2023
Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study
del Mar Castro M, Rode J, Machado P, Llanos-Cuentas A, Hueb M, Cota G, Rojas I, Orobio Y, Sarmiento O, Rojas E, Quintero J, Pimentel M, Soto J, Suprien C, Alvarez F, Ramos A, dos Santos Arantes R, da Silva R, Arenas C, Vélez I, Lyra M, Saravia N, Arana B, Alexander N. Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study. PLOS Neglected Tropical Diseases 2023, 17: e0011029. PMID: 36689465, PMCID: PMC9894540, DOI: 10.1371/journal.pntd.0011029.Peer-Reviewed Original ResearchConceptsCollaborative retrospective studyRetrospective studyAdverse reactionsCutaneous leishmaniasisAge groupsMedian lesion diameterOverall cure rateOlder adult patientsMost adverse reactionsCutaneous leishmaniasis treatmentYears of ageMonotherapy regimenAdult patientsReferral centerLocal therapyPediatric populationClinical recordsCure rateCL patientsTherapeutic responseClinical trialsDisease presentationMedian numberMild intensityAntileishmanial treatment
2021
Diagnostic performance of a Recombinant Polymerase Amplification Test—Lateral Flow (RPA-LF) for cutaneous leishmaniasis in an endemic setting of Colombia
Cossio A, Jojoa J, del Mar Castro M, Castillo R, Osorio L, Shelite T, Saravia N, Melby P, Travi B. Diagnostic performance of a Recombinant Polymerase Amplification Test—Lateral Flow (RPA-LF) for cutaneous leishmaniasis in an endemic setting of Colombia. PLOS Neglected Tropical Diseases 2021, 15: e0009291. PMID: 33909619, PMCID: PMC8081229, DOI: 10.1371/journal.pntd.0009291.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChildChild, PreschoolChromatography, AffinityColombiaCross-Sectional StudiesDNA PrimersDNA, KinetoplastDNA, ProtozoanFemaleHumansLeishmaniaLeishmaniasis, CutaneousMaleMiddle AgedMolecular Diagnostic TechniquesNucleic Acid Amplification TechniquesSensitivity and SpecificityYoung AdultConceptsCommunity health workersHealth workersCutaneous leishmaniasisRPA-LFReference centerHealth systemPrimary health facilitiesBurden of diseaseCross-sectional studyYears of ageRoutine diagnostic testsPublic health systemPositive likelihood ratioLeishmania kinetoplast DNANegative likelihood ratioLikelihood ratioUlcerated lesionsPolymerase chain reaction detectionSpecificity 89Endemic settingsEarly diagnosisHealth facilitiesDiagnostic test performanceWeek evolutionReal-time polymerase chain reaction detection
2018
Simultaneous population pharmacokinetic modelling of plasma and intracellular PBMC miltefosine concentrations in New World cutaneous leishmaniasis and exploration of exposure–response relationships
Kip AE, del Mar Castro M, Gomez MA, Cossio A, Schellens JHM, Beijnen JH, Saravia NG, Dorlo TPC. Simultaneous population pharmacokinetic modelling of plasma and intracellular PBMC miltefosine concentrations in New World cutaneous leishmaniasis and exploration of exposure–response relationships. Journal Of Antimicrobial Chemotherapy 2018, 73: 2104-2111. PMID: 29757380, PMCID: PMC6251527, DOI: 10.1093/jac/dky143.Peer-Reviewed Original ResearchConceptsExposure-response relationshipProbability of curePopulation PK modelMiltefosine concentrationsDosing simulationsPK targetPK modelNew World cutaneous leishmaniasisPlasma concentration-time curveCutaneous leishmaniasis patientsPopulation pharmacokinetic modelLarge cohort studyPopulation pharmacokinetic modellingConcentration-time curvePlasma concentration ratioDistribution rate constantMiltefosine exposureCohort studyLeishmaniasis patientsPatient populationEffect compartmentCutaneous leishmaniasisDay 1Three-compartment modelPharmacokinetic modelling
2017
Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis
Berger BA, Cossio A, Saravia NG, del Mar Castro M, Prada S, Bartlett AH, Pho MT. Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis. PLOS Neglected Tropical Diseases 2017, 11: e0005459. PMID: 28384261, PMCID: PMC5404883, DOI: 10.1371/journal.pntd.0005459.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAntiprotozoal AgentsCaregiversChildChild, PreschoolCost-Benefit AnalysisDirectly Observed TherapyDrug CostsFemaleHumansInjections, IntramuscularLeishmaniaLeishmaniasis, CutaneousMaleMeglumineMeglumine AntimoniateMonte Carlo MethodOrganometallic CompoundsPhosphorylcholineSensitivity and SpecificityTreatment OutcomeUnited StatesConceptsPediatric cutaneous leishmaniasisMeglumine antimoniateCutaneous leishmaniasisGovernment payer perspectivePayer perspectivePatient's perspectiveMean differenceSocietal perspectiveCost-effectiveness analysisSurvey of providersOral miltefosineAdverse eventsObserved therapyPrimary outcomeHealthcare utilizationClinical trialsMean costTreatment efficacyDrug effectivenessMiltefosineHome caregiversSocietal costsLeishmaniasisCureTreatmentPharmacokinetics of Miltefosine in Children and Adults with Cutaneous Leishmaniasis
del Mar Castro M, Gomez MA, Kip AE, Cossio A, Ortiz E, Navas A, Dorlo TP, Saravia NG. Pharmacokinetics of Miltefosine in Children and Adults with Cutaneous Leishmaniasis. Antimicrobial Agents And Chemotherapy 2017, 61: 10.1128/aac.02198-16. PMID: 27956421, PMCID: PMC5328512, DOI: 10.1128/aac.02198-16.Peer-Reviewed Original ResearchConceptsCutaneous leishmaniasisMiltefosine concentrationsPeripheral blood mononuclear cellsInitiation of treatmentCompletion of treatmentBlood mononuclear cellsEnd of treatmentOutcome of treatmentConcentration-time curvePharmacokinetic clinical trialsClinical responsePediatric patientsPediatric populationMononuclear cellsTherapeutic regimensDrug exposureClinical trialsNoncompartmental analysisParasite eliminationTherapeutic outcomesStudy participantsMiltefosinePatientsLiquid chromatography-tandem mass spectrometryPK differences
2015
Parasitological Confirmation and Analysis of Leishmania Diversity in Asymptomatic and Subclinical Infection following Resolution of Cutaneous Leishmaniasis
Rosales-Chilama M, Gongora RE, Valderrama L, Jojoa J, Alexander N, Rubiano LC, Cossio A, Adams ER, Saravia NG, Gomez MA. Parasitological Confirmation and Analysis of Leishmania Diversity in Asymptomatic and Subclinical Infection following Resolution of Cutaneous Leishmaniasis. PLOS Neglected Tropical Diseases 2015, 9: e0004273. PMID: 26659114, PMCID: PMC4684356, DOI: 10.1371/journal.pntd.0004273.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAsymptomatic InfectionsBlotting, SouthernChildCluster AnalysisColombiaDNA, HelminthDNA, KinetoplastFemaleGenetic VariationGenotypeHumansLeishmaniaLeishmaniasis, CutaneousMaleMiddle AgedMolecular Sequence DataPhylogenyPolymerase Chain ReactionRNA, Small CytoplasmicSequence Analysis, DNASignal Recognition ParticleYoung AdultConceptsCutaneous leishmaniasisSubclinical infectionParasitological confirmationAsymptomatic infectionEndemic areasHistory of CLTest-positive individualsImmunological evidenceViability of LeishmaniaMucosal swab samplesPersistent subclinical infectionMucosal tissue samplesReservoir of infectionActive diseaseLeishmania kDNALeishmania infectionPositive individualsPersistent infectionBlood monocytesParasite burdenInfectionParasite populationsSwab samplesTransmission of diseaseTissue samples
2014
Sensitive diagnosis of cutaneous leishmaniasis by lesion swab sampling coupled to qPCR
ADAMS ER, GOMEZ MA, SCHESKE L, RIOS R, MARQUEZ R, COSSIO A, ALBERTINI A, SCHALLIG H, SARAVIA NG. Sensitive diagnosis of cutaneous leishmaniasis by lesion swab sampling coupled to qPCR. Parasitology 2014, 141: 1891-1897. PMID: 25111885, PMCID: PMC4654403, DOI: 10.1017/s0031182014001280.Peer-Reviewed Original ResearchConceptsCutaneous leishmaniasisMiltefosine and Antimonial Drug Susceptibility of Leishmania Viannia Species and Populations in Regions of High Transmission in Colombia
Fernández OL, Diaz-Toro Y, Ovalle C, Valderrama L, Muvdi S, Rodríguez I, Gomez MA, Saravia NG. Miltefosine and Antimonial Drug Susceptibility of Leishmania Viannia Species and Populations in Regions of High Transmission in Colombia. PLOS Neglected Tropical Diseases 2014, 8: e2871. PMID: 24853871, PMCID: PMC4031164, DOI: 10.1371/journal.pntd.0002871.Peer-Reviewed Original ResearchConceptsV. panamensisLine treatmentClinical strainsDrug susceptibilitySecond-line treatmentFirst-line treatmentEmergence of resistancePopulations of LeishmaniaViannia speciesResistant clinical strainsAntimony susceptibilityClinical evidenceMeglumine antimoniatePentavalent antimonialsDermal leishmaniasisEpidemiologic differencesLeishmania VianniaProxy markerIntracellular amastigotesMunicipality of TumacoResistant strainsMiltefosineDisparate susceptibilityDrugsL. panamensis
2013
Treatment Failure and Miltefosine Susceptibility in Dermal Leishmaniasis Caused by Leishmania Subgenus Viannia Species
Obonaga R, Fernández O, Valderrama L, Rubiano L, del Mar Castro M, Barrera M, Gomez M, Saravia N. Treatment Failure and Miltefosine Susceptibility in Dermal Leishmaniasis Caused by Leishmania Subgenus Viannia Species. Antimicrobial Agents And Chemotherapy 2013, 58: 144-152. PMID: 24145529, PMCID: PMC3910710, DOI: 10.1128/aac.01023-13.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultATP Binding Cassette Transporter, Subfamily GATP-Binding Cassette TransportersChildDrug ResistanceFemaleHumansLeishmaniaLeishmaniasis, CutaneousMaleMiddle AgedMultidrug Resistance-Associated Protein 2Multidrug Resistance-Associated ProteinsPhosphorylcholineProspective StudiesTreatment FailureYoung AdultConceptsTreatment failureDermal leishmaniasisQuantitative reverse transcription PCRLoss of susceptibilityMiltefosine susceptibilityDrug susceptibilityIntracellular amastigotesL. panamensis infectionsL. braziliensis infectionPanamensis infectionMucocutaneous diseaseMiltefosine treatmentBraziliensis infectionCutaneous lesionsProspective evaluationMucosal diseaseDrug exposureReverse transcription-PCRClinical failureIndividual patientsGene polymorphismsLeishmania panamensisConcurrent conditionsDecreased expressionTransporter expressionClinical and Epidemiologic Profile of Cutaneous Leishmaniasis in Colombian Children: Considerations for Local Treatment
Blanco VM, Cossio A, Martinez JD, Saravia NG. Clinical and Epidemiologic Profile of Cutaneous Leishmaniasis in Colombian Children: Considerations for Local Treatment. American Journal Of Tropical Medicine And Hygiene 2013, 89: 359-364. PMID: 23798581, PMCID: PMC3741260, DOI: 10.4269/ajtmh.12-0784.Peer-Reviewed Original ResearchConceptsLocal treatmentCutaneous leishmaniasisNew World cutaneous leishmaniasisIndividual risk-benefit assessmentHead/neckYears of ageRisk-benefit assessmentWHO criteriaEpidemiologic profileEpidemiological profileOrganization criteriaCase reportChildren 0Months durationSingle lesionInternational guidelinesTreatment alternativesEffectiveness dataLesionsColombian childrenTreatmentChildrenLeishmaniasisNeckEligibility
2012
Noninferiority of Miltefosine Versus Meglumine Antimoniate for Cutaneous Leishmaniasis in Children
Rubiano L, Miranda M, Arenas S, Montero L, Rodríguez-Barraquer I, Garcerant D, Prager M, Osorio L, Rojas M, Pérez M, Nicholls R, Saravia N. Noninferiority of Miltefosine Versus Meglumine Antimoniate for Cutaneous Leishmaniasis in Children. The Journal Of Infectious Diseases 2012, 205: 684-692. PMID: 22238470, PMCID: PMC3266136, DOI: 10.1093/infdis/jir816.Peer-Reviewed Original ResearchConceptsPediatric cutaneous leishmaniasisMeglumine antimoniateCutaneous leishmaniasisTreatment failureInitiation of treatmentNoninferiority clinical trialPercent of childrenLow response rateOral miltefosineAdverse eventsMasked evaluationPrimary outcomeTreat analysisWeek 26Clinical trialsOral administrationAntimonial drugsTreatment groupsResponse rateAntimoniateLeishmania panamensisLeishmania guyanensisMiltefosineLeishmaniasisElimination rate
2008
Etiologic agent of an epidemic of cutaneous leishmaniasis in Tolima, Colombia.
Rodríguez-Barraquer I, Góngora R, Prager M, Pacheco R, Montero LM, Navas A, Ferro C, Miranda MC, Saravia NG. Etiologic agent of an epidemic of cutaneous leishmaniasis in Tolima, Colombia. American Journal Of Tropical Medicine And Hygiene 2008, 78: 276-82. PMID: 18256429, DOI: 10.4269/ajtmh.2008.78.276.Peer-Reviewed Original ResearchConceptsAmerican cutaneous leishmaniasisCutaneous leishmaniasisEtiologic agentLeishmania guyanensisProbable etiologic agentLeishmaniasis control programLarge epidemicsMonoclonal antibodiesLeishmania isolatesLeishmaniasisPeridomestic settingsZoonotic diseaseL. panamensisEpidemicDomestic transmissionControl programsPresent studyIsoenzyme electrophoresisIsolatesAgentsGuyanensisPatientsDiseaseDiagnosisAntibodies
2007
Pharmacokinetics of Antimony in Children Treated for Leishmaniasis with Meglumine Antimoniate
Cruz A, Rainey PM, Herwaldt BL, Stagni G, Palacios R, Trujillo R, Saravia NG. Pharmacokinetics of Antimony in Children Treated for Leishmaniasis with Meglumine Antimoniate. The Journal Of Infectious Diseases 2007, 195: 602-608. PMID: 17230422, DOI: 10.1086/510860.Peer-Reviewed Original ResearchConceptsPharmacokinetics of antimonyMeglumine antimoniateDrug exposureIntramuscular meglumine antimoniateWeight-adjusted clearancePeak concentrationPotential clinical relevanceTime-concentration curveLower peak concentrationsAntimonial therapyPharmacokinetic differencesCutaneous leishmaniasisClinical relevanceChildren 3Day 20Clearance rateAntimoniateLeishmaniasisAdultsChildrenSecond groupFirst groupPharmacokineticsDaysExposure
2006
Resistance to Antimony and Treatment Failure in Human Leishmania (Viannia) Infection
Rojas R, Valderrama L, Valderrama M, Varona MX, Ouellette M, Saravia NG. Resistance to Antimony and Treatment Failure in Human Leishmania (Viannia) Infection. The Journal Of Infectious Diseases 2006, 193: 1375-1383. PMID: 16619185, DOI: 10.1086/503371.Peer-Reviewed Original ResearchConceptsTreatment failureMeglumine antimoniatePrimary resistanceAntimonial drugsSecondary resistanceDrug resistanceHuman Leishmania infectionsEffective immune responseAnthroponotic visceral leishmaniasisAmerican cutaneous leishmaniasisAntimonial therapyStandard treatmentCutaneous diseaseLeishmania infectionTherapeutic responseImmune responseCutaneous leishmaniasisVisceral leishmaniasisAnthroponotic transmissionResistant organismsEffective doseIntracellular amastigotesSusceptible strainsAntimoniatePatients
2005
Amplification of human DNA by primers targeted to Leishmania kinetoplast DNA and post-genome considerations in the detection of parasites by a polymerase chain reaction.
Vergel C, Walker J, Saravia NG. Amplification of human DNA by primers targeted to Leishmania kinetoplast DNA and post-genome considerations in the detection of parasites by a polymerase chain reaction. American Journal Of Tropical Medicine And Hygiene 2005, 72: 423-9. PMID: 15827280, DOI: 10.4269/ajtmh.2005.72.423.Peer-Reviewed Original ResearchConceptsMolecular amplification techniquesPerformance of primersPolymerase chain reaction productsAmplification techniquesMonocyte DNADNA probesLeishmania kinetoplast DNANew applicationsChain reaction productsDNA amplificationHuman DNA sequencesDNA sequencesDetection of parasitesPolymerase chain reaction
2003
Efficacy of amodiaquine and sulfadoxine/pyrimethamine in the treatment of malaria not complicated by Plasmodium falciparum in Nariño, Colombia, 1999-2002.
González IJ, Padilla JO, Giraldo LE, Saravia NG. Efficacy of amodiaquine and sulfadoxine/pyrimethamine in the treatment of malaria not complicated by Plasmodium falciparum in Nariño, Colombia, 1999-2002. Biomédica 2003, 23: 38-46. PMID: 12696398, DOI: 10.7705/biomedica.v23i1.1196.Peer-Reviewed Original ResearchConceptsSulfadoxine/pyrimethamineTreatment failureUncomplicated Plasmodium falciparum malariaCombination of amodiaquineEfficacy of amodiaquinePlasmodium falciparum malariaSP treatment failureModerate malaria transmissionAntimalarial drug resistanceTreatment of malariaFalciparum malariaAntimalarial treatmentTherapeutic failureAntimalarial resistanceCurrent doseAntimalarial efficacyMalaria transmissionPatientsAntimalarial drugsDrug resistanceAmodiaquinePlasmodium falciparumTreatment regimesMalariaEfficacy
1998
Frequency of the Asn-108 and Thr-108 point mutations in the dihydrofolate reductase gene in Plasmodium falciparum from southwest Colombia.
Giraldo L, Acosta M, Labrada L, Praba A, Montenegro-James S, Saravia N, Krogstad D. Frequency of the Asn-108 and Thr-108 point mutations in the dihydrofolate reductase gene in Plasmodium falciparum from southwest Colombia. American Journal Of Tropical Medicine And Hygiene 1998, 59: 124-8. PMID: 9684639, DOI: 10.4269/ajtmh.1998.59.124.Peer-Reviewed Original Research
1993
Epidemiology of Cutaneous Leishmaniasis in Colombia: A Longitudinal Study of the Natural History, Prevalence, and Incidence of Infection and Clinical Manifestations
Weigle K, Santrich C, Martinez F, Valderrama L, Saravia N. Epidemiology of Cutaneous Leishmaniasis in Colombia: A Longitudinal Study of the Natural History, Prevalence, and Incidence of Infection and Clinical Manifestations. The Journal Of Infectious Diseases 1993, 168: 699-708. PMID: 8354912, DOI: 10.1093/infdis/168.3.699.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAnimalsAntigens, ProtozoanChildChild, PreschoolCohort StudiesColombiaFemaleHumansIncidenceInfantInfant, NewbornLeishmania braziliensisLeishmaniasis, CutaneousLongitudinal StudiesMaleMiddle AgedModels, BiologicalProspective StudiesRespiratory SystemRural PopulationSex FactorsSkinSkin TestsTime FactorsConceptsLeishmanin skin test conversionMost primary infectionsSkin test conversionBurden of diseaseIncidence of infectionLeishmaniasis control programClinical manifestationsProspective studyPrimary infectionTest conversionLeishmania infectionIncidence rateTypical scarCutaneous leishmaniasisEndemic areasNew infectionsLeishmaniasis casesNatural historyInfectionLeishmaniasisNaive hostsLongitudinal studyLesionsOne-thirdIncidenceEpidemiology of Cutaneous Leishmaniasis in Colombia: Environmental and Behavioral Risk Factors for Infection, Clinical Manifestations, and Pathogenicity
Weigle K, Santrich C, Martinez F, Valderrama L, Saravia N. Epidemiology of Cutaneous Leishmaniasis in Colombia: Environmental and Behavioral Risk Factors for Infection, Clinical Manifestations, and Pathogenicity. The Journal Of Infectious Diseases 1993, 168: 709-714. PMID: 8354913, DOI: 10.1093/infdis/168.3.709.Peer-Reviewed Original ResearchConceptsRisk factorsFarming occupationLeishmania panamensis infectionRisk factor informationBehavioral risk factorsAcquisition of infectionYears of ageRisk of lesionsPanamensis infectionLeishmanial lesionsClinical manifestationsMale sexActive surveillanceLeishmania infectionCase ascertainmentCutaneous leishmaniasisNew infectionsInfectionLeishmania braziliensisLesionsFactor informationStrongest predictorAgeLeishmaniasisSexLeishmania (Viannia) panamensis-specific IgE and IgA antibodies in relation to expression of human tegumentary leishmaniasis.
O'Neil C, Labrada M, Saravia N. Leishmania (Viannia) panamensis-specific IgE and IgA antibodies in relation to expression of human tegumentary leishmaniasis. American Journal Of Tropical Medicine And Hygiene 1993, 49: 181-8. PMID: 8357080, DOI: 10.4269/ajtmh.1993.49.181.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnimalsAntibodies, ProtozoanAntibody SpecificityAntigens, ProtozoanChildChild, PreschoolCross ReactionsDose-Response Relationship, ImmunologicEnzyme-Linked Immunosorbent AssayFemaleHumansImmunoglobulin AImmunoglobulin EInfantLeishmania braziliensisLeishmaniasis, CutaneousLeishmaniasis, MucocutaneousMaleRadioallergosorbent TestRetrospective StudiesConceptsAmerican tegumentary leishmaniasisIgA antibodiesEnzyme-linked immunosorbent assayTegumentary leishmaniasisRadioallergosorbent testRAST valuesHuman tegumentary leishmaniasisDuration of diseaseIgA levelsMucocutaneous diseaseBiopsy specimenBiopsy specimensCutaneous diseaseSevere formPatientsHeterologous antigensDisease evolutionIgEImmunosorbent assayElevated levelsLeishmaniasisDiseaseInhibition testingAntibodiesSeparate groups