| Clinical risk factors for therapeutic failure in kala-azar patients treated with pentavalent antimonials in Nepal. | |
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MedLine Citation:
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PMID: 19726065 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Drug-related factors and parasite resistance have been implicated in the failure of pentavalent antimonials (Sb(v)) in the Indian subcontinent; however, little information is available on host-related factors. Parasitologically confirmed kala-azar patients, treatment na?ve to Sb(v), were prospectively recruited at a referral hospital in Nepal and were treated under supervision with 30 doses of quality-assured sodium stibogluconate (SSG) 20mg/kg/day and followed for 12 months to assess cure. Analysis of risk factors for treatment failure was assessed in those receiving >or=25 doses and completing 12 months of follow-up. One hundred and ninety-eight cases were treated with SSG and the overall cure rate was 77.3% (153/198). Of the 181 cases who received >or=25 doses, 12-month follow-up data were obtained in 169, comprising 153 patients (90.5%) with definite cure and 16 (9.5%) treatment failures. In the final logistic regression model, increased failure to SSG was significantly associated with fever for >or=12 weeks [odds ratio (OR)=7.4], living in districts bordering the high SSG resistance zone in Bihar (OR=6.1), interruption of treatment (OR=4.3) and ambulatory treatment (OR=10.2). Early diagnosis and supervised treatment is of paramount importance to prevent treatment failures within the control programme. |
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Authors:
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S Rijal; S Bhandari; S Koirala; R Singh; B Khanal; L Loutan; J C Dujardin; M Boelaert; F Chappuis |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-09-01 |
Journal Detail:
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Title: Transactions of the Royal Society of Tropical Medicine and Hygiene Volume: 104 ISSN: 1878-3503 ISO Abbreviation: Trans. R. Soc. Trop. Med. Hyg. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-01 Completed Date: 2010-05-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7506129 Medline TA: Trans R Soc Trop Med Hyg Country: England |
Other Details:
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Languages: eng Pagination: 225-9 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan 056700, Nepal. sumanrijal2@yahoo.com <sumanrijal2@yahoo.com> |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Antimony Sodium Gluconate / administration & dosage* Antiprotozoal Agents / administration & dosage* Child Epidemiologic Methods Female Humans Leishmaniasis, Visceral / drug therapy*, parasitology Male Nepal Treatment Failure Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antimony Sodium Gluconate; 0/Antiprotozoal Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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