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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.
SUBMITTER: Al-Salem WS
PROVIDER: S-EPMC6498568 | biostudies-literature | 2019 May
REPOSITORIES: biostudies-literature
Al-Salem Waleed S WS Solórzano Carla C Weedall Gareth D GD Dyer Naomi A NA Kelly-Hope Louise L Casas-Sánchez Aitor A Alraey Yasser Y Alyamani Essam J EJ Halliday Alice A Balghonaim Salah M SM Alsohibany Khalid S KS Alzeyadi Zeyad Z Alzahrani Mohamed H MH Al-Shahrani Ali M AM Assiri Abdullah M AM Memish Ziad Z Acosta-Serrano Álvaro Á
Parasites & vectors 20190502 1
<h4>Background</h4>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 t ...[more]