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A case-control study on the association between intestinal helminth infections and treatment failure in patients with cutaneous leishmaniasis

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Show simple item record Martinez, D. Y. en_US Llanos-Cuentas, A. en_US Dujardin, J. C. en_US Polman, K. en_US Adaui, V. en_US Boelaert, M. en_US Verdonck, K. en_US 2020-08-25T09:37:58Z 2020-08-25T09:37:58Z 2020 en_US
dc.identifier.issn 2328-8957 en_US
dc.identifier.doi en_US
dc.description.abstract Background: Endemic regions of cutaneous leishmaniasis (CL) and intestinal helminthiasis overlap. CL treatment with systemic pentavalent antimonial drugs (Sb(5+)) fails in 10%-30% of patients. The study objective was to assess the etiological role of intestinal helminthiasis in CL treatment failure. Methods: An unmatched case-control study was done in 4 CL treatment sites in Peru in 2012-2015. Cases were CL patients with Sb(5+) treatment failure; controls were CL patients with Sb(5+) treatment success. Patients with a parasitologically confirmed CL diagnosis who had received supervised Sb(5+) treatment and could be classified as cases or controls were eligible. The main exposure variables were intestinal helminthiasis and strongyloidiasis, diagnosed through direct examination, rapid sedimentation, Baermann, Kato-Katz, or agar culture of stool samples. Additional exposure variables were other infections (HIV, human T-lymphotropic virus 1, tuberculosis, hepatitis B, intestinal protozoa) and noninfectious conditions (diabetes, renal insufficiency, and immunosuppressive medication). Age, gender, CL history, probable exposure place, and Leishmania species were treated as potential confounders in multiple logistic regression. Results: There were 94 case and 122 control subjects. Overall, infectious and noninfectious comorbidities were frequent both among cases (64%) and controls (71%). The adjusted odds ratio (OR) for the association between any intestinal helminth infection and CL treatment failure was 0.65 (95% confidence interval [CI], 0.30-1.38), and the adjusted OR for the association between strongyloidiasis and CL treatment failure was 0.34 (95% CI, 0.11-0.92). Conclusions: In the Peruvian setting, high Sb(5+) treatment failure rates are not explained by intestinal helminthiasis. On the contrary, strongyloidiasis had a protective effect against treatment failure. en_US
dc.language English en_US
dc.relation.uri en_US
dc.subject Helminthic diseases en_US
dc.subject Intestinal diseases en_US
dc.subject leishmaniasis-cutaneous en_US
dc.subject Protozoal diseases en_US
dc.subject Co-infections en_US
dc.subject Treatment failure en_US
dc.title A case-control study on the association between intestinal helminth infections and treatment failure in patients with cutaneous leishmaniasis en_US
dc.type Article-E en_US
dc.citation.issue 5 en_US
dc.citation.jtitle Open Forum Infectious Diseases en_US
dc.citation.volume 7 en_US
dc.citation.pages ofaa155 en_US
dc.citation.abbreviation Open Forum Infect Dis en_US

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