. Single dose of liposomal amphotericin B (LAmB) and multidrug therapy (LAmB + miltefosine, LAmB + paromomycin (PM), or miltefosine + PM) are recommended treatment regimen for treatment of VL in Indian sub-continent. Combination therapy of pentavalent antimonials (Sbv) and PM in East Africa and LAmB in the Mediterranean region/South America remains the treatment of choice. Various drugs having anti-leishmania properties are in preclinical phase and need further development. An effective treatment and secondary prophylaxis of HIV-VL co-infection should be developed to decrease treatment failure and drug resistance.

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