Monitoring the response of patients with cutaneous leishmaniasis to treatment with pentamidine isethionate by quantitative real-time PCR, and identification of<i>Leishmania</i>parasites not responding to therapy

Mans, Dennis R.A.; Kent, Alida D.; Hu, Ricardo V. P. F.; Fat, E. J. Lai A.; Schoone, Gerard J.; Adams, Emily R.; Rood, Ente; Alba, Sandra; Sabajo, Leslie O. A.; Fat, R. F. Lai A; Vries, Henry J. C. de; Schallig, Henk D. F. H.

doi:10.1111/ced.12786

Cited by 8 publications

(10 citation statements)

References 22 publications

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“…In Suriname CL is endemic and a major concern to public health. The disease is generally known in Suriname as ‘bosyaws’ or ‘busi yasi’ - meaning ‘disease from the jungle’ – and is mainly caused by L. ( V. ) guyanensis , but other infecting species, such as L. naiffi, L. braziliensis and L. amazonensis are also reported [4, 5]. CL is widespread in the country’s interior, where it mainly affects young males involved in mining, logging and tourism operations, at an annual rate of 6/1000 [6].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of point of care tests for the diagnosis of cutaneous leishmaniasis in Suriname

Schallig

Kent

et al. 2019

BMC Infect Dis

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BackgroundCutaneous leishmaniasis (CL) is a serious health problem in Suriname. To expand the diagnostic options, two newly developed diagnostic tests, i.e. the rapid diagnostic test CL Detect™ Rapid Test (CL Detect) and the Loopamp™ Leishmania Detection Kit (Loopamp) were evaluated.MethodsDiagnostic test performance was compared to the routine diagnostic approach in place, i.e. clinical symptoms combined with microscopy, and to polymerase chain reaction (PCR), which was used as a reference standard. The study population (n = 93) was a typical representation of the CL affected population in Suriname and mainly infected with Leishmania guyanensis.ResultsCL Detect had a very low sensitivity compared to microscopy (36.7%) or PCR (35.8%), due to a high number of false negative results. The specificity of the CL Detect compared to microscopy and PCR was 85.7 and 83.3% respectively. Loopamp sensitivity was 84.8% compared to microscopy and 91.4% compared to PCR. The Loopamp test had a moderate specificity (42.9%) compared to microscopy, but a good specificity compared to PCR (91.7%).ConclusionThe CL Detect is not likely to be a good replacement for the routine diagnostic procedure for CL in Suriname. The high sensitivity of the easy to perform Loopamp enables the implementation of sensitive molecular diagnosis in resource limited settings.

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Section: Introductionmentioning

confidence: 99%

“…CL is widespread in the country’s interior, where it mainly affects young males involved in mining, logging and tourism operations, at an annual rate of 6/1000 [6]. Pentamidine isethionate (PI) is the first-line and the only available drug against CL in Suriname, but treatment failures are increasingly reported [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of point of care tests for the diagnosis of cutaneous leishmaniasis in Suriname

Schallig

Kent

et al. 2019

BMC Infect Dis

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“…In Suriname, pentamidine isethionate is in use since 1994 and is the only treatment option for CL by L. (V.) guyanensis [109]. It is given as 3 intramuscular injections of 300 mg in 7 days [109] but is not effective in about 25% of CL patients [109,111,112]. The possibility that the unsatisfactory responses were attributable to infections by unreposive varaiants of L. (V.) guyanensis, unresponsive Leishmania species other than L. (V.) guyanensis, and/or poor therapy compliance needs to be verified.…”

Section: Treatmentmentioning

confidence: 99%

“…It is given as three intramuscular injections of 300 mg on days 1, 4, and 7 [109,165]. The infection responds in general favorably to pentamidine isethionate [109,110] if not resolving spontaneously [54,83,84], but, as mentioned above, accomplishes cures in only about 75% of patients [112,165]. This suggests that some of the infections may be caused by Leishmania species other than L. (V.) guyanensis which do not respond to pentamidine isethionate [159,[164][165][166].…”

Section: Leishmania Species In Surinamementioning

confidence: 99%

“…CL is the main manifestation of leishmaniasis in Suriname [109,112,159,165] [159,165,166]. As both parasite species have also been associated with more serious forms of leishmaniasis [35,176,[211][212][213]235], it is necessary to develop and implement proper measures for diagnosing and treating cases of MCL that may emerge in the country.…”

Section: Future Directionsmentioning

confidence: 99%

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Epidemiological, Biological and Clinical Aspects of Leishmaniasis with Special Emphasis on Busi Yasi in Suriname

Mans¹,

Kent²,

Hu³

et al. 2017

J Clin Exp Dermatol Res

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The parasitic disease leishmaniasis is caused by protozoa of the genus Leishmania which are transmitted by sand fly vectors of the genus Phlebotomus in the Old World and Lutzomyia in the New World. Transmission can either be anthroponotic (human to human) or zoonotic through mammalian reservoirs such as dogs and rodents. Leishmaniasis has three principal clinical manifestations, namely cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL). The cutaneous form characteristically causes skin ulcers, the mucocutaneous form manifests as lesions of skin, mouth, and nose, and the (potentially lethal) visceral form affects the internal organs such as spleen and liver and also invades the bone marrow. Leishmaniasis is endemic in about ninety-eight countries and the diverse types of the disease occur in different regions of the world. CL is most common in Afghanistan, Algeria, Pakistan, Iran, Brazil, and Colombia; MCL is mainly restricted to countries of the Amazon Basin; and VL is most frequently seen in the Indian sub-continent, the Horn of Africa (Sudan and Ethiopia), and Brazil. The current global prevalence is estimated at about 12 million, and each year, the disease in one of its forms makes about 2 million new victims and claims up to 50,000 fatalities. This paper presents epidemiological, biological, and clinical aspects of leishmaniasis throughout the world; then focuses on the disease in the Republic of Suriname (South America); addresses in more detail the species of Leishmania parasites in that country; and concludes with potential future directions to improve our understanding of leishmaniasis in Suriname.

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Cutaneous Leishmaniasis: A 2022 Updated Narrative Review into Diagnosis and Management Developments

2022

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This review is an update of an earlier narrative review published in 2015 on developments in the clinical management of cutaneous leishmaniasis (CL) including diagnosis, treatment, prevention and control measurements. CL is a vector-borne infection caused by the protozoan parasite Leishmania . The vector is the female sandfly. Globally, CL affects 12 million cases and annually 2 million new cases occur. CL is endemic in almost 100 countries and the total risk population is approximately 350 million people. WHO lists CL an emerging and uncontrolled disease and a neglected tropical disease. Local experience-based evidence remains the mainstay for the management of CL. Whereas intralesional therapeutic options are the first treatment option for most CL patients, those with mucocutaneous and disseminated involvement require a systemic therapeutic approach. Moreover, different Leishmania species can vary in their treatment outcomes. Therefore, species determination is critical for optimal CL clinical management. New DNA techniques allow for relatively easy Leishmania species determination, yet they are not easily implemented in resource-limited settings. There is a desperate need for novel, less toxic, and less painful treatment options, especially for children with CL. Yet, the large and well conducted studies required to provide the necessary evidence are lacking. To further control and potentially eliminate CL, we urgently need to improve vector control, and diagnostics, and we require efficient and safe vaccines. Alas, since CL primarily affects poor people, biotechnical companies dedicate little investment into the research programs that could lead to diagnostic, pharmaceutical, and vaccine innovations.

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Monitoring the response of patients with cutaneous leishmaniasis to treatment with pentamidine isethionate by quantitative real-time PCR, and identification ofLeishmaniaparasites not responding to therapy

Cited by 8 publications

References 22 publications

Evaluation of point of care tests for the diagnosis of cutaneous leishmaniasis in Suriname

Evaluation of point of care tests for the diagnosis of cutaneous leishmaniasis in Suriname

Epidemiological, Biological and Clinical Aspects of Leishmaniasis with Special Emphasis on Busi Yasi in Suriname

Cutaneous Leishmaniasis: A 2022 Updated Narrative Review into Diagnosis and Management Developments

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