Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: a collaborative retrospective study

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dc.creatorMaria del Mar Castro
dc.creatorErnesto Rojas
dc.creatorJuliana Quintero
dc.creatorMaria Inês Fernandes Pimentel
dc.creatorJaime Soto
dc.creatorCarvel Suprien
dc.creatorFiorela Alvarez
dc.creatorAna Pilar Ramos
dc.creatorRayssa Basílio dos Santos Arantes
dc.creatorRosiana Estéfane da Silva
dc.creatorClaudia Marcela Arenas
dc.creatorJoelle Rode
dc.creatorIvan Darío Vélez
dc.creatorPaulo Roberto Lima Machado
dc.creatorAlejandro Llanos-Cuentas
dc.creatorMarcia Hueb
dc.creatorGlaucia Fernandes Cota
dc.creatorIsis Valentina Rojas
dc.creatorYenifer Orobio
dc.creatorOscar Oviedo Sarmiento
dc.creatorMarcelo Rosandiski Lyra
dc.creatorNancy Gore Saravia
dc.creatorByron Arana
dc.creatorNeal Alexander
dc.date.accessioned2024-12-06T12:49:24Z
dc.date.accessioned2025-09-09T01:02:52Z
dc.date.available2024-12-06T12:49:24Z
dc.date.issued2023-01-23
dc.description.sponsorshipOutra Agência
dc.format.mimetypepdf
dc.identifier.doi10.1371/journal.pntd.0011029
dc.identifier.issn1935-2727
dc.identifier.urihttps://hdl.handle.net/1843/78495
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofPLOS Neglected Tropical Diseases
dc.rightsAcesso Aberto
dc.subjectLeishmaniose Cutânea
dc.subjectPacientes
dc.subjectTerapêutica
dc.titleCutaneous leishmaniasis treatment and therapeutic outcomes in special populations: a collaborative retrospective study
dc.typeArtigo de periódico
local.citation.epage21
local.citation.issue1
local.citation.spage1
local.citation.volume17
local.description.resumoBackground: Treatment guidance for children and older adult patients affected by cutaneous leishmaniasis (CL) is unclear due to limited representation of these groups in clinical trials. Methods: We conducted a collaborative retrospective study to describe the effectiveness and safety of antileishmanial treatments in children ≤ 10 and adults ≥ 60 years of age, treated between 2014 and 2018 in ten CL referral centers in Latin America. Results: 2,037 clinical records were assessed for eligibility. Of them, the main reason for non-inclusion was lack of data on treatment follow-up and therapeutic response (182/242, 75% of children and 179/468, 38% of adults). Data on 1,325 eligible CL patients (736 children and 589 older adults) were analyzed. In both age groups, disease presentation was mild, with a median number of lesions of one (IQR: 1–2) and median lesion diameter of less than 3 cm. Less than 50% of the patients had data for two or more follow-up visits post-treatment (being only 28% in pediatric patients). Systemic antimonials were the most common monotherapy regimen in both age groups (590/736, 80.2% of children and 308/589, 52.3% of older adults) with overall cure rates of 54.6% (95% CI: 50.5–58.6%) and 68.2% (95% CI: 62.6–73.4%), respectively. Other treatments used include miltefosine, amphotericin B, intralesional antimonials, and pentamidine. Adverse reactions related to the main treatment were experienced in 11.9% (86/722) of children versus 38.4% (206/537) of older adults. Most adverse reactions were of mild intensity. Conclusion: Our findings support the need for greater availability and use of alternatives to systemic antimonials, particularly local therapies, and development of strategies to improve patient follow-up across the region, with special attention to pediatric populations.
local.publisher.countryBrasil
local.publisher.departmentMEDICINA - FACULDADE DE MEDICINA
local.publisher.initialsUFMG
local.url.externahttps://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011029

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