Browsing by Autor "Rojas, E"

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Generic sodium stibogluconate is as safe and effective as branded meglumine antimoniate, for the treatment of tegumentary leishmaniasis in Isiboro Secure Park, Bolivia.
(2006) Bermúdez, H; Rojas, E; Garcia, L; Desjeux, P; Dujardin, J-C; Boelaert, M; Chappuis, F
Human cutaneous leishmaniasis (CL) and mucous leishmaniasis (ML) are highly endemic in Isiboro Secure Park, which lies in the Bolivian department of Cochabamba--an area where branded meglumine antimoniate (Glucantime) is expensive and poorly distributed. The safety and efficacy of generic sodium stibogluconate (SSG), from Albert David Ltd, was therefore explored, in CL and ML cases from the park, who were treated with 20 mg/kg.day for 20 and 30 days, respectively. A questionnaire recording adverse effects was completed by a physician in each treatment centre. Efficacy of treatment was assessed at the end of treatment and at follow-ups 1 month and 3, 6 and 12 months later. Overall, 146 patients completed treatment with SSG in 2003-2004. No fatalities or severe adverse effects were reported but mild to moderate adverse effects were noted in 41 (28%) of the patients. The incidence of adverse effects was significantly higher among the cases of ML than among the cases of CL. Of the 86 patients with CL who completed 6 months of follow-up, 81 (94.2%) were considered to have been clinically cured; a comparable cohort of 69 CL cases who had been treated with Glucantime in 2001-2002 showed a similar frequency of clinical cure (90%). Generic SSG was shown to be safe and efficacious for the treatment of tegumentary leishmaniasis in Bolivia. Being several times cheaper than Glucantime, it could contribute to improving the access of CL and ML patients to treatment, not only in Bolivia but also in other countries of Latin America.
Leishmaniasis in the lowlands of Bolivia, prevalence of the disease in two groups of localities with different settlement ages in Carrasco Tropical, Cochabamba.
(1993) Bermúdez, H; Torrico, F; Rojas, E; Balderrama, F; Le Ray, D; Guerra, H; Arévalo, J
The invasion of the Bolivian Jungle has brought the new colonists some unfamiliar diseases, among which we study Leishmaniasis. A previous study described the situation in Yapacaní. Departamento of Santa Cruz, a primary rain forest lowland area. We now focus on the characteristics of Carrasco Tropical, close to a hilly territory of the andean mountains. We studied 11 localities ("colonies") grouped as unions with different lengths of residence in the area. We considered males and females over 15 years old as "at risk" and studied in them all forms of leishmanial infection, through clinical and laboratory (smears) means, including the Montenegro Skin Test (IDRM). Cutaneous ulcers and scars were seen in 2.9% (10 patients of 339 at risk, 6 from "27 de octubre", a younger settlement, 4 from the older Tamboradas): mucocutaneous lesions in 3 (1 from the younger settlement); and skin scars alone in 10.3% (35 from the younger area). The only 2 females with positive findings in the study were seen in this latter group. Transmission is apparently associated with the primary forest which exists at the foot of the Andes in the area, which is visited preferentially by young men.