Abstract:
BACKGROUND:In the Kingdom of Saudi Arabia (KSA), Leishmania major and L. tropica are the main causative agents of Old World cutaneous leishmaniasis (CL). The national CL treatment regimen consists of topical 1% clotrimazole/2% fusidic acid cream followed by 1-2 courses of intralesional sodium stibogluconate (SSG); however, treatment efficacy is highly variable and the reasons for this are not well understood. In this study, we present a complete epidemiological map of CL and determined the efficacy of the standard CL treatment regime in several endemic regions of KSA. RESULTS:Overall, three quarters of patients in all CL-endemic areas studied responded satisfactorily to the current treatment regime, with the remaining requiring only an extra course of SSG. The majority of unresponsive cases were infected with L. tropica. Furthermore, the development of secondary infections (SI) around or within the CL lesion significantly favoured the treatment response of L. major patients but had no effect on L. tropica cases. CONCLUSIONS:The response of CL patients to a national treatment protocol appears to depend on several factors, including Leishmania parasite species, geographical location and occurrences of SI. Our findings suggest there is a need to implement alternative CL treatment protocols based on these parameters.
journal_name
Parasit Vectorsjournal_title
Parasites & vectorsauthors
Al-Salem WS,Solórzano C,Weedall GD,Dyer NA,Kelly-Hope L,Casas-Sánchez A,Alraey Y,Alyamani EJ,Halliday A,Balghonaim SM,Alsohibany KS,Alzeyadi Z,Alzahrani MH,Al-Shahrani AM,Assiri AM,Memish Z,Acosta-Serrano Ádoi
10.1186/s13071-019-3453-4subject
Has Abstractpub_date
2019-05-02 00:00:00pages
195issue
1issn
1756-3305pii
10.1186/s13071-019-3453-4journal_volume
12pub_type
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