Este estudo identificou características da população associadas com reações adversas laboratoriais e eletrocardiográficas em pacientes durante o tratamento de leishmaniose tegumentar. Os efeitos adversos foram monitorados em prontuário médico de pacientes em Hospital Universitário no Brasil. Os resultados mostraram que dos 470 prontuários analisados, 367 (78,09%) eram homens, 249 (52,98%) dos pacientes tinham educação fundamental incompleta e 438 (93,19%) se identificaram como pardos. O efeito adverso mais frequente foi a alteração no eletrocardiograma (85,48%). As variáveis mais prevalentes associadas com os efeitos adversos foram idade acima de 60 anos (RP = 9,79/IC95% = 5,86 – 16,34), leishmaniose mucosa (RP = 2,45/IC95% = 1,55 – 3,86), doenças pré-existentes (RP = 5,44/IC95% = 3,52 – 8,40), uso de anfotericina B (RP = 18,31/IC95% = 9,26 – 36,21) e pentamidina (RP = 25,51/IC95% = 15,08 – 43,14) como tratamento de primeira escolha. Entre os indivíduos com doenças pré-existentes, 74,03% (n=57) foram hipertensos e 24,59% (n=14) dos pacientes com hipertensão tinham algum tipo de efeito adverso. O conhecimento do perfil da população com leishmaniose tegumentar é importante para o desenvolvimento de novas estratégias para prevenção e redução das reações adversas, levando a um tratamento mais efetivo e rápido. Palavras-chave: Efeitos Adversos. Anfotericina B. Pentamidina. Antimonial Pentavalente. Abstract This study identified population characteristics associated with laboratory and electrocardiographic adverse reactions in patients during the treatment of tegumentary leishmaniasis. Side effects were monitored in patients’ medical record in the University Hospital, Brazil. The results show that of the 470 records analyzed, 367 (78.09%) were from males, 249 (52.98%) of the patients had incomplete elementary education and 438 (93.19%) identified themselves as brown skinned. The most frequent was alterations in the electrocardiogram (85.48%). The most prevalent variables associated with adverse effects were age above 60 years old (PR = 9.79/CI95% = 5.86 – 16.34), mucosal leishmaniasis (PR = 2.45/CI95% = 1.55 – 3.86), pre-existing diseases (PR = 5.44/CI95% = 3.52 – 8.40), use of amphotericin B (PR = 18.31/CI95% = 9.26 – 36.21) and pentamidine (PR = 25.51/CI95% = 15.08 – 43.14) as first treatment choice. Among individuals with pre-existing disease, 74.03% (n=57) are hypertensive and 24.59% (n=14) of patients with hypertension had some type of adverse effect. In conclusion, although the treatments have achieved high rate of cure, this study identified socio-demographic and health characteristics associated with adverse effects in patients leishmaniasis treatment. Knowledge of the population profile with tegumentary leishmaniasis is important for the development of new strategies for prevention and reduction of adverse reactions. Keywords: Adverse Effects. Amphotericin B. Pentamidine. Pentavalent Antimonial.
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RESUMOA leishmaniose está presente em diversos estados no Brasil, caracterizando um grave problema de saúde pública. É uma doença infecciosa, não contagiosa, crônica, causada pelo protozoário do gênero Leishmania. Pode assumir formas graves e letais quando não diagnosticada e tratada corretamente. É uma zoonose comum ao homem e animais. A terapia existente para leishmaniose apresenta importantes limitações em termos de segurança, pois a maioria das drogas leishmanicidas apresenta efeitos colaterais graves. O tratamento é longo, doloroso e muitas vezes necessitam de hospitalização. Recentemente, melhoramentos foram alcançados através da terapia de combinação: a redução do tempo, a duração do tratamento, a diminuição do tempo de hospitalização e a carga no sistema de saúde. No entanto, a identificação de novas drogas ainda é urgentemente necessária. ABSTRACTLeishmaniasis is present in several states in Brazil, seeing a serious public health problem. It is an infectious, non-contagious, chronic disease caused by the protozoan of the genus Leishmania. It can take severe and lethal forms when not diagnosed and treated properly and is a zoonosis common to man and animals. The therapy for leishmaniasis has important safety limitations, as most leishmanicides have serious side effects. The treatment is long, painful and often require hospitalization. Recently, improvements have been achieved through combination therapy: reduction of time, duration of treatment, reduction of hospitalization time and burden on the health system. However, identification of new drugs is still urgently needed.
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