Amphotericin B deoxycholate for relapse visceral leishmaniasis in Bangladesh: a cross-sectional study |
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Authors: | Md Golam Hasnain Proggananda Nath Shomik Maruf Shah Golam Nabi A F M Akhtar Hossain Be-Nazir Ahmed Dinesh Mondal Ariful Basher |
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Institution: | 1.Nutrition and Clinical Service Division (NCSD),International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b),Dhaka,Bangladesh;2.Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine,The University of Newcastle (UoN),Callaghan,Australia;3.Infection and Tropical Medicine, Mymensingh Medical College and Hospital (MMCH),Mymensingh,Bangladesh;4.Mugda Medical College and Hospital,Dhaka,Bangladesh;5.National Kala-azar Elimination Program (NKEP), Directorate General Health Services (DGHS),Ministry of Health and Family Welfare (MoHFW), Government of Bangladesh (GoB),Dhaka,Bangladesh;6.Co-ordination and Support Centre (CSC), Directorate General Health Services (DGHS),Ministry of Health and Family Welfare (MoHFW), Government of Bangladesh (GoB),Dhaka,Bangladesh;7.Critical Care Medicine (CCM), Bangabandhu Sheikh Mujib Medical University (BSMMU),Dhaka,Bangladesh |
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Abstract: | ObjectiveBased on studies in India (as there was no studies from outside India) amphotericin B deoxycholate has been considered as a backup drug for treatment of visceral leishmaniasis. However, treatment response and adverse effect to anti-leishmanial drugs may vary across different populations and in Bangladesh the effect to amphotericin B deoxycholate for treatment of visceral leishmaniasis is still unknown. Therefore, there is a need to explore cure rate and adverse effects to amphotericin B deoxycholate to justify its use on visceral leishmaniasis patients in Bangladesh.ResultHere we report 34 visceral leishmaniasis patients who received treatment with amphotericin B deoxycholate in the Surya Kanta Kala-azar Research Centre from December 2011 to June 2015. The dose of the treatment was 1 mg/kg body weight for 15 days followed up until 12 months after treatment. Response to amphotericin B deoxycholate treatment was excellent as all 34 patients achieved a final cure. Hypokalaemia (47%), shivering (47%), vomiting (35%) and acidity (15%) were most common adverse events. However, we did not observe any serious adverse events. Amphotericin B deoxycholate for relapse visceral leishmaniasis was found to be highly effective and safe. Our study justified to include amphotericin B deoxycholate as a second line drug for visceral leishmaniasis in Bangladesh. |
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