A STUDY ON EFFICACY AND TOLERABILITY OF MILTEFOSINE FOR CHILDHOOD VISCERAL LEISHMANIASIS IN A TERTIARY CARE CENTRE IN EASTERN BIHAR

Dr Kishore Kumar Sinha, Dr Ashish Basant, Dr Amarjeet Patel

Abstract


Introduction: Leishmania donovani is an intracellular protozoan parasite of genus Leishmania. It causes Visceral leishmaniasis (VL), which is a disseminated and serious form of leishmaniasis. VL causes an estimated 500,000 new cases of disease and 60,000 deaths every year. VL is deadly and debilitating disease affecting children of Bihar and U.P. Antimony resistance is a serious problem, Amphotericin B and Pentamidine are effective by parenteral administration, associated with toxicities. Thus there is a need for an effective, orally administered, non-toxic and less expensive alternative drug like Miltefosine, to be used in children.

Aims and Objectives: The present study was designed to observe the efficacy of Miltefosine in VL, in Bihar by evaluating the usage of adult dosage of Miltefosine (2.5 mg/kg/d for 28 days) in 160 children (age, 2–11 years).

Materials and Methods: Our study is an open-label, clinical trial involving 160 patients admitted at JLNMCH, Bhagalpur, Bihar who were parasitologically proven cases of VL who received Miltefosine and were followed up for the following one year.

Results: Out of 160 children, 2 died of pneumonia, other 158 patients demonstrated no parasites after treatment and improved clinically. 6 patients relapsed, 2 patients lost follow-up.  Cure rate was 94% .Side effects included vomiting or diarrhea (each 25%) and transient elevations in the AST level (55%).

Conclusions: The present study concludes that Miltefosine is effective, well tolerated, and easily administrable oral drug in the treatment of VL in Children in resource poor country like India

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References


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