Efficacy and Safety of Combination of Sodium Stibogluconate and Paromomycin for Treatment of Visceral Leishmaniasis and Factors Associated with Poor Treatment Outcomes. A Retrospective Study, North West Ethiopia
| dc.contributor.advisor | Hailu Asrat | |
| dc.contributor.advisor | Medhin Girmay | |
| dc.contributor.author | Tamiru Aschalew | |
| dc.date.accessioned | 2021-03-23T06:46:52Z | |
| dc.date.accessioned | 2023-11-06T08:10:36Z | |
| dc.date.available | 2021-03-23T06:46:52Z | |
| dc.date.available | 2023-11-06T08:10:36Z | |
| dc.date.issued | 2020-06 | |
| dc.description.abstract | Background: Visceral leishmaniasis is among the most neglected tropical infectiousdisease caused by the protozoan parasite of the genius lesihmania. The incidence of VL isestimated to be 0.2 to 0.4 million cases /year worldwide. It is fatal if left untreated. Objective: The objective of this study was to assess efficacy and safety of combinationof SSG (20mg/kg/day) and paromomycin (15mg/kg/day) and associated factors for poortreatment outcomes. Methods: A retrospective cohort study design was used. Medical record review of VLpatients treated with combination of sodium stibogluconate and Paromomycin between2012 and 2019 was conducted. Results: In total, 1000 VL patients were included. The overall initial cure was achievedin 924 (92.4%). Treatment failure, treatment interruptions, default and deaths respectivelywere noted in 30(3%), 25 (2.5%), 13 (1.3%) and 8(0.8%). The efficacy of SSG/PM(186/208, 89.4%) Vs (738/792, 93.2%) was not different respectively for patients withweight ≤ 42.5kg and >42.5kg (p=0.07). The most common adverse events were raisedliver transaminases 351(35.1%), injection site pain 291(29.1%) and increased in serumalpha-amylase 291 (29.1%). The frequency of cardiac arrhythmia 6(0.6%) and clinicalpancreatitis 21(2.1%) were low. Factors associated with poor treatment outcomes weresepsis (OR= 7.6, 95% CI: 1.86 - 31.03, P = 0.005), clinical pancreatitis (OR= 4, 95% CI:1.21 – 13.43, P= 0.02), and cardiac arrhythmia (OR=13, 95% CI: 2.30 – 84.34, P: 0.004).Patients’ body weight had no effect on poor treatment outcome (OR = 1.6, 95% CI: 0.89– 3.06). Of patients who attended six-month visit, cure was achieved in 259/276 (93.8%). Post kala-azar dermal leishmaniasis was 13 (1.3%). Conclusion and Recommendations. The efficacy of SSG at 20mg/kg with uppermaximum dose limit (850mg/day) and PM at 15mg/kg was 92.4%. Our data affirmseffectiveness of SSG/PM, as presently used in Eastern African countries, and no issues ofconcern have been identified. The continued use of the combination therapy is warranted.Similar studies are recommended in the countries affected by the disease. Sepsis,pancreatitis and cardiac arrhythmias should be identified and managed as per VLmanagement protocol to prevent poor treatment outcomes . | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/25625 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Abeba University | en_US |
| dc.subject | Sodium Stibogluconate , Paromomycin , Visceral Leishmaniasis | en_US |
| dc.title | Efficacy and Safety of Combination of Sodium Stibogluconate and Paromomycin for Treatment of Visceral Leishmaniasis and Factors Associated with Poor Treatment Outcomes. A Retrospective Study, North West Ethiopia | en_US |
| dc.type | Thesis | en_US |