Who Is a Typical Patient with Visceral Leishmaniasis? Characterizing the Demographic and Nutritional Profile of Patients in Brazil, East Africa, and South Asia

Abstract

Drug-dosing recommendations for visceral leishmaniasis (VL) treatment are based on the patients' weight or age. A current lack of demographic and anthropometric data on patients hinders (1) the ability of health providers to properly prepare for patient management, (2) an informed drug procurement for disease control, and (3) the design of clinical trials and development of new drug therapies in the different endemic areas. We present information about the age, gender, weight, and height of 29,570 consecutive VL patients presenting to 20 locations in six geographic endemic regions of Brazil, East Africa, Nepal, and India between 1997 and 2009. Our compilation shows substantial heterogeneity in the types of patients seeking care for VL at the clinics within the different locations. This suggests that drug development, procurement, and perhaps even treatment protocols, such as the use of the potentially teratogenic drug miltefosine, may require distinct strategies in these geographic settings.

Nutritional Status of Adult Kala-azar Patients and Associated Factors in North West, Ethiopia

“…The high magnitude of malnutrition among kala-azar patients was in agreement with the results reported from Nepal (71%), and Uganda (80%), but higher than a study conducted from North Sudan (61.9%) and India (60%) [6,10]. This could be explained by the inadequate infrastructure of the area, which could affect the socio economic status, and health coverage of the residents.…”

“…The magnitude of malnutrition was lower than the prevalence reported from Northwest Ethiopia which was 95.5% and south Sudan (92.6%) [6,11]. This could be because of the seasonal variation in which the research was conducted, people become more malnourished during rainy season, this is because people may experience hunger, increased physical activity and diarrheal diseases, malaria, and respiratory tract infections are more prevalent during this season [12,13].…”

“…All adult Kala-azar patients whose age is >19 years old were included in the study whereas pregnant women, patients with abdominal mass or ascites or patients who are bedridden were excluded from the study. Open epi software was used to calculate sample size using the single population proportion formula by assuming the estimated proportion of malnutrition among kala-azar patients from North Sudan (P)=62% [6], 5% degree of precision, 95% confidence level. Thus, considering a 5% non-response rate the final sample size becomes 383.…”

Space-time cluster analysis of American visceral leishmaniasis in Bauru, São Paulo State, Brazil

“…It should be noted that cases occurring at the same location (i.e., in the same block), are represented by a single point. 16 . Despite being a common finding, the explanation for this trend remains uncertain.…”

Vanadium Complexes Are in vitro Inhibitors of Leishmania Secreted Acid Phosphatases

“…Current treatments also have substantial side effects; these side effects may be related to the similarity of cell biology of protozoan parasites to other eukaryotic cells thus increasing toxicity risks. Owing to the large association of this disease with poverty and rural regions, these treatments may not always be available, and there continues to be many chemotherapy challenges (Berman, 1997;Pathak & Batra, 2009;Croft & Buffet, 2011;Harhay et al, 2011). Thus, the study of other viable therapy directions is important.…”