Old World Cutaneous Leishmaniasis Treatment Response Varies Depending on Parasite Species, Geographical Location and Development of Secondary Infection

Overview

Journal Parasit Vectors

Publisher Biomed Central

Specialties Parasitology
Tropical Medicine

Date 2019 May 4

PMID 31046820

Citations 11

Authors

Waleed S Al-Salem

Carla Solorzano

Gareth D Weedall

Naomi A Dyer

Louise Kelly-Hope

Aitor Casas-Sanchez

Yasser Alraey

Essam J Alyamani

Alice Halliday

Salah M Balghonaim

Khalid S Alsohibany

Zeyad Alzeyadi

Mohamed H Alzahrani

Ali M Al-Shahrani

Abdullah M Assiri

Ziad Memish

Alvaro Acosta-Serrano

Affiliations

Soon will be listed here.

Abstract

Background: In the Kingdom of Saudi Arabia (KSA), Leishmania major and L. tropica are the main causative agents of Old World cutaneous leishmaniasis (CL). The national CL treatment regimen consists of topical 1% clotrimazole/2% fusidic acid cream followed by 1-2 courses of intralesional sodium stibogluconate (SSG); however, treatment efficacy is highly variable and the reasons for this are not well understood. In this study, we present a complete epidemiological map of CL and determined the efficacy of the standard CL treatment regime in several endemic regions of KSA.

Results: Overall, three quarters of patients in all CL-endemic areas studied responded satisfactorily to the current treatment regime, with the remaining requiring only an extra course of SSG. The majority of unresponsive cases were infected with L. tropica. Furthermore, the development of secondary infections (SI) around or within the CL lesion significantly favoured the treatment response of L. major patients but had no effect on L. tropica cases.

Conclusions: The response of CL patients to a national treatment protocol appears to depend on several factors, including Leishmania parasite species, geographical location and occurrences of SI. Our findings suggest there is a need to implement alternative CL treatment protocols based on these parameters.

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