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A comprehensive evaluation of therapy regimens for Visceral Leishmaniasis (VL) has been conducted by researchers and published in The Lancet Regional Health-Southeast Asia journal. This meta-analysis, encompassing 131 studies, aimed to assess the efficacy of current treatments for VL, a neglected tropical disease.
Using the University of Oxford’s Infectious Diseases Data Observatory (IDDO) systematic review database, researchers scrutinized data from 27,687 patients, identifying 1193 cases of relapse. Studies from various regions, including the Indian sub-continent, East Africa, the Mediterranean, Latin America, and Central Asia, were included in the analysis.
The team, which included researchers from India’s Banaras Hindu University in Varanasi, discovered that the relapse rate among VL patients following the recommended drug regimen ranged from 0.5 to 4.5 percent in the Indian sub-continent. Moreover, more than a quarter of relapses were undetected within a 6-month follow-up, indicating a potential need for extended monitoring periods.
In the Indian sub-continent, where Visceral Leishmaniasis is prevalent, the study highlighted that single doses of liposomal amphotericin B (L-AmB) demonstrated varying relapse rates, with 4.5 percent for a specific dosage and 1.5 percent for combination therapy. Notably, a higher dosage of L-AmB (15 mg/kg) exhibited a significantly lower relapse rate (1.8 percent) compared to lower dosages, suggesting the potential effectiveness of increased dosages in preventing relapse.
The research emphasized the influence of factors like dosage, patient characteristics, parasite susceptibility, and drug mechanisms on the efficacy of the L-AmB regimen. Notably, for every 1 mg/kg increase in dosage, there was a 19 percent decrease in the likelihood of relapse.
Furthermore, combination therapy showcased reduced relapse rates compared to monotherapy, significantly reducing treatment duration and lessening the burden on healthcare systems. The researchers advocated strongly for the adoption of combination therapy in VL treatment, potentially delaying drug resistance emergence.
The study also highlighted the decreasing rates of relapse in the Indian sub-continent over time, attributing this improvement to prompt changes in treatment recommendations and the importance of continuous drug efficacy surveillance.
This insightful analysis sheds light on the effectiveness of current therapies for Visceral Leishmaniasis, underscoring the significance of dosage optimization and combination treatments in reducing relapse rates and improving patient outcomes.
