Tags

Type your tag names separated by a space and hit enter

Efficacy of thermotherapy to treat cutaneous leishmaniasis caused by Leishmania tropica in Kabul, Afghanistan: a randomized, controlled trial.
Clin Infect Dis. 2005 Apr 15; 40(8):1148-55.CI

Abstract

BACKGROUND

Pentavalent antimony is the agent recommended for treatment of cutaneous leishmaniasis (CL). Its use is problematic, because it is expensive and because of the potential for drug-associated adverse effects during a lengthy and painful treatment course.

METHODS

We tested the efficacy of thermotherapy for the treatment of CL due to Leishmania tropica in a randomized, controlled trial in Kabul, Afghanistan. We enrolled 401 patients with a single CL lesion and administered thermotherapy using radio-frequency waves (1 treatment of >or=1 consecutive application at 50 degrees C for 30 s) or sodium stibogluconate (SSG), administered either intralesionally (a total of 5 injections of 2-5 mL every 5-7 days, depending on lesion size) or intramuscularly (20 mg/kg daily for 21 days).

RESULTS

Cure, defined as complete reepithelialization at 100 days after treatment initiation, was observed in 75 (69.4%) of 108 patients who received thermotherapy, 70 (75.3%) of 93 patients who received intralesional SSG, and 26 (44.8%) of 58 patients who received intramuscular SSG. The OR for cure with thermotherapy was 2.80 (95% confidence interval [CI], 1.45-5.41), compared with intramuscular SSG treatment (P=.002). No statistically significant difference was observed in the odds of cure in comparison of intralesional SSG and thermotherapy treatments. The OR for cure with intralesional SSG treatment was 3.75 (95% CI, 1.86-7.54), compared with intramuscular SSG treatment (P<.001). The time to cure was significantly shorter in the thermotherapy group (median, 53 days) than in the intralesional SSG or intramuscularly SSG group (median, 75 days and >100 days, respectively; P=.003).

CONCLUSIONS

Thermotherapy is an effective, comparatively well-tolerated, and rapid treatment for CL, and it should be considered as an alternative to antimony treatment.

Authors+Show Affiliations

Malaria and Leishmaniasis Control Program, HealthNet International, University Town, Peshawar, Pakistan. rreithinger@yahoo.co.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15791515

Citation

Reithinger, R, et al. "Efficacy of Thermotherapy to Treat Cutaneous Leishmaniasis Caused By Leishmania Tropica in Kabul, Afghanistan: a Randomized, Controlled Trial." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 40, no. 8, 2005, pp. 1148-55.
Reithinger R, Mohsen M, Wahid M, et al. Efficacy of thermotherapy to treat cutaneous leishmaniasis caused by Leishmania tropica in Kabul, Afghanistan: a randomized, controlled trial. Clin Infect Dis. 2005;40(8):1148-55.
Reithinger, R., Mohsen, M., Wahid, M., Bismullah, M., Quinnell, R. J., Davies, C. R., Kolaczinski, J., & David, J. R. (2005). Efficacy of thermotherapy to treat cutaneous leishmaniasis caused by Leishmania tropica in Kabul, Afghanistan: a randomized, controlled trial. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 40(8), 1148-55.
Reithinger R, et al. Efficacy of Thermotherapy to Treat Cutaneous Leishmaniasis Caused By Leishmania Tropica in Kabul, Afghanistan: a Randomized, Controlled Trial. Clin Infect Dis. 2005 Apr 15;40(8):1148-55. PubMed PMID: 15791515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of thermotherapy to treat cutaneous leishmaniasis caused by Leishmania tropica in Kabul, Afghanistan: a randomized, controlled trial. AU - Reithinger,R, AU - Mohsen,M, AU - Wahid,M, AU - Bismullah,M, AU - Quinnell,R J, AU - Davies,C R, AU - Kolaczinski,J, AU - David,J R, Y1 - 2005/03/16/ PY - 2004/11/11/received PY - 2004/12/07/accepted PY - 2005/3/26/pubmed PY - 2006/10/7/medline PY - 2005/3/26/entrez SP - 1148 EP - 55 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 40 IS - 8 N2 - BACKGROUND: Pentavalent antimony is the agent recommended for treatment of cutaneous leishmaniasis (CL). Its use is problematic, because it is expensive and because of the potential for drug-associated adverse effects during a lengthy and painful treatment course. METHODS: We tested the efficacy of thermotherapy for the treatment of CL due to Leishmania tropica in a randomized, controlled trial in Kabul, Afghanistan. We enrolled 401 patients with a single CL lesion and administered thermotherapy using radio-frequency waves (1 treatment of >or=1 consecutive application at 50 degrees C for 30 s) or sodium stibogluconate (SSG), administered either intralesionally (a total of 5 injections of 2-5 mL every 5-7 days, depending on lesion size) or intramuscularly (20 mg/kg daily for 21 days). RESULTS: Cure, defined as complete reepithelialization at 100 days after treatment initiation, was observed in 75 (69.4%) of 108 patients who received thermotherapy, 70 (75.3%) of 93 patients who received intralesional SSG, and 26 (44.8%) of 58 patients who received intramuscular SSG. The OR for cure with thermotherapy was 2.80 (95% confidence interval [CI], 1.45-5.41), compared with intramuscular SSG treatment (P=.002). No statistically significant difference was observed in the odds of cure in comparison of intralesional SSG and thermotherapy treatments. The OR for cure with intralesional SSG treatment was 3.75 (95% CI, 1.86-7.54), compared with intramuscular SSG treatment (P<.001). The time to cure was significantly shorter in the thermotherapy group (median, 53 days) than in the intralesional SSG or intramuscularly SSG group (median, 75 days and >100 days, respectively; P=.003). CONCLUSIONS: Thermotherapy is an effective, comparatively well-tolerated, and rapid treatment for CL, and it should be considered as an alternative to antimony treatment. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/15791515/Efficacy_of_thermotherapy_to_treat_cutaneous_leishmaniasis_caused_by_Leishmania_tropica_in_Kabul_Afghanistan:_a_randomized_controlled_trial_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/428736 DB - PRIME DP - Unbound Medicine ER -