Al-Salem, WS, Solórzano, C, Weedall, GD, Dyer, NA, Kelly-Hope, L, Casas-Sánchez, A, Alraey, Y, Alyamani, EJ, Halliday, A, Balghonaim, SM, Alsohibany, KS, Alzeyadi, Z, Alzahrani, MH, Al-Shahrani, AM, Assiri, AM, Memish, Z and Acosta-Serrano, Á (2019) Old World cutaneous leishmaniasis treatment response varies depending on parasite species, geographical location and development of secondary infection. Parasites and Vectors, 12 (1). ISSN 1756-3305

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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.

Item Type:	Article
Uncontrolled Keywords:	1108 Medical Microbiology, 1117 Public Health and Health Services
Subjects:	R Medicine > RM Therapeutics. Pharmacology
Divisions:	Natural Sciences & Psychology (closed 31 Aug 19)
Publisher:	BioMed Central
Date Deposited:	13 May 2019 10:57
Last Modified:	04 Sep 2021 09:25
DOI or ID number:	10.1186/s13071-019-3453-4
URI:	https://researchonline.ljmu.ac.uk/id/eprint/10669

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