Clinical and Parasite Species Risk Factors for Pentavalent Antimonial Treatment Failure in Cutaneous Leishmaniasis in Peru

Background. Treatment for cutaneous leishmaniasis (CL) with standard pentavalent antimonial therapy is hampered by cumbersome administration, toxicity, and potential failure. Knowledge of factors influencing treatment outcome is essential for successful management. Methods. A case-control study of incident cases was performed with patients experiencing their first CL episode. The standard treatment for CL for these patients was 20 mg/kg/day of sodium stibogluconate for 20 days. Clinical and epidemiological data were recorded, and parasite isolates were species typed. Patients were followed up for 6 months to assess treatment outcome. Clinical cure was defined as complete wound closure and re-epithelization without inflammation or infiltration; new lesions, wound reopening, or signs of activity were classified as treatment failure. Descriptive, bivariate, and logistic regression analyses were performed. Results. One hundred twenty-seven patients were recruited; 63 (49.6%) were infected with Leishmania (Viannia) peruviana, 29 (22.8%) were infected with Leishmania (Viannia) braziliensis, 27 (21.3%) were infected with Leishmania (Viannia) guyanensis, and 8 (6.3%) were infected with other species. Only patients infected with the 3 most common species were selected for risk-factor analysis (n=119). Final failure rate at 6 months was 24.4% (95% confidence interval [CI], 16.5%-32.1%), with 96% of failures occurring within the first 3 months of follow-up assessment. Risk factors for treatment failure identified in the final multivariate model were age (per year, odds ratio [OR], 0.95; 95% CI, 0.92-0.99; P=.017), stay of <72 months in area of disease acquisition (OR, 30.45; 95% CI, 2.38-389.25; P=.009), duration of disease <5 weeks (OR, 4.39; 95% CI, 1.12-17.23; P=.034), additional lesion (per lesion, OR, 2.06; 95% CI, 1.3-3.28; P=.002), infection with L. (V.) peruviana (OR, 9.85; 95% CI, 1.01-95.65; P=.049), and infection with L. (V.) braziliensis (OR, 22.36; 95% CI, 1.89-263.96; P=.014). Conclusions. The identification of parasite species and clinical risk factors for antimonial treatment failure should lead to an improved management of CL in patients in Per

High Failure Rates of Melarsoprol for Sleeping Sickness, Democratic Republic of Congo

A retrospective chart review of 4,925 human African trypanosomiasis patients treated with melarsoprol in 2001–2003 in Equateur Nord Province of the Democratic Republic of Congo showed a treatment failure rate of 19.5%. This rate increased over the 3 years. Relapse rates were highest in the central part of the province

Cost-effectiveness of Algorithms for Confirmation Test of Human African Trypanosomiasis

Algorithms that incorporate concentration techniques are more effective and efficient than the currently used algorithms

Evidence from a two-stage cluster randomised survey in a protracted crisis

Funding Information: Médecins Sans Frontières (MSF) provided support in the form of salaries for MPD, Ab.A, AA, YS, AW, JGC, JR, RV, SA. MSF programmatic funding covered all costs associated with the survey which was conducted for operational purposes. MSF was involved in the study design, data collection and analysis, decision to publish, and preparation of the manuscript. AA is funded through funds from Fundação para a Ciência e Tecnologia (FCT) to GHTM-UID/04413/2020 and LA-REAL-LA/P/0117/2020. MPD is currently funded by Gates Cambridge Trust (OPP1144), which had no role in the study and decision to publish. Publisher Copyright: © 2025 Perez Duque et al.The ongoing conflict in Yemen, which began in 2014, has led to one of the world’s most severe humanitarian crises. The Hudaydah region, located on the Red Sea coast and home to the country’s second-largest port, is critical for the delivery of food and medical supplies. We conducted a two-stage cluster randomised survey to estimate the prevalence of acute malnutrition among children and pregnant and lactating women (PLW). We estimated the prevalence of household food insecurity and quantified death rates. During February-March 2021, acute malnutrition prevalence was 14.1%(95%CI: 12.2-16.2) among children aged 6–59 months, with 4.0%(95%CI: 3.3-4.9) severely malnourished. 43% of malnourished children were not in a nutritional programme. Acute malnutrition among PLW was 25.7%(95%CI: 23.0-28.6). We estimated 54%(95%CI: 44–63) of households were food insecure, 22%(95%CI: 15–31) severely. Crude and under-five death rates were below humanitarian thresholds. More than half of the children reported sickness in the last 14 days, and this proportion was higher among the malnourished.publishersversionpublishe

Dépistage oncogénétique du syndrome de Lynch et de la polypose adénomateuse familiale : Résumé

7 p.ill.,Dans le classement des tumeurs malignes les plus fréquentes, le cancer du côlon occupe actuellement la troisième place chez les hommes et la deuxième chez les femmes. Une prise en charge multidisciplinaire a toutefois permis d’améliorer sensiblement son pronostic : dans l’état actuel des choses, 60 à 70% des malades sont toujours en vie après 5 ans. Les éléments déterminants de cette approche sont les soins pré-, péri- et postopératoires et le recours à un traitement sur mesure (« personalised care »). Ces conclusions figurent dans les recommandations actualisées rédigées par le Centre Fédéral d’Expertise des Soins de Santé (KCE) en collaboration avec le Collège d’Oncologie et le centre d’expertise néerlandais Integraal Kankercentrum Nederland

Oncogenetic testing, diagnosis and follow-up in Birt-Hogg-Dubé syndrome, familial atypical multiple mole melanoma syndrome and neurofibromatosis 1 and 2 : Summary

13 p.ill.