Epidemic Visceral Leishmaniasis in Sudan: A Randomized Trial of Aminosidine plus Sodium Stibogluconate versus Sodium Stibogluconate Alone

• Published in: The Journal of infectious diseases Vol. 168; no. 3; pp. 715 - 720
• Main Authors: Seaman, J., Pryce, D., Sondorp, H. E., Moody, A., Bryceson, A. D. M., Davidson, R. N.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.09.1993; University of Chicago Press
• Subjects: Adolescent; Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimony Sodium Gluconate - therapeutic use; Antiparasitic agents; Biological and medical sciences; Body mass index; Child; Child, Preschool; Disease Outbreaks; Drug Therapy, Combination; Epidemics; Female; Fever; Giardiasis - drug therapy; Humans; Infant; Leishmania; Leishmaniasis, Visceral - complications; Leishmaniasis, Visceral - drug therapy; Liver; Major Articles; Malaria - drug therapy; Male; Medical sciences; Middle Aged; Nutrition Disorders - complications; Parasites; Parasitism; Paromomycin - therapeutic use; Pharmacology. Drug treatments; Pregnancy; Sodium; Spleen; Splenomegaly; Sudan - epidemiology; Tropical medicine; Visceral leishmaniasis; Weight Loss; Africa; Sudan; Infection; Human; Protozoal disease; Drug combination; Chemotherapy; Treatment; Aminoglycoside; Treatment efficiency; Parasiticid; Kala azar; Leishmaniasis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/168.3.715

In a comparative trial of treatment in southern Sudan, visceral leishmaniasis was diagnosed by the following symptoms: fever for > 1 month, splenomegaly, and antileishmanial direct agglutination test (DAT) titer of ⩾ 1:25,600. Patients (200) were randomized to receive sodium stibogluconate (Sbv) at 20 mg/kg/day for 30 days (groups S, n = 99) or Sbv at 20 mg/kg/day plus aminosidine at 15 mg/kg/day for 17 days (group AS, n = 101), Of 192 patients who had spleens or lymph nodes aspirated at entry, 134 (70%) were positive for parasites. During treatment, 7% in group Sand 4% in group AS died. All 184 patients who completed treatment were clinically cured. At days 15–17, microscopy of aspirates showed that 57 (95%) of 60 in group AS were negative for parasites compared with 47 (81 %) of 58 in group S (P = .018). At day 30, 57 (93.4%) of 61 group S aspirates were negative.