Friday, 9 September 2016

Efficacy of azoles in the Treatment of Cutaneous Leishmaniasis

Leishmaniasis is a disease of tropical and subtropical areas, caused by a protozoan of the order Kinetoplastida, Trypanosomatidae family, genus Leishmania spp. with multiple species and high phenotypic diversity. It is transmitted to humans by the bite of Phlebotomus spp. in Africa, Europe and Asia, and Lutzomyia spp. In America. It can occur in pets such as dogs, or wild as sloths, opossums and small mammals.

This disease is endemic in 98 countries, mainly in India, Central and South America, Southern Europe, North Africa and the Middle East. About 90% of cases of cutaneous leishmaniasis are in Brazil, Peru, Pakistan, Syria, Algeria, Afghanistan and Iran; with an estimated number of incident cases per year of 500,000. These data show its importance to public health, especially to keep in mind that this disease produces an adverse impact on psychological, social, economic and occupational dimensions of those affected.

The disease control focuses on chemotherapy and preventing transmission of the parasite; treatment due to factors such as the parasite species, the clinical form, geographic location and availability of drugs. Treatment options include cryotherapy, thermotherapy, paromomycin, imiquimod, antimonial, pentamidine, imidazole, oral fluconazole, ketoconazole, amphotericin B and miltefosine; which have differences in adverse effects, effectiveness, access and cost; making it difficult to further its control.

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