• Developments in the treatment of visceral leishmaniasis

      den Boer, Margriet Leontine; Alvar, Jorge; Davidson, Robert N; Ritmeijer, Koert; Balasegaram, Manica; Medecins Sans Frontieres, Amsterdam, The Netherlands (2009-09-01)
      BACKGROUND: Visceral leishmaniasis (VL) is one of the most neglected parasitic diseases causing large scale mortality and morbidity among the poorest of the poor in the Indian subcontinent and Africa. OBJECTIVE: This review aims to describe the potential and the (lack of) current impact of newly developed treatments on the control of VL. It describes how the problem of an empty research pipeline is addressed, and discusses the emerging threat of incurable HIV/VL coinfection. METHODS: The literature was searched for drugs used in VL. CONCLUSION: Research and development of VL drugs has received a financial boost but no new drugs are expected in the next 5 years. Only three new and highly effective treatments have been licensed in the past 10 years. These remain, however, largely inaccessible as VL control programs in the developing world are lacking. This is deserving of immediate and urgent attention, especially in the context of the rapidly expanding HIV/VL coinfection.
    • Geographical Variation in the Response of Visceral Leishmaniasis to Paromomycin in East Africa: A Multicentre, Open-Label, Randomized Trial

      Hailu, Asrat; Musa, Ahmed; Wasunna, Monique; Balasegaram, Manica; Yifru, Sisay; Mengistu, Getahun; Hurissa, Zewdu; Hailu, Workagegnehu; Weldegebreal, Teklu; Tesfaye, Samson; et al. (2010-10-26)
      Visceral leishmaniasis (VL) is a major health problem in developing countries. The untreated disease is fatal, available treatment is expensive and often toxic, and drug resistance is increasing. Improved treatment options are needed. Paromomycin was shown to be an efficacious first-line treatment with low toxicity in India.
    • Liposomal amphotericin B as a treatment for human leishmaniasis

      Balasegaram, Manica; Ritmeijer, Koert; Lima, Maria Angeles; Burza, Sakib; Ortiz Genovese, Gemma; Milani, Barbara; Gaspani, Sara; Potet, Julien; Chappuis, François; Drugs for Neglected Diseases Initiative, Geneva, Switzerland;2 Médecins Sans Frontières, Operational Centre Amsterdam, Amsterdam, The Netherlands; Médecins Sans Frontières, Operational Centre Barcelona Athens, Barcelona, Spain; Médecins Sans Frontières, Access Campaign, Paris, France; Médecins Sans Frontières, Operational Centre Geneva, Geneva, Switzerland;Médecins Sans Frontières, Access Campaign, Geneva, Switzerland; University of Geneva, andGeneva University Hospitals, Division of International and Humanitarian Medicine, 6, rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland. (Informa, 2012-12-11)
    • Sodium Stibogluconate (SSG) & Paromomycin Combination Compared to SSG for Visceral Leishmaniasis in East Africa: A Randomised Controlled Trial

      Musa, Ahmed; Khalil, Eltahir; Hailu, Asrat; Olobo, Joseph; Balasegaram, Manica; Omollo, Raymond; Edwards, Tansy; Rashid, Juma; Mbui, Jane; Musa, Brima; et al. (Public Library of Science, 2012-06)
      Alternative treatments for visceral leishmaniasis (VL) are required in East Africa. Paromomycin sulphate (PM) has been shown to be efficacious for VL treatment in India.
    • 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)
    • Who Is a Typical Patient with Visceral Leishmaniasis? Characterizing the Demographic and Nutritional Profile of Patients in Brazil, East Africa, and South Asia

      Harhay, Michael O; Olliaro, Piero L; Vaillant, Michel; Chappuis, François; Lima, María Angeles; Ritmeijer, Koert; Costa, Carlos Henrique; Costa, Dorcas Lamounier; Rijal, Suman; Sundar, Shyam; et al. (2011-04-01)
      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.