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Efficacy and safety of single-dose liposomal amphotericin B in patients with visceral leishmaniasis in Bangladesh: a real-life experience

Efficacy and safety of single-dose liposomal amphotericin B in patients with visceral leishmaniasis in Bangladesh: a real-life experience
Efficacy and safety of single-dose liposomal amphotericin B in patients with visceral leishmaniasis in Bangladesh: a real-life experience

Liposomal amphotericin B (LAmB) is the drug of choice in Bangladesh to eliminate the burden of visceral leishmaniasis, also known as kala-azar, a fatal protozoan parasitic disease if left untreated. We aimed to assess efficacy and safety of a single-dose (10 mg/kg) LAmB in visceral leishmaniasis (VL) treatment among the visiting children and adults in a tertiary care setting. This prospective study includes 11 children and 19 adults with a confirmed diagnosis of kala-azar (total 30 cases). Intravenous infusion of LAmB (10 mg/kg body weight) was given to all of the patients. Clinical assessments were conducted during treatment, before hospital discharge, and on days 30 and 180 after treatment. Efficacy was estimated in terms of initial cure (at day 30) and the final cure (at 180 days). All information was recorded in a preformed case record form and analysis was performed in SPSS 22. The mean age was 27.13 ± 18.04 years (3-65) with male predominance (60%). Significant regression of spleen size was found following treatment with LAmB at 30 days and 180 days follow up visit (p < 0.05 for all). Overall, rate of initial cure was 90% (n = 27) (child 90.9% vs 89.47% adult) and final cure was 96.66% (n = 29) (child 100% vs 94.73% adult). Fourteen adverse events were recorded mostly including fever and/or shivering (85.71%). No case relapsed or were referred either due to management or Severe Adverse Event (SAE). In real-life experience, the LAmB treatment for visceral leishmaniasis is as safe and effective for treatment of kala-azar patients.

Supplementary Information: The online version contains supplementary material available at 10.1007/s12639-021-01379-w.

Efficacy, Kala-azar, LAmB, Leishmaniasis, Real life experience
0971-7196
903-911
Ekram, Md Rezaul
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Amin, Mohammad Robed
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Hasan, Mohammad Jahid
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Khan, Md Abdullah Saeed
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Nath, Rajib
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Mallik, Pranab Kumar
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Lister, Alex
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Rahman, Monjur
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Ekram, Md Rezaul
c945684c-8e82-429c-ae51-ddf67444d920
Amin, Mohammad Robed
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Hasan, Mohammad Jahid
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Khan, Md Abdullah Saeed
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Nath, Rajib
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Mallik, Pranab Kumar
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Lister, Alex
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Rahman, Monjur
667f5811-a90c-49b3-9127-7d691b83038e

Ekram, Md Rezaul, Amin, Mohammad Robed, Hasan, Mohammad Jahid, Khan, Md Abdullah Saeed, Nath, Rajib, Mallik, Pranab Kumar, Lister, Alex and Rahman, Monjur (2021) Efficacy and safety of single-dose liposomal amphotericin B in patients with visceral leishmaniasis in Bangladesh: a real-life experience. Journal of parasitic diseases : official organ of the Indian Society for Parasitology, 45 (4), 903-911. (doi:10.1007/s12639-021-01379-w).

Record type: Article

Abstract

Liposomal amphotericin B (LAmB) is the drug of choice in Bangladesh to eliminate the burden of visceral leishmaniasis, also known as kala-azar, a fatal protozoan parasitic disease if left untreated. We aimed to assess efficacy and safety of a single-dose (10 mg/kg) LAmB in visceral leishmaniasis (VL) treatment among the visiting children and adults in a tertiary care setting. This prospective study includes 11 children and 19 adults with a confirmed diagnosis of kala-azar (total 30 cases). Intravenous infusion of LAmB (10 mg/kg body weight) was given to all of the patients. Clinical assessments were conducted during treatment, before hospital discharge, and on days 30 and 180 after treatment. Efficacy was estimated in terms of initial cure (at day 30) and the final cure (at 180 days). All information was recorded in a preformed case record form and analysis was performed in SPSS 22. The mean age was 27.13 ± 18.04 years (3-65) with male predominance (60%). Significant regression of spleen size was found following treatment with LAmB at 30 days and 180 days follow up visit (p < 0.05 for all). Overall, rate of initial cure was 90% (n = 27) (child 90.9% vs 89.47% adult) and final cure was 96.66% (n = 29) (child 100% vs 94.73% adult). Fourteen adverse events were recorded mostly including fever and/or shivering (85.71%). No case relapsed or were referred either due to management or Severe Adverse Event (SAE). In real-life experience, the LAmB treatment for visceral leishmaniasis is as safe and effective for treatment of kala-azar patients.

Supplementary Information: The online version contains supplementary material available at 10.1007/s12639-021-01379-w.

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More information

Accepted/In Press date: 8 March 2021
e-pub ahead of print date: 23 March 2021
Published date: December 2021
Keywords: Efficacy, Kala-azar, LAmB, Leishmaniasis, Real life experience

Identifiers

Local EPrints ID: 455604
URI: http://eprints.soton.ac.uk/id/eprint/455604
ISSN: 0971-7196
PURE UUID: b9b8b77d-3a47-40c1-bde2-614266c38db3

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Date deposited: 28 Mar 2022 16:50
Last modified: 16 Mar 2024 15:24

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Contributors

Author: Md Rezaul Ekram
Author: Mohammad Robed Amin
Author: Mohammad Jahid Hasan
Author: Md Abdullah Saeed Khan
Author: Rajib Nath
Author: Pranab Kumar Mallik
Author: Alex Lister
Author: Monjur Rahman

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