Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.

BACKGROUND:Cutaneous leishmaniasis (CL) is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking. METHODOLOGY/PRINCIPAL FINDINGS:In this report we re...

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Main Authors: Mustafa Aksoy, Nebiye Doni, Hatice Uce Ozkul, Yavuz Yesilova, Nurittin Ardic, Abdullah Yesilova, Jennifer Ahn-Jarvis, Steve Oghumu, Cesar Terrazas, Abhay R Satoskar
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-07-01
Series:PLoS Neglected Tropical Diseases
Online Access:http://europepmc.org/articles/PMC4945060?pdf=render
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author Mustafa Aksoy
Nebiye Doni
Hatice Uce Ozkul
Yavuz Yesilova
Nurittin Ardic
Abdullah Yesilova
Jennifer Ahn-Jarvis
Steve Oghumu
Cesar Terrazas
Abhay R Satoskar
author_facet Mustafa Aksoy
Nebiye Doni
Hatice Uce Ozkul
Yavuz Yesilova
Nurittin Ardic
Abdullah Yesilova
Jennifer Ahn-Jarvis
Steve Oghumu
Cesar Terrazas
Abhay R Satoskar
author_sort Mustafa Aksoy
collection DOAJ
description BACKGROUND:Cutaneous leishmaniasis (CL) is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking. METHODOLOGY/PRINCIPAL FINDINGS:In this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL cases, and how children respond to antimonial therapy. CL was observed most frequently in children between 6-10 years old. Interestingly this group showed shorter duration of disease and smaller lesions compared to 0-5 year and 11-15 year old groups. Females were more affected in all groups. Lesion localization and types varied among groups, with 0-5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this could be associated to the longest duration of the disease in this group. Eleven-15 year old group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0-5 year old received intramuscular treatment more often than the other groups. Furthermore, the majority of 0-5 year old group which received intra-lesional treatment did not received subsequent intra-lesional cycles, as did children in the range of 6-15 years old. CONCLUSIONS/SIGNIFICANCE:We report an increase in pediatric CL patients within the last four years. Analysis of pediatric CL patients by age revealed significant differences in CL progression. The data suggest that children between 0-5 years old responded better than other groups to intralesional treatment, since they received more often a single cycle of IL treatment, although follow up observation is required since they were more prone to develop recidivans. Eleven-15 year old patients comprise the largest percentage of patients receiving two or three cycles of intralesional treatment, suggesting that this group did not respond efficiently to intralesional treatment and highlighting the need for more effective therapeutic strategies against CL.
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spelling doaj.art-a9a787a709d244809ccdf521969cdba92022-12-21T19:03:08ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352016-07-01107e000483510.1371/journal.pntd.0004835Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.Mustafa AksoyNebiye DoniHatice Uce OzkulYavuz YesilovaNurittin ArdicAbdullah YesilovaJennifer Ahn-JarvisSteve OghumuCesar TerrazasAbhay R SatoskarBACKGROUND:Cutaneous leishmaniasis (CL) is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking. METHODOLOGY/PRINCIPAL FINDINGS:In this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL cases, and how children respond to antimonial therapy. CL was observed most frequently in children between 6-10 years old. Interestingly this group showed shorter duration of disease and smaller lesions compared to 0-5 year and 11-15 year old groups. Females were more affected in all groups. Lesion localization and types varied among groups, with 0-5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this could be associated to the longest duration of the disease in this group. Eleven-15 year old group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0-5 year old received intramuscular treatment more often than the other groups. Furthermore, the majority of 0-5 year old group which received intra-lesional treatment did not received subsequent intra-lesional cycles, as did children in the range of 6-15 years old. CONCLUSIONS/SIGNIFICANCE:We report an increase in pediatric CL patients within the last four years. Analysis of pediatric CL patients by age revealed significant differences in CL progression. The data suggest that children between 0-5 years old responded better than other groups to intralesional treatment, since they received more often a single cycle of IL treatment, although follow up observation is required since they were more prone to develop recidivans. Eleven-15 year old patients comprise the largest percentage of patients receiving two or three cycles of intralesional treatment, suggesting that this group did not respond efficiently to intralesional treatment and highlighting the need for more effective therapeutic strategies against CL.http://europepmc.org/articles/PMC4945060?pdf=render
spellingShingle Mustafa Aksoy
Nebiye Doni
Hatice Uce Ozkul
Yavuz Yesilova
Nurittin Ardic
Abdullah Yesilova
Jennifer Ahn-Jarvis
Steve Oghumu
Cesar Terrazas
Abhay R Satoskar
Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.
PLoS Neglected Tropical Diseases
title Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.
title_full Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.
title_fullStr Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.
title_full_unstemmed Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.
title_short Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.
title_sort pediatric cutaneous leishmaniasis in an endemic region in turkey a retrospective analysis of 8786 cases during 1998 2014
url http://europepmc.org/articles/PMC4945060?pdf=render
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