•Nearly 90 per cent of participants in the Doka, Sudan, trial were 12 years or younger when it started in 2018. For 42 days, Arm 1 was given injectable paromomycin (MF+PM) and oral miltefosine.
•Before the breakthrough, treatment for PKDL was done through sodium stibogluconate, an injectable drug given for lengthy 60–90 days that carries life-threatening toxicity when used for an extended period and requires hospital admission as it must be administered under close supervision
Scientists have broken through the treatment barrier after finding a cure for an uncommon skin illness.
A news release from the Drugs for Neglected Diseases project stated on July 17 that scientists had discovered a more affordable, shorter, safer, and child-friendly treatment for post-kala-azar dermal leishmaniasis.
Kala-azar dermal leishmaniasis manifests as tiny spots or nodular rash on the face, upper arms, and trunk.
The mouth is the first site of infection for the skin condition, which can then spread to the arms and upper torso before infecting the entire body. The disease comes after treatment of visceral leishmaniasis (VL).
Sandflies, which transfer VL when infected and feed on PKDL lesions in people's wounds, spread the disease, making therapy an important step in preventing further infections.
The study was done by DNDi and the Institute of Endemic Diseases at the University of Khartoum.
Ahmed Musa, Senior Investigator for Leishmaniasis and a researcher, stated that previous therapies have been "prolonged, toxic, and expensive.
“But we have now found a safer and better treatment option where patients only need to be admitted to hospital for 14 days and then complete the oral treatment at home. This makes it more patient-friendly, which is important since most people affected by this terrible disease are children.” Musa said.
Before the breakthrough, treatment for PKDL was done through sodium stibogluconate, an injectable drug given for lengthy 60–90 days that carries life-threatening toxicity when used for an extended period and requires hospital admission as it must be administered under close supervision
“However, these new results have found that a 42-day therapy combining oral miltefosine and injectable paromomycin (MF+PM) is very promising for treating PKDL,” DNDi said in a press statement.
Nearly 90 per cent of participants in the Doka, Sudan, trial were 12 years or younger when it started in 2018. For 42 days, Arm 1 was given injectable paromomycin (MF+PM) and oral miltefosine.
According to DNDi, cases of Kala-azar infection have been documented in South Sudan, Ethiopia, Kenya, Uganda, and Sudan.
This is one of the many diseases that conventional pharmaceutical companies have overlooked.
With the novel approach, patients can begin oral miltefosine concurrently with injectables and remain in the hospital for 14 days while receiving the paromomycin treatment. Patients can continue receiving oral medicine at home after they leave the hospital.
The results found that 98 per cent of subjects who followed this regimen were completely cured after a 12-month follow-up visit.
‘For a long time, medical research has left behind patients with PKDL in Eastern Africa because the disease is not considered life-threatening. Many have had to endure not only stigma but expensive, lengthy treatments exposing them to toxicity,’ said Fabiana Alves, Director of the Leishmaniasis Cluster at DNDi.
The World Health Organization said detecting and treating PKDL is crucial for eliminating VL as a public health problem. It targets eliminating the disease in the Eastern African region by 2030.
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