Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic states
Background & objectives: Detection and treatment of post-kala-azar dermal leishmaniasis (PKDL) cases is considered important for kala-azar elimination. The objective of our study was to find out the proportion of different forms of lesions, interruption of treatment and rate of treatment complet...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Journal of Vector Borne Diseases |
| Subjects: | |
| Online Access: | http://www.jvbd.org/article.asp?issn=0972-9062;year=2020;volume=57;issue=2;spage=161;epage=169;aulast=Saurabh |
| _version_ | 1829507483182301184 |
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| author | Suman Saurabh Pritam Roy Dhruv K Pandey Dipanjan Ray Shourabh Tarak Rajesh Pandey Dileep Kumar Sarosh Jamil Anand Paulraj Amarendra Kumar Siddhartha Dutta |
| author_facet | Suman Saurabh Pritam Roy Dhruv K Pandey Dipanjan Ray Shourabh Tarak Rajesh Pandey Dileep Kumar Sarosh Jamil Anand Paulraj Amarendra Kumar Siddhartha Dutta |
| author_sort | Suman Saurabh |
| collection | DOAJ |
| description | Background & objectives: Detection and treatment of post-kala-azar dermal leishmaniasis (PKDL) cases is considered important for kala-azar elimination. The objective of our study was to find out the proportion of different forms of lesions, interruption of treatment and rate of treatment completion, cure rates of PKDL, risk factors for developing severe forms of PKDL and utilization of services offered by the kala-azar elimination program.
Methods: A cross-sectional survey of PKDL patients registered for treatment at all levels of care during 2015 and 2016 was done.
Results: 576 PKDL patients who had started treatment in 2015 and 2016 were studied. Three-fourths of all patients were found to be clinically cured after a year of follow-up. Around 90% lesions were of macular type. Interruption of treatment was observed in one-fourth of PKDL patients. Median duration between kala-azar treatment and development of PKDL was 4.5 years. Around 79% patients had past history of kala-azar treatment. Discontinuation of treatment during earlier kala-azar episode was significantly associated with the development of papular and nodular forms of lesion. 43% of patients had received the incentive of INR 2000 after completion of treatment. Around three-fourths women in the reproductive age group were found not to use any contraceptive method during PKDL treatment.
Interpretation & conclusion: PKDL treatment interruption should be reduced through ensuring drug supply and timely retrieval of patients. Directly observed treatment should be implemented and combination regimen should be explored to improve final cure rate. Delivery of financial incentive to PKDL patients and counselling and contraception to women of reproductive age group should be improved. |
| first_indexed | 2024-12-16T11:08:25Z |
| format | Article |
| id | doaj.art-41d6b2d250f34dc8a5f2109e5bf6368d |
| institution | Directory Open Access Journal |
| issn | 0972-9062 |
| language | English |
| last_indexed | 2024-12-16T11:08:25Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Vector Borne Diseases |
| spelling | doaj.art-41d6b2d250f34dc8a5f2109e5bf6368d2022-12-21T22:33:47ZengWolters Kluwer Medknow PublicationsJournal of Vector Borne Diseases0972-90622020-01-0157216116910.4103/0972-9062.310875Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic statesSuman SaurabhPritam RoyDhruv K PandeyDipanjan RayShourabh TarakRajesh PandeyDileep KumarSarosh JamilAnand PaulrajAmarendra KumarSiddhartha DuttaBackground & objectives: Detection and treatment of post-kala-azar dermal leishmaniasis (PKDL) cases is considered important for kala-azar elimination. The objective of our study was to find out the proportion of different forms of lesions, interruption of treatment and rate of treatment completion, cure rates of PKDL, risk factors for developing severe forms of PKDL and utilization of services offered by the kala-azar elimination program. Methods: A cross-sectional survey of PKDL patients registered for treatment at all levels of care during 2015 and 2016 was done. Results: 576 PKDL patients who had started treatment in 2015 and 2016 were studied. Three-fourths of all patients were found to be clinically cured after a year of follow-up. Around 90% lesions were of macular type. Interruption of treatment was observed in one-fourth of PKDL patients. Median duration between kala-azar treatment and development of PKDL was 4.5 years. Around 79% patients had past history of kala-azar treatment. Discontinuation of treatment during earlier kala-azar episode was significantly associated with the development of papular and nodular forms of lesion. 43% of patients had received the incentive of INR 2000 after completion of treatment. Around three-fourths women in the reproductive age group were found not to use any contraceptive method during PKDL treatment. Interpretation & conclusion: PKDL treatment interruption should be reduced through ensuring drug supply and timely retrieval of patients. Directly observed treatment should be implemented and combination regimen should be explored to improve final cure rate. Delivery of financial incentive to PKDL patients and counselling and contraception to women of reproductive age group should be improved.http://www.jvbd.org/article.asp?issn=0972-9062;year=2020;volume=57;issue=2;spage=161;epage=169;aulast=Saurabhindia; miltefosine; post-kala-azar dermal leishmaniasis; treatment interruption; visceral leishmaniasis |
| spellingShingle | Suman Saurabh Pritam Roy Dhruv K Pandey Dipanjan Ray Shourabh Tarak Rajesh Pandey Dileep Kumar Sarosh Jamil Anand Paulraj Amarendra Kumar Siddhartha Dutta Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic states Journal of Vector Borne Diseases india; miltefosine; post-kala-azar dermal leishmaniasis; treatment interruption; visceral leishmaniasis |
| title | Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic states |
| title_full | Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic states |
| title_fullStr | Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic states |
| title_full_unstemmed | Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic states |
| title_short | Changing clinico-epidemiology of post-kala-azar dermal leishmaniasis (PKDL) in India: Results of a survey in four endemic states |
| title_sort | changing clinico epidemiology of post kala azar dermal leishmaniasis pkdl in india results of a survey in four endemic states |
| topic | india; miltefosine; post-kala-azar dermal leishmaniasis; treatment interruption; visceral leishmaniasis |
| url | http://www.jvbd.org/article.asp?issn=0972-9062;year=2020;volume=57;issue=2;spage=161;epage=169;aulast=Saurabh |
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