Treatment characteristics, outcomes, and safety for cutaneous leishmaniasis in Colombian adults aged over 44 years between 2011 and 2023

Abstract

Objective: To describe the effectiveness and safety of treatment for cutaneous leishmaniasis in patients over the age of 44 years treated at a specialized research center in Colombia.

Methods: Clinical profiles of cutaneous leishmaniasis patients were retrospectively described and effectiveness and safety of systemic and local and systemic treatments were compared with Pearson's Chi-square test or Fisher's exact test.

Results: A total of 151 patients were included and 65% were male, 78% were over 50 years of age, 28% had hypertension and 11% had diabetes. The main treatments were systemic glucantime (10%), miltefosine (15%), and local treatments (48%). Treatment effectiveness was 68% for systemic and 64% for local treatments. Patients on systemic treatments had a significantly higher frequency of systemic adverse events. In contrast, those on local treatments only showed a statistically higher proportion of vesicles in application site.

Conclusions: Our findings show moderate effectiveness across treatments. Crucially, while systemic and local treatments had similar effectiveness, systemic treatments were associated with a significantly higher frequency of adverse events. This finding highlights that local therapies offer a safer alternative for older adults, making them a viable and potentially preferable first-line option to minimize toxicity in this vulnerable population.

Keywords

Cutaneous leishmaniasis / Treatment / Older adult / Effectiveness / Safety

Conflict of interest statement

All authors declare there is no conflict of interest.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors’ contributions

LLC and ESR participated in the conceptualization and design of the work; ESR participated in the data collection; LLC, IVC, VRR and JACA participated in the validation; LLC, IVC, VRR and JACA participated in the formal analysis and interpretation; ESR, IVC, VRR and JACA participated in the data curation; LLC, IVC, VRR and JACA participated in the writing—original draft preparation; LLC, IVC, VRR, ESR and JACA participated in the writing—review and editing, and LLC participated in the supervision. All authors have read and agreed to the final version of the manuscript.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Edited by Lei Y, Pan Y, Zhang Q

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