دورية أكاديمية
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The increasing incidence of visceral leishmaniasis relapse in South Sudan: A retrospective analysis of field patient data from 2001-2018.

التفاصيل البيبلوغرافية
العنوان: The increasing incidence of visceral leishmaniasis relapse in South Sudan: A retrospective analysis of field patient data from 2001-2018.
المؤلفون: Naylor-Leyland G; Médecins Sans Frontières, Amsterdam, The Netherlands., Collin SM; UK Health Security Agency (UKHSA), London, United Kingdom.; Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Brazil., Gatluak F; Médecins Sans Frontières, Lankien, South Sudan., den Boer M; Médecins Sans Frontières, London, United Kingdom., Alves F; Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland., Mullahzada AW; Médecins Sans Frontières, Amsterdam, The Netherlands., Ritmeijer K; Médecins Sans Frontières, Amsterdam, The Netherlands.
المصدر: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2022 Aug 18; Vol. 16 (8), pp. e0010696. Date of Electronic Publication: 2022 Aug 18 (Print Publication: 2022).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Leishmaniasis, Visceral*/drug therapy , Leishmaniasis, Visceral*/epidemiology, Chronic Disease ; Humans ; Incidence ; Recurrence ; Retrospective Studies ; South Sudan/epidemiology
مستخلص: Background: Visceral Leishmaniasis (VL) is endemic in South Sudan, manifesting periodically in major outbreaks. Provision of treatment during endemic periods and as an emergency response is impeded by instability and conflict. Médecins Sans Frontières (MSF) has provided health care in South Sudan since the late 1980's, including treatment for 67,000 VL patients. In recent years, MSF monitoring data have indicated increasing numbers of VL relapse cases. A retrospective analysis of these data was performed in order to provide insight into the possible causes of this increase.
Methodology/principal Findings: Programme monitoring data from the MSF hospital in Lankien, Jonglei State, South Sudan, for the period 2001-2018 were analysed to detect trends in VL relapse as a proportion of all VL cases presenting to MSF treatment centres. Routinely collected patient-level data from relapse and primary VL cases treated at all MSF sites in South Sudan over the same period were analysed to describe patient characteristics and treatments received. VL relapse as a proportion of all VL cases increased by 6.5% per annum (95% CI 0.3% to 13.0%, p = 0.04), from 5.2% during 2001-2003 to 14.4% during 2016-2018. Primary VL and VL relapse patients had similar age, sex and anthropometric characteristics, the latter indicating high indices of undernutrition which were relatively constant over time. Clinical factors (Hb, spleen size, and VL severity score) also did not vary substantially over time. SSG/PM was the main treatment regimen from 2001-2018, used in 68.7% of primary and 70.9% of relapse VL cases; AmBisome was introduced in 2013, received by 22.5% of primary VL and 32.6% of VL relapse cases from 2013-2018.
Conclusion: Increasing incidence of VL relapse in South Sudan does not appear to be explained by changes in patient characteristics or other factors. Our data are concerning and may indicate an emergence of treatment-resistant parasite strains, decreasing the effectiveness of treatment regimens. This warrants further investigation as a causal factor. New chemical entities that will enable safe and highly effective short-course oral treatments for VL are urgently needed.
Competing Interests: The authors have declared that no competing interests exist.
التعليقات: Erratum in: PLoS Negl Trop Dis. 2024 Feb 12;18(2):e0011952. (PMID: 38346002)
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تواريخ الأحداث: Date Created: 20220818 Date Completed: 20220902 Latest Revision: 20240212
رمز التحديث: 20240212
مُعرف محوري في PubMed: PMC9426874
DOI: 10.1371/journal.pntd.0010696
PMID: 35981057
قاعدة البيانات: MEDLINE
الوصف
تدمد:1935-2735
DOI:10.1371/journal.pntd.0010696