A Randomized Controlled Double Blind Trial of Ciclosporin versus Prednisolone in the Management of Leprosy Patients with New Type 1 Reaction, in Ethiopia.


BACKGROUND:Leprosy Type 1 (T1R) reactions are immune-mediated events leading to nerve damage and preventable disability affecting hands, feet and eyes. Type 1 Reactions are treated with oral corticosteroids. There is little evidence on alternative treatments for patients who do not respond to steroids or experience steroid adverse effects. We report the results of a randomized controlled trial testing the efficacy and adverse effect profile of ciclosporin and prednisolone (CnP) in comparison to prednisolone only (P) in patients with new T1R in Ethiopia. Ciclosporin is a potent immunosuppressant. Outcomes were measured using a clinical severity score, recurrence rate, adverse events and quality of life. RESULTS:Seventy three patients with new T1R were randomized to receive CnP or P for 20 weeks. Recovery rates in skin signs was similar in both groups (91% vs 88%). Improvements in nerve function both, new and old, sensory (66% vs 49%) and motor (75% vs 74%) loss were higher (but not significantly so) in the patients on CnP. Recurrences rates of T1R (85%) were high in both groups, and recurrences occurred significantly earlier (8 weeks) in patients CnP, who needed 10% more additional prednisolone. Serious major and minor adverse events rates were similar in patients in the two treatment arms of the study. Both groups had a significant improvement in their quality of life after the study, measured by the SF-36. CONCLUSIONS:This is the first double-blind RCT assessing ciclosporin, in the management of T1R in Africa. Ciclosporin could be a safe alternative second-line drug for patients with T1R who are not improving with prednisolone or are experiencing adverse events related to prednisolone. This study illustrates the difficulty in switching off leprosy inflammation. Better treatment agents for leprosy patients with reactions and nerve damage are needed.


PLoS Negl Trop Dis


Lambert SM,Alembo DT,Nigusse SD,Yamuah LK,Walker SL,Lockwood DN




Has Abstract


2016-04-05 00:00:00














  • Detection of venom after antivenom is not associated with persistent coagulopathy in a prospective cohort of Russell's viper (Daboia russelii) envenomings.

    abstract:BACKGROUND:Venom recurrence or persistence in the circulation after antivenom treatment has been documented many times in viper envenoming. However, it has not been associated with clinical recurrence for many snakes, including Russell's viper (Daboia spp.). We compare the recovery of coagulopathy to the recurrence or ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Maduwage K,O'Leary MA,Scorgie FE,Shahmy S,Mohamed F,Abeysinghe C,Karunathilake H,Lincz LF,Gnanathasan CA,Isbister GK

    更新日期:2014-12-18 00:00:00

  • Melioidosis in Malaysia: A Review of Case Reports.

    abstract:BACKGROUND:Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. OBJECTIVE:We sought to review case reports of melioidosis from Malaysia. METHODS:We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRA...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,评审


    authors: Kingsley PV,Leader M,Nagodawithana NS,Tipre M,Sathiakumar N

    更新日期:2016-12-22 00:00:00

  • Evaluation of nephroprotective and immunomodulatory activities of antioxidants in combination with cisplatin against murine visceral leishmaniasis.

    abstract:BACKGROUND:Most available drugs against visceral leishmaniasis are toxic, and growing limitations in available chemotherapeutic strategies due to emerging resistant strains and lack of an effective vaccine against visceral leishmaniasis deepens the crisis. Antineoplastic drugs like miltefosine have in the past been eff...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Sharma M,Sehgal R,Kaur S

    更新日期:2012-01-01 00:00:00

  • Evaluation of ocular involvement in patients with Hansen's disease.

    abstract::Hansen's disease (HD) belongs to the group of neglected diseases and can cause physical deformities and disabilities, in addition to leading to social discrimination. Ocular involvement in HD is estimated at 70-75% worldwide. About 10-50% suffer from severe ocular symptoms and loss of vision occurs in approximately 5%...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Pavezzi PD,do Prado RB,Boin Filho PÂ,Gon ADS,Tuma B,Fornazieri MA,Scalone FM,Alves LRM,Montero RH,Casella AMB

    更新日期:2020-09-21 00:00:00

  • Risk factors for Cryptosporidium infection in low and middle income countries: A systematic review and meta-analysis.

    abstract:BACKGROUND:Cryptosporidium infection causes gastrointestinal disease and has a worldwide distribution. The highest burden is in developing countries. OBJECTIVES:We sought to conduct a systematic review and meta-analysis to identify Cryptosporidium risk factors in Low and Middle Income countries (LMICs). METHODS:Medli...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,meta分析,评审


    authors: Bouzid M,Kintz E,Hunter PR

    更新日期:2018-06-07 00:00:00

  • Impacts of host gender on Schistosoma mansoni risk in rural Uganda-A mixed-methods approach.

    abstract:BACKGROUND:The World Health Organization identified Uganda as one of the 10 highly endemic countries for schistosomiasis. Annual mass drug administration (MDA) with praziquantel has led to a decline in intensity of Schistosoma mansoni infections in several areas. However, as hotspots with high (re)infection rates remai...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Trienekens SCM,Faust CL,Meginnis K,Pickering L,Ericsson O,Nankasi A,Moses A,Tukahebwa EM,Lamberton PHL

    更新日期:2020-05-13 00:00:00

  • Correction: Trypanosoma brucei CYP51: Essentiality and Targeting Therapy in an Experimental Model.

    abstract::[This corrects the article DOI: 10.1371/journal.pntd.0005125.]. ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 已发布勘误


    authors: PLOS Neglected Tropical Diseases Staff.

    更新日期:2017-01-31 00:00:00

  • Leishmania-specific surface antigens show sub-genus sequence variation and immune recognition.

    abstract:BACKGROUND:A family of hydrophilic acylated surface (HASP) proteins, containing extensive and variant amino acid repeats, is expressed at the plasma membrane in infective extracellular (metacyclic) and intracellular (amastigote) stages of Old World Leishmania species. While HASPs are antigenic in the host and can induc...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Depledge DP,MacLean LM,Hodgkinson MR,Smith BA,Jackson AP,Ma S,Uliana SR,Smith DF

    更新日期:2010-09-28 00:00:00

  • Distribution of Dengue Virus Types 1 and 4 in Blood Components from Infected Blood Donors from Puerto Rico.

    abstract:BACKGROUND:Dengue is a mosquito-borne viral disease caused by the four dengue viruses (DENV-1 to 4) that can also be transmitted by blood transfusion and organ transplantation. The distribution of DENV in the components of blood from infected donors is poorly understood. METHODS:We used an in-house TaqMan qRT-PCR assa...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Añez G,Heisey DA,Chancey C,Fares RC,Espina LM,Souza KP,Teixeira-Carvalho A,Krysztof DE,Foster GA,Stramer SL,Rios M

    更新日期:2016-02-12 00:00:00

  • Indoleamine 2,3-dioxygenase controls fungal loads and immunity in Paracoccidioidomicosis but is more important to susceptible than resistant hosts.

    abstract:BACKGROUND:Paracoccidioidomycosis, a primary fungal infection restricted to Latin America, is acquired by inhalation of fungal particles. The immunoregulatory mechanisms that control the severe and mild forms of paracoccidioidomycosis are still unclear. Indoleamine 2,3-dioxygenase (IDO), an IFN-γ induced enzyme that ca...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Araújo EF,Loures FV,Bazan SB,Feriotti C,Pina A,Schanoski AS,Costa TA,Calich VL

    更新日期:2014-11-20 00:00:00

  • Immunization of mice with recombinant mosquito salivary protein D7 enhances mortality from subsequent West Nile virus infection via mosquito bite.

    abstract:BACKGROUND:Mosquito salivary proteins (MSPs) modulate the host immune response, leading to enhancement of arboviral infections. Identification of proteins in saliva responsible for immunomodulation and counteracting their effects on host immune response is a potential strategy to protect against arboviral disease. We s...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Reagan KL,Machain-Williams C,Wang T,Blair CD

    更新日期:2012-01-01 00:00:00

  • Optimization of a Membrane Feeding Assay for Plasmodium vivax Infection in Anopheles albimanus.

    abstract:INTRODUCTION:Individuals exposed to malaria infections for a long time develop immune responses capable of blocking Plasmodium transmission to mosquito vectors, potentially limiting parasite spreading in nature. Development of a malaria TB vaccine requires a better understanding of the mechanisms and main effectors res...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Vallejo AF,Rubiano K,Amado A,Krystosik AR,Herrera S,Arévalo-Herrera M

    更新日期:2016-06-29 00:00:00

  • Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS).

    abstract:BACKGROUND:Cryptosporidium is a leading cause of moderate-to-severe diarrhea (MSD) in young children in Africa. We examined factors associated with Cryptosporidium infection in MSD cases enrolled at the rural western Kenya Global Enteric Multicenter Study (GEMS) site from 2008-2012. METHODOLOGY/PRINCIPAL FINDINGS:At h...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,多中心研究


    authors: Delahoy MJ,Omore R,Ayers TL,Schilling KA,Blackstock AJ,Ochieng JB,Moke F,Jaron P,Awuor A,Okonji C,Juma J,Farag TH,Nasrin D,Panchalingam S,Nataro JP,Kotloff KL,Levine MM,Oundo J,Roellig DM,Xiao L,Parsons MB,Laser

    更新日期:2018-07-12 00:00:00

  • Molecular xenomonitoring for Wuchereria bancrofti in Culex quinquefasciatus in two districts in Bangladesh supports transmission assessment survey findings.

    abstract:BACKGROUND:Careful monitoring for recrudescence of Wuchereria bancrofti infection is necessary in communities where mass drug administration (MDA) for the elimination of lymphatic filariasis (LF) as a public health problem has been stopped. During the post-MDA period, transmission assessment surveys (TAS) are recommend...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Irish SR,Al-Amin HM,Paulin HN,Mahmood ASMS,Khan RK,Muraduzzaman AKM,Worrell CM,Flora MS,Karim MJ,Shirin T,Shamsuzzaman AKM,Tahmina S,Lenhart A,Dubray C

    更新日期:2018-07-26 00:00:00

  • Cinnamomum cassia exhibits antileishmanial activity against Leishmania donovani infection in vitro and in vivo.

    abstract:BACKGROUND:There is a pressing need for drug discovery against visceral leishmaniasis, a life-threatening protozoal infection, as the available chemotherapy is antiquated and not bereft of side effects. Plants as alternate drug resources has rewarded mankind in the past and aimed in this direction, we investigated the ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Afrin F,Chouhan G,Islamuddin M,Want MY,Ozbak HA,Hemeg HA

    更新日期:2019-05-09 00:00:00

  • Hyperendemic dengue transmission and identification of a locally evolved DENV-3 lineage, Papua New Guinea 2007-2010.

    abstract:BACKGROUND:Dengue is endemic in the Western Pacific and Oceania and the region reports more than 200,000 cases annually. Outbreaks of dengue and severe dengue occur regularly and movement of virus throughout the region has been reported. Disease surveillance systems, however, in many areas are not fully established and...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Luang-Suarkia D,Mitja O,Ernst T,Bennett S,Tay A,Hays R,Smith DW,Imrie A

    更新日期:2018-03-01 00:00:00

  • Protection conferred by typhoid fever against recurrent typhoid fever in urban Kolkata.

    abstract::We evaluated the protection conferred by a first documented visit for clinical care of typhoid fever against recurrent typhoid fever prompting a visit. This study takes advantage of multi-year follow-up of a population with endemic typhoid participating in a cluster-randomized control trial of Vi capsular polysacchari...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,随机对照试验


    authors: Im J,Islam MT,Kim DR,Ahmmed F,Chon Y,Zaman K,Khan AI,Ali M,Sur D,Kanungo S,Dutta S,Bhattacharya SK,Dougan G,Holt KE,Marks F,Kim JH,Qadri F,Clemens JD

    更新日期:2020-08-17 00:00:00

  • Rapid identification of paragonimiasis foci by lay informants in Lao People's Democratic Republic.

    abstract:BACKGROUND:Paragonimiasis is a food-borne trematodiasis leading to lung disease. Worldwide, an estimated 21 million people are infected. Foci of ongoing transmission remain often unnoticed. We evaluated a simple questionnaire approach using lay-informants at the village level to identify paragonimiasis foci and suspect...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Odermatt P,Veasna D,Zhang W,Vannavong N,Phrommala S,Habe S,Barennes H,Strobel M

    更新日期:2009-09-22 00:00:00

  • Mixed Th1 and Th2 Mycobacterium tuberculosis-specific CD4 T cell responses in patients with active pulmonary tuberculosis from Tanzania.

    abstract::Mycobacterium tuberculosis (Mtb) and helminth infections elicit antagonistic immune effector functions and are co-endemic in several regions of the world. We therefore hypothesized that helminth infection may influence Mtb-specific T-cell immune responses. We evaluated the cytokine profile of Mtb-specific T cells in 7...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Amelio P,Portevin D,Reither K,Mhimbira F,Mpina M,Tumbo A,Nickel B,Marti H,Knopp S,Ding S,Penn-Nicholson A,Darboe F,Ohmiti K,Scriba TJ,Pantaleo G,Daubenberger C,Perreau M

    更新日期:2017-07-31 00:00:00

  • Development of a single nucleotide polymorphism barcode to genotype Plasmodium vivax infections.

    abstract::Plasmodium vivax, one of the five species of Plasmodium parasites that cause human malaria, is responsible for 25-40% of malaria cases worldwide. Malaria global elimination efforts will benefit from accurate and effective genotyping tools that will provide insight into the population genetics and diversity of this par...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Baniecki ML,Faust AL,Schaffner SF,Park DJ,Galinsky K,Daniels RF,Hamilton E,Ferreira MU,Karunaweera ND,Serre D,Zimmerman PA,Sá JM,Wellems TE,Musset L,Legrand E,Melnikov A,Neafsey DE,Volkman SK,Wirth DF,Sabeti PC

    更新日期:2015-03-17 00:00:00

  • High throughput selection of effective serodiagnostics for Trypanosoma cruzi infection.

    abstract:BACKGROUND:Diagnosis of Trypanosoma cruzi infection by direct pathogen detection is complicated by the low parasite burden in subjects persistently infected with this agent of human Chagas disease. Determination of infection status by serological analysis has also been faulty, largely due to the lack of well-characteri...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Cooley G,Etheridge RD,Boehlke C,Bundy B,Weatherly DB,Minning T,Haney M,Postan M,Laucella S,Tarleton RL

    更新日期:2008-10-08 00:00:00

  • Mild manifestations of COVID-19 in healthcare workers.

    abstract::Medical staff treating Coronavirus Disease 2019 (COVID-19) patients are at high risk for exposure to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and many have been infected, which may cause panic among medical workers, their relatives, health professionals, and government leaders. We report the epide...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Li J,Long X,Zhang Q,Fang X,Li N,Lin Z,Li J,Xiong N

    更新日期:2020-12-22 00:00:00

  • In Vivo MRI Assessment of Hepatic and Splenic Disease in a Murine Model of Schistosomiasis [corrected].

    abstract:BACKGROUND:Schistosomiasis (or bilharzia), a major parasitic disease, affects more than 260 million people worldwide. In chronic cases of intestinal schistosomiasis caused by trematodes of the Schistosoma genus, hepatic fibrosis develops as a host immune response to the helminth eggs, followed by potentially lethal por...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Masi B,Perles-Barbacaru TA,Laprie C,Dessein H,Bernard M,Dessein A,Viola A

    更新日期:2015-09-22 00:00:00

  • Infrared fluorescent imaging as a potent tool for in vitro, ex vivo and in vivo models of visceral leishmaniasis.

    abstract:BACKGROUND:Visceral leishmaniasis (VL) is hypoendemic in the Mediterranean region, where it is caused by the protozoan Leishmania infantum. An effective vaccine for humans is not yet available and the severe side-effects of the drugs in clinical use, linked to the parenteral administration route of most of them, are si...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Calvo-Álvarez E,Stamatakis K,Punzón C,Álvarez-Velilla R,Tejería A,Escudero-Martínez JM,Pérez-Pertejo Y,Fresno M,Balaña-Fouce R,Reguera RM

    更新日期:2015-03-31 00:00:00

  • Temporal-spatial distribution characteristics of leprosy: A new challenge for leprosy prevention and control in Zhejiang, China.

    abstract:BACKGROUND:After the elimination of leprosy in 1995, there were 10-30 newly detected leprosy cases every year in Zhejiang Province, and the epidemiological characteristics of the newly detected leprosy cases have changed. While most of the newly detected cases came from other provinces in China, not Zhejiang, it brough...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Wu L,Shen Y,Yao Q,Sang X,Fei L,Kong W,Huang Y,Wang Y,Zeng F,Du N

    更新日期:2021-01-07 00:00:00

  • Potent inhibition of Junín virus infection by interferon in murine cells.

    abstract::The new world arenavirus Junín virus (JUNV) is the causative agent of Argentine hemorrhagic fever, a lethal human infectious disease. Adult laboratory mice are generally resistant to peripheral infection by JUNV. The mechanism underlying the mouse resistance to JUNV infection is largely unknown. We have reported that ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Huang C,Walker AG,Grant AM,Kolokoltsova OA,Yun NE,Seregin AV,Paessler S

    更新日期:2014-06-05 00:00:00

  • The iron distribution and magnetic properties of schistosome eggshells: implications for improved diagnostics.

    abstract:BACKGROUND:Schistosoma mansoni and Schistosoma japonicum are the most frequent causative agents of human intestinal schistosomiasis. Approximately 200 million people in the world are infected with schistosomes. Diagnosis of schistosomiasis is often difficult. High percentages of low level infections are missed in routi...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Karl S,Gutiérrez L,Lucyk-Maurer R,Kerr R,Candido RR,Toh SQ,Saunders M,Shaw JA,Suvorova A,Hofmann A,House MJ,Woodward RC,Graeff-Teixera C,St Pierre TG,Jones MK

    更新日期:2013-05-16 00:00:00

  • A Four-Point Screening Method for Assessing Molecular Mechanism of Action (MMOA) Identifies Tideglusib as a Time-Dependent Inhibitor of Trypanosoma brucei GSK3β.

    abstract:BACKGROUND:New therapeutics are needed for neglected tropical diseases including Human African trypanosomiasis (HAT), a progressive and fatal disease caused by the protozoan parasites Trypanosoma brucei gambiense and T. b. rhodesiense. There is a need for simple, efficient, cost effective methods to identify new molecu...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Swinney ZT,Haubrich BA,Xia S,Ramesha C,Gomez SR,Guyett P,Mensa-Wilmot K,Swinney DC

    更新日期:2016-03-04 00:00:00

  • Oxidative stress and DNA lesions: the role of 8-oxoguanine lesions in Trypanosoma cruzi cell viability.

    abstract::The main consequence of oxidative stress is the formation of DNA lesions, which can result in genomic instability and lead to cell death. Guanine is the base that is most susceptible to oxidation, due to its low redox potential, and 8-oxoguanine (8-oxoG) is the most common lesion. These characteristics make 8-oxoG a g...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Aguiar PH,Furtado C,Repolês BM,Ribeiro GA,Mendes IC,Peloso EF,Gadelha FR,Macedo AM,Franco GR,Pena SD,Teixeira SM,Vieira LQ,Guarneri AA,Andrade LO,Machado CR

    更新日期:2013-06-13 00:00:00

  • Epidemiological characterization of incident cases of Rickettsia infection in rural areas of Urabá region, Colombia.

    abstract:INTRODUCTION:Most of the studies related to rickettsial infection in Colombia are cross-sectional because of the challenge in conducting prospective studies on infectious disease that may have a difficult diagnosis. Although cross-sectional studies are essential to detect people exposed to rickettsiae, they are not sui...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Quintero Vélez JC,Aguirre-Acevedo DC,Rodas JD,Arboleda M,Troyo A,Vega Aguilar F,Osorio Quintero L,Rojas Arbeláez C

    更新日期:2018-10-31 00:00:00