• Access to liposomal generic formulations: beyond AmBisome and Doxil/Caelyx

      Gaspani, Sara (Pro Pharma Communications International, 2014-04-18)
      The lack of clear regulatory guidance remains a key bottleneck for securing a second quality-assured source of liposomal amphotericin B (LAmB), the WHO-recommended drug for visceral leishmaniasis. The approval of the first generic liposomal product by the US Food and Drug Administration in February 2013 could be a turning point, and serve as a basis for WHO to develop guidance for the evaluation of generic liposomal formulations.
    • Active and passive case detection strategies for the control of leishmaniasis in Bangladesh

      Das, A. K.; Harries, A. D.; Hinderaker, S. G.; Zachariah, R; Ahmad, B; Shah, G. N.; Khogali, M. A.; Das, G. I.; Ahmed, E. M.; Ritmeijer, K (The Union, 2014-03-21)
    • Clinical Epidemiology, Diagnosis and Treatment of Visceral Leishmaniasis in the Pokot Endemic Area of Uganda and Kenya

      Mueller, Yolanda K; Kolaczinski, Jan H; Koech, Timothy; Lokwang, Peter; Riongoita, Mark; Velilla, Elena; Brooker, Simon J; Chappuis, François; Epicentre, Paris, France; Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom; Médecins Sans Frontières, Operational Centre, Geneva, Switzerland; Geneva University Hospitals and University of Geneva, Geneva, Switzerland. (2013-11-11)
      Between 2000 and 2010, Médecins Sans Frontières diagnosed and treated 4,831 patients with visceral leishmaniasis (VL) in the Pokot region straddling the border between Uganda and Kenya. A retrospective analysis of routinely collected clinical data showed no marked seasonal or annual fluctuations. Males between 5 and 14 years of age were the most affected group. Marked splenomegaly and anemia were striking features. An Rk39 antigen-based rapid diagnostic test was evaluated and found sufficiently accurate to replace the direct agglutination test and spleen aspiration as the first-line diagnostic procedure. The case-fatality rate with sodium stibogluconate as first-line treatment was low. The VL relapses were rare and often diagnosed more than 6 months post-treatment. Post-kala-azar dermal leishmaniasis was rare but likely to be underdiagnosed. The epidemiological and clinical features of VL in the Pokot area differed markedly from VL in Sudan, the main endemic focus in Africa.
    • Concomitant malaria among visceral leishmaniasis in-patients from Gedarif and Sennar States, Sudan: a retrospective case-control study

      van den Bogaart, Erika; Berkhout, Marieke Mz; Nour, Ayman Bym; Mens, Pètra F; Talha, Al-Badawi A; Adams, Emily R; Ahmed, Hashim Bm; Abdelrahman, Samira H; Ritmeijer, Koert; Nour, Bakri Ym; et al. (BioMed Central, 2013-04-11)
      In areas where visceral leishmaniasis (VL) and malaria are co-endemic, co-infections are common. Clinical implications range from potential diagnostic delay to increased disease-related morbidity, as compared to VL patients. Nevertheless, public awareness of the disease remains limited. In VL-endemic areas with unstable and seasonal malaria, vulnerability to the disease persists through all age-groups, suggesting that in these populations, malaria may easily co-occur with VL, with potentially severe clinical effects.
    • Five-Year Field Results and Long-Term Effectiveness of 20 mg/kg Liposomal Amphotericin B (Ambisome) for Visceral Leishmaniasis in Bihar, India

      Burza, Sakib; Sinha, Prabhat K; Mahajan, Raman; Lima, María Angeles; Mitra, Gaurab; Verma, Neena; Balasegarem, Manica; Das, Pradeep (Public Library of Science, 2014-01)
      Visceral Leishmaniasis (VL; also known as Kala-azar) is an ultimately fatal disease endemic in Bihar. A 2007 observational cohort study in Bihar of 251 patients with VL treated with 20 mg/Kg intravenous liposomal amphotericin B (Ambisome) demonstrated a 98% cure rate at 6-months. Between July 2007 and August 2012, Médecins Sans Frontières (MSF) and the Rajendra Memorial Research Institute (RMRI) implemented a VL treatment project in Bihar, India-an area highly endemic for Leishmania donovani-using this regimen as first-line treatment.
    • Liposomal amphotericin B for complicated visceral leishmaniasis (kala-azar) in eastern Sudan: how effective is treatment for this neglected disease?

      Salih, Niven A; van Griensven, Johan; Chappuis, François; Antierens, Annick; Mumina, Ann; Hammam, Omar; Boulle, Philippa; Alirol, Emilie; Alnour, Mubarak; Elhag, Mousab S; et al. (John Wiley & Sons Ltd, 2014-02)
      The aim of this study was to report the patient profile and treatment outcomes, including relapses, of patients with visceral leishmaniasis (VL) treated with liposomal amphotericin B (AmBisome) in Gedaref, Sudan.
    • One-year follow-up of immunocompetent male patients treated with miltefosine for primary visceral leishmaniasis in Bihar, India

      Burza, Sakib; Nabi, Emara; Mahajan, Raman; Mitra, Gaurab; Lima, María Angeles (Oxford University Press, 2013-11)
    • Post Kala-Azar Dermal Leishmaniasis following Treatment with 20 mg/kg Liposomal Amphotericin B (Ambisome) for Primary Visceral Leishmaniasis in Bihar, India

      Burza, Sakib; Sinha, Prabhat Kumar; Mahajan, Raman; Sanz, Marta González; Lima, María Angeles; Mitra, Gaurab; Verma, Neena; Das, Pradeep (Public Library of Science, 2014-01)
      The skin disorder Post Kala-Azar Dermal Leishmaniasis (PKDL) occurs in up to 10% of patients treated for visceral leishmaniasis (VL) in India. The pathogenesis of PKDL is not yet fully understood. Cases have been reported in India following therapy with most available treatments, but rarely in those treated with liposomal amphotericin B (Ambisome). Between July 2007 and August 2012 with the support of the Rajendra Memorial Research Institute (RMRI), Médecins Sans Frontières (MSF) supported a VL treatment programme in Bihar, India-an area highly endemic for Leishmania donovani-in which 8749 patients received 20 mg/kg intravenous Ambisome as first-line treatment. This study describes the characteristics of patients who returned to the MSF supported treatment programme with PKDL.
    • Risk Factors for Visceral Leishmaniasis Relapse in Immunocompetent Patients following Treatment with 20 mg/kg Liposomal Amphotericin B (Ambisome) in Bihar, India

      Burza, Sakib; Sinha, Prabhat K; Mahajan, Raman; Lima, María Angeles; Mitra, Gaurab; Verma, Neena; Balsegaram, Manica; Das, Pradeep (Public Library of Science, 2014-01)
      A proportion of all immunocompetent patients treated for visceral leishmaniasis (VL) are known to relapse; however, the risk factors for relapse are not well understood. With the support of the Rajendra Memorial Research Institute (RMRI), Médecins Sans Frontières (MSF) implemented a program in Bihar, India, using intravenous liposomal amphotericin B (Ambisome) as a first-line treatment for VL. The aim of this study was to identify risk factors for VL relapse by examining the characteristics of immunocompetent patients who relapsed following this regimen.
    • Severe post-kala-azar dermal leishmaniasis successfully treated with miltefosine in an Ethiopian HIV patient.

      Abongomera, C; Battaglioli, T; Adera, C; Ritmeijer, K (Elsevier, 2019-02-18)
      Post-kala-azar dermal leishmaniasis (PKDL) is a neglected tropical disease characterized by a dermatosis which often appears after successful treatment of visceral leishmaniasis caused by Leishmania donovani. PKDL treatment options are few and have severe limitations. In East- Africa, the standard treatment of PKDL is with daily painful potentially toxic sodium stibogluconate injections, administered for a prolonged duration of 30-60 days. In the Indian subcontinent, PKDL is mainly treated with miltefosine, a safer orally administered drug. However, in East-Africa, there is very limited experience in the use of miltefosine for treatment of severe PKDL, with only one published case report. Here we report a severe PKDL case in an Ethiopian HIV patient successfully treated with oral miltefosine (100 milligrams/day for 28 days). Miltefosine was efficacious, safe and well tolerated, suggesting that it can play an important role in the treatment of severe PKDL also in East-African patients. Further research is warranted.
    • Validation of Two Rapid Diagnostic Tests for Visceral Leishmaniasis in Kenya

      Mbui, Jane; Wasunna, Monique; Balasegaram, Manica; Laussermayer, Adrian; Juma, Rashid; Njenga, Simon Njoroge; Kirigi, George; Riongoita, Mark; de la Tour, Roberto; van Peteghem, Joke; et al. (Public Library of Science, 2013-09-26)
    • Visceral leishmaniasis and HIV co-infection in Bihar, India: a wake-up call?

      van Griensven, Johan (Oxford University Press, 2014-05-10)