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

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...

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Autores principales:	Hermali Silva, Achala Liyanage, Theja Deerasinghe, Vasana Chandrasekara, Kalaivani Chellappan, Nadira D. Karunaweera
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b73e940762d94542831d7882060eabb3
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spelling	oai:doaj.org-article:b73e940762d94542831d7882060eabb32021-11-04T06:07:11ZTreatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination1932-6203https://doaj.org/article/b73e940762d94542831d7882060eabb32021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8535432/?tool=EBIhttps://doaj.org/toc/1932-6203The 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.Hermali SilvaAchala LiyanageTheja DeerasingheVasana ChandrasekaraKalaivani ChellappanNadira D. KarunaweeraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hermali Silva Achala Liyanage Theja Deerasinghe Vasana Chandrasekara Kalaivani Chellappan Nadira D. Karunaweera Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination
description	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.
format	article
author	Hermali Silva Achala Liyanage Theja Deerasinghe Vasana Chandrasekara Kalaivani Chellappan Nadira D. Karunaweera
author_facet	Hermali Silva Achala Liyanage Theja Deerasinghe Vasana Chandrasekara Kalaivani Chellappan Nadira D. Karunaweera
author_sort	Hermali Silva
title	Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination
title_short	Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination
title_full	Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination
title_fullStr	Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination
title_full_unstemmed	Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination
title_sort	treatment failure to sodium stibogluconate in cutaneous leishmaniasis: a challenge to infection control and disease elimination
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b73e940762d94542831d7882060eabb3
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Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination

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