Who Is a Typical Patient with Visceral Leishmaniasis? Characterizing the Demographic and Nutritional Profile of Patients in Brazil, East Africa, and South Asia
AuthorsHarhay, Michael O
Olliaro, Piero L
Lima, María Angeles
Costa, Carlos Henrique
Costa, Dorcas Lamounier
AffiliationGraduate Group in Demography, University of Pennsylvania, Philadelphia, Pennsylvania; United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland; Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom; Clinical Epidemiology and Public Health Unit, Center for Health Studies, Centre de Recherche Publique (CRP-Santé), Luxembourg; Médecins Sans Frontières, Operational Centre Geneva (MSF-OCG), Geneva, Switzerland; Division of International and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Médecins Sans Frontières, Operational Centre Barcelona-Athens (MSF-OCBA), Barcelona, Spain; Médecins Sans Frontières, Operational Centre Amsterdam (MSF-OCA), Amsterdam, The Netherlands; Instituto de Doenças Tropicais Natan Portella, Teresina, Piauí, Brazil; Federal University of Piauí, Piauí, Brazil; Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal; Institute of Medical Sciences, Banaras Hindu University, Varanasi, India; Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland
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AbstractAbstract. 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.
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