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Ann Trop Med Parasitol. 2008 January 1; Volume 102 (Issue 1); DOI:10.1179/136485908X252142
Mueller YK, Nguimfack A, Cavailler P, Couffignal S, Rwakimari JB, et al.
Ann Trop Med Parasitol. 2008 January 1; Volume 102 (Issue 1); DOI:10.1179/136485908X252142
Between September 2003 and April 2004, the supply of antimonial drugs to Amudat Hospital, in north-eastern Uganda, was interrupted and all cases of visceral leishmaniasis presenting at the hospital could only be treated with amphotericin B deoxycholate (AmB). This allowed the safety and effectiveness of the AmB to be evaluated, in comparison with an historical cohort of patients treated, at the same hospital, with meglumine antimoniate (Sb(V)). Demographic and clinical data were collected before and after treatment. Adverse effects were recorded passively in all the subjects, and actively, using a standardized questionnaire, in a sub-group of the patients given AmB. The in hospital case-fatality 'rates' were 4.8% [95% confidence interval (CI) = 2.4%-8.8%] among the 210 patients treated with AmB and 3.7% (CI = 1.4%-7.9%) among the 161 patients treated with Sb(V) (P>0.20). Adverse effects requiring treatment interruption were rare in both cohorts. Treatment failures (i.e. non-responses or relapses) were observed in 2.9% (CI = 1.2%-6.4%) of the patients treated with AmB and 1.2% (CI = 0.1%-4.4%) of the patients treated with Sb(V) (P>0.20). For the treatment of visceral leishmaniasis in Uganda, AmB therefore had a similar effectiveness and safety profile to that of meglumine antimoniate.
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Ann Trop Med Parasitol. 2002 September 1; Volume 96 (Issue 6); DOI:10.1179/000349802125001654
Guthmann JP, Kasparian S, Phetsouvanh R, Nathan N, Garcia MG, et al.
Ann Trop Med Parasitol. 2002 September 1; Volume 96 (Issue 6); DOI:10.1179/000349802125001654
To assess the local efficacy of chloroquine for the treatment of acute, uncomplicated, Plasmodium falciparum malaria, children and adults from Sekong province (an area of Laos with a low intensity of transmission) were tested in a 28-day, in-vivo study. Complete data were collected from 88 of the 102 subjects enrolled between October 1999 and September 2000. After genotypic analysis to distinguish recrudescing infections from re-infections, 35 (39.7%, with a 95% confidence interval of 29.5%-50.7%) of these 88 patients were considered treatment failures. These results seriously question the use of chloroquine as the first-line treatment for P. falciparum malaria in the study area.
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Ann Trop Med Parasitol. 2006 April 1; Volume 100 (Issue 3); DOI:10.1179/136485906X91440
Belay AD, Asafa Y, Mesure J, Davidson RN
Ann Trop Med Parasitol. 2006 April 1; Volume 100 (Issue 3); DOI:10.1179/136485906X91440
The first two patients to be treated with miltefosine for post-kala-azar dermal leishmaniasis (PKDL) are reported. One was a 26-year-old Ethiopian man who had been treated with sodium stibogluconate, for relapsing visceral leishmaniasis (VL), four times between August 2002 and March 2004. In January 2004 this patient was found to be seropositive for HIV and began antiretroviral treatment with stavudine, lamivudine and nevirapine. Five months later he developed clinical PKDL, with extensive cutaneous, conjunctival and oral mucosal involvement. The second patient was a 42-year-old Ethiopian man who was treated for relapsing VL in November 2003. He too was subsequently found to be seropositive for HIV and was treated with stavudine, lamivudine and nevirapine from May 2004. He developed a nodular rash of PKDL over his face and upper body 2 weeks after starting the antiretroviral therapy. Treatment of both patients with oral miltefosine, at 100 mg/day for 28 days, led to the complete regression of their PKDL lesions. When checked 3-6 months after the end of the miltesofine treatment, neither patient showed any signs of VL, PKDL or other HIV-associated disease.
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Ann Trop Med Parasitol. 1988 October 1; Volume 82 (Issue 5); 499-502.; DOI:10.1080/00034983.1988.11812282
Brown V, Larouze B, Desve G, Rousset JJ, Thibon M, et al.
Ann Trop Med Parasitol. 1988 October 1; Volume 82 (Issue 5); 499-502.; DOI:10.1080/00034983.1988.11812282
Louse-borne relapsing fever (LBRF) is still endemic among Ethiopian populations. In order to assess the clinical presentation of LBRF in an Ethiopian refugee camp in northern Somalia, a referral system was organized for all pyrexias of unknown origin. Among the 134 patients referred, 37 showed Borrelia in fresh and stained blood smears. Common clinical features were: high fever (above 39 degrees C in 73% of the cases), headache and general body pain (88%), liver tenderness (62%), petechia (54%), nausea and vomiting (46%), chills and rigors (30%) and epistaxis (11%). Jaundice was absent. No fatalities were observed. The clinical picture was less severe than in previous studies on LBRF. This difference might be due to the fact that the present study was community-based as opposed to the previous studies which were hospital-based.
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Ann Trop Med Parasitol. 1992 October 1; Volume 86 (Issue 5); 481-486.; DOI:10.1080/00034983.1992.11812697
Seaman J, Ashford RW, Schorscher J, Dereure J
Ann Trop Med Parasitol. 1992 October 1; Volume 86 (Issue 5); 481-486.; DOI:10.1080/00034983.1992.11812697
A combination of interview, serology and skin testing was used to investigate the status of apparently healthy villagers during a visceral leishmaniasis epidemic in southern Sudan. The number of people who had died equalled the number who were alive at the time of the survey. The direct agglutination test (DAT) identified 10% of the people as being serologically positive. Most young children (36/39) and 34% (22/64) of adults had neither positive serology nor skin test. About 64% (42/66) of adults had positive skin tests. In two villages, 54% and 76% of those over four years of age showed evidence of having been infected. The mortality associated with infection was estimated as at least 69%; 25% of those infected appeared to have cured spontaneously. The outcome for the remaining 6% was still doubtful. Even in this devastating epidemic there is, therefore, evidence of a considerable amount of infection without severe disease. Serological tests, while useful clinically, are apparently not useful for detecting early cases. Combined skin testing and serology produces a comprehensive though partially hypothetical picture.