What's new for 'Trypanosomatids' in PubMed

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Sent on Saturday, 2010 May 29
Search kinetoplastids OR kinetoplastid OR Kinetoplastida OR "trypanosoma brucei" OR leishmania OR brucei OR leishmaniasis OR "African trypanosomiasis"
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1.	Infection. 2010 May 28. [Epub ahead of print] Treatment of visceral leishmaniasis in children in the Central-West Region of Brazil. Brustoloni YM, Cunha RV, Cônsolo LZ, Oliveira AL, Dorval ME, Oshiro ET. Federal University of Mato Grosso do Sul, Campo Grande, Brasil, brustoloni@uol.com.br. Abstract BACKGROUND: Detailed reports on the treatment of visceral leishmaniasis (VL) are scarce, particularly with regard to the utilization of antimoniate of N-methylglucamine. The aim of this study was to analyze the treatment of children admitted to a reference hospital, focusing in particular on the use of antimoniate of N-methylglucamine and on the supportive measures adopted. MATERIALS AND METHODS: Medical records of children treated for VL from January 1998 to February 2005 in the Hospital of the University of Mato Grosso do Sul, Central-West Region of Brazil, were reviewed retrospectively. RESULTS: A total of 116 children were treated, and 111 received antimoniate as the first therapeutic choice. The drug was highly efficient (96.9%) in patients with no signs of gravity on admission, in cases presenting warning signs of potential evolution to gravity, and even in some severely ill children. The most common adverse effects were increases in transaminase (22.5%) and amylase (17.5%) levels, and generally reversible electrocardiogram changes (18%). Some problems were detected during the treatment, such as inadequate prescription (causing an under- or overdose) or inappropriate change to a second-line scheme. Of the 116 children, 80% were given antibiotics, 71.5% needed a transfusion of red blood cells, 10.3% required a transfusion of platelets, fresh frozen plasma was given to 4.3%, albumin was administered in 3.4, and 8.6% needed intensive care support. The mortality rate was about 2.6%. CONCLUSION: Antimoniate of N-methylglucamine remains highly efficient and well tolerated in pediatric patients, which allows its utilization as a first-line therapy in Brazilian children until a better drug for widespread use becomes available; however, it should be used with caution, and special attention is required during its prescription and for the management of adverse effects. The low mortality rate obtained confirms that, in addition, successful treatment demands the correction of serious anemia and thrombocytopenia, the vigorous use of antibiotics to fight intercurrent bacterial infections, and sometimes the availability of intensive care units to treat more severe patients.
	PMID: 20508967 [PubMed - as supplied by publisher]
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2.	Ann Trop Med Parasitol. 2010 Apr;104(3):213-23. Clinical and epidemiological studies on the cutaneous leishmaniasis caused by Leishmania (Leishmania) donovani in Sri Lanka.Siriwardana HV, Thalagala N, Karunaweera ND. Department of Parasitology, Faculty of Medicine, University of Colombo, P.O. Box 274, Kynsey Road, Colombo 08, Sri Lanka. Abstract Sri Lanka is the newest reported focus of human leishmaniasis within the Indian subcontinent. Over the last 8 years, more than 2000 cases of cutaneous leishmaniasis (CL), apparently caused by Leishmania donovani (a species usually associated with the visceral form of the disease), have been passively identified in the country. The clinical profiles of 401 suspected cases of CL in Sri Lanka were recently explored and some of the cases' immunological responses were investigated, in antibody-detection assays based on the rk39 antigen. These studies were followed by cross-sectional surveys, involving active case detection, in three areas of Sri Lanka, two of them known to be at relatively high risk for CL, with the aims of estimating the local prevalences of the disease and identifying the main risk factors for its acquisition. This appears to be the first detailed report on the prevalence, risk factors and human serological response associated with human leishmaniasis in Sri Lanka. Although the data collected indicated that the transmission of the parasite causing CL was mostly outdoor (and possibly zoonotic) in the north of the country, most of the transmission in the south seemed to be peridomestic. The CL was found to affect a wide age range, in both male and female subjects. Curiously, the 24 cases of CL that were investigated in the rk39 assays gave negative results whereas the single cases of mucosal or visceral leishmaniasis that were studied were found positive for antibodies reacting with the rk39 antigen. More programmes of active case detection need to be launched across Sri Lanka before the true national burden posed by human leishmaniasis can be accurately evaluated. General awareness of leishmaniasis needs to be raised. Hopefully, continued research and disease monitoring will allow the effective control of leishmaniasis in Sri Lanka.
	PMID: 20507695 [PubMed - in process]
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