Nancy Saravia, PhD, MSc
Professor Adjunct of Epidemiology (Microbial Diseases)About
Research
Publications
2024
Natural resistance to meglumine antimoniate is associated with treatment failure in cutaneous leishmaniasis caused by Leishmania (Viannia) panamensis
Fernández O, Rosales-Chilama M, Sánchez-Hidalgo A, Gómez P, Rebellón-Sánchez D, Regli I, Díaz-Varela M, Tacchini-Cottier F, Saravia N. Natural resistance to meglumine antimoniate is associated with treatment failure in cutaneous leishmaniasis caused by Leishmania (Viannia) panamensis. PLOS Neglected Tropical Diseases 2024, 18: e0012156. PMID: 38709850, PMCID: PMC11098511, DOI: 10.1371/journal.pntd.0012156.Peer-Reviewed Original ResearchConceptsAssociated with treatment failureTreatment failureHost risk factorsBALB/c miceRisk factorsDrug susceptibilityClinical strainsOutcome of cutaneous leishmaniasisOdds of treatment failureMeglumine antimoniateParasitological response to treatmentLeishmania (Viannia) panamensisSubgroup of patientsAntimicrobial drug susceptibilityResponse to treatmentU937 macrophagesEvaluate drug susceptibilityCutaneous leishmaniasis patientsCutaneous leishmaniasisFailed treatmentPlasma CmaxTherapeutic responseClinical outcomesPatient's lesionsTreatment outcomesThe different impact of drug-resistant Leishmania on the transcription programs activated in neutrophils
Díaz-Varela M, Sanchez-Hidalgo A, Calderon-Copete S, Tacchini V, Shipley T, Ramírez G, Marquis J, Fernández O, Saravia N, Tacchini-Cottier F. The different impact of drug-resistant Leishmania on the transcription programs activated in neutrophils. IScience 2024, 27: 109773. PMID: 38711445, PMCID: PMC11070714, DOI: 10.1016/j.isci.2024.109773.Peer-Reviewed Original ResearchDrug-resistant parasitesDrug resistanceEffective control of infectionProduction of cytokinesDrug-resistant infectionsControl of infectionMyeloid recruitmentImmune microenvironmentChemokines CCL3Drug susceptibilityMyeloid cellsCCL3 levelsMouse modelNeutrophil subsetsDrug-resistant LeishmaniaNeutrophilsAntimicrobial controlImpaired abilityInfectionCCL3Neutrophil genesTranscriptional programsParasite strainsDrugParasitic diseasesBuilding Research Capacity in Low- and Middle-Income Countries and Pandemic Preparedness: Lessons Learned and Future Directions
Kilmarx P, Goraleski K, Khan E, Lindo J, Saravia N. Building Research Capacity in Low- and Middle-Income Countries and Pandemic Preparedness: Lessons Learned and Future Directions. American Journal Of Tropical Medicine And Hygiene 2024, 110: 417-420. PMID: 38266289, PMCID: PMC10919184, DOI: 10.4269/ajtmh.23-0675.Peer-Reviewed Original ResearchMiddle-income countriesResearch capacityShortage of trained staffLow-and-middle-income countriesBuilding Research CapacityAnd Middle-Income CountriesGlobal Health Security AgendaWorld Health Assembly resolutionPandemic preparednessInterdisciplinary trainingRapid pathogen identificationTask ForceCapacity buildingGlobal initiativesPandemic responseEbola outbreakProactive engagementClinical trialsCollaborative effortsPreparednessGlobal partnershipPathogen identificationDisease researchExperiences of leadersGenome sequence
2023
Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia
Castillo M, Alexander N, Rubiano L, Rojas C, Navarro A, Rincon D, Bernal L, Lerma Y, Saravia N, Aronoff-Spencer E. Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. PLOS Neglected Tropical Diseases 2023, 17: e0011180. PMID: 36972285, PMCID: PMC10079216, DOI: 10.1371/journal.pntd.0011180.Peer-Reviewed Original ResearchConceptsEffectiveness of treatmentIntervention armWeek 26Therapeutic responseCutaneous leishmaniasisHealth systemSerious adverse eventsEnd of treatmentStart of treatmentCutaneous leishmaniasis treatmentProportion of participantsMobile health strategiesPublic health systemCommunity-based detectionTreatment of CLPrimary endpointAdverse eventsMore patientsClinical managementControl armImproved careMedical attentionNational guidelinesParallel armsHealth strategiesCutaneous 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
2022
Pentoxifylline in the Treatment of Cutaneous Leishmaniasis: A Randomized Clinical Trial in Colombia
del Mar Castro M, Cossio A, Navas A, Fernandez O, Valderrama L, Cuervo-Pardo L, Marquez-Oñate R, Gómez MA, Saravia NG. Pentoxifylline in the Treatment of Cutaneous Leishmaniasis: A Randomized Clinical Trial in Colombia. Pathogens 2022, 11: 378. PMID: 35335703, PMCID: PMC8949591, DOI: 10.3390/pathogens11030378.Peer-Reviewed Original ResearchAddition of pentoxifyllinePeripheral blood mononuclear cellsMeglumine antimoniate treatmentPlacebo-controlled trialCutaneous leishmaniasis patientsBlood mononuclear cellsInflammatory gene expressionAntimoniate treatmentOral pentoxifyllineTrial patientsAdverse eventsInflammatory mediatorsMucosal leishmaniasisLeishmaniasis patientsAntimonial treatmentClinical benefitMononuclear cellsStandard treatmentMultiple lesionsTherapeutic failureTherapeutic responseClinical trialsFailure rateStudy groupSingle lesion
2021
Potency and Preclinical Evidence of Synergy of Oral Azole Drugs and Miltefosine in an Ex Vivo Model of Leishmania (Viannia) panamensis Infection
Fernández OL, Rosales-Chilama M, Quintero N, Travi BL, Wetzel DM, Gómez MA, Saravia NG. Potency and Preclinical Evidence of Synergy of Oral Azole Drugs and Miltefosine in an Ex Vivo Model of Leishmania (Viannia) panamensis Infection. Antimicrobial Agents And Chemotherapy 2021, 66: e01425-21. PMID: 34694879, PMCID: PMC8765415, DOI: 10.1128/aac.01425-21.Peer-Reviewed Original ResearchConceptsFractional inhibitory concentration indexPeripheral blood mononuclear cellsL. panamensisHuman peripheral blood mononuclear cellsClinical strainsLeishmania panamensis infectionOral azole drugsOral combination therapyFailure of treatmentBlood mononuclear cellsEfficacy of treatmentNovel therapeutic strategiesEffectiveness of treatmentHigh potencyReduction of infectionEx vivo modelInhibitory concentration indexFree drug concentrationPanamensis infectionPreclinical evidenceCombination therapyMononuclear cellsAntimonial drugsCutaneous leishmaniasisDrug combinationsNeutrophil Activation: Influence of Antimony Tolerant and Susceptible Clinical Strains of L. (V.) panamensis and Meglumine Antimoniate
Fernández OL, Ramírez G, Díaz-Varela M, Tacchini-Cottier F, Saravia NG. Neutrophil Activation: Influence of Antimony Tolerant and Susceptible Clinical Strains of L. (V.) panamensis and Meglumine Antimoniate. Frontiers In Cellular And Infection Microbiology 2021, 11: 710006. PMID: 34631596, PMCID: PMC8493214, DOI: 10.3389/fcimb.2021.710006.Peer-Reviewed Original ResearchMeglumine antimoniateActivation of neutrophilsClinical strainsActivation markersNET formationExpression of CD62LReactive oxygen speciesMaximal plasma concentrationInnate host responseSusceptible clinical strainsROS productionDrug-sensitive strainsCD66b expressionNeutrophil activationHealthy donorsInflammatory responsePlasma concentrationsTherapeutic effectAntimonial drugsAntimicrobial medicationsDsDNA releaseHost responseNeutrophilsAntileishmanial drugsCD62LDiagnostic 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 detectionAdaptation and performance of a mobile application for early detection of cutaneous leishmaniasis
Rubiano L, Alexander N, Castillo R, Martínez Á, Luna J, Arango J, Vargas L, Madriñán P, Hurtado L, Orobio Y, Rojas C, del Corral H, Navarro A, Saravia N, Aronoff-Spencer E. Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. PLOS Neglected Tropical Diseases 2021, 15: e0008989. PMID: 33571192, PMCID: PMC7904137, DOI: 10.1371/journal.pntd.0008989.Peer-Reviewed Original ResearchConceptsCommunity health volunteersHealth volunteersCase detectionHealth workersCutaneous leishmaniasisHealth servicesPrediction rulePassive case detectionChance-adjusted agreementCommunity health workersActive case detectionProportion of participantsMobile health technologyStudy physiciansCutaneous ulcersPresumptive diagnosisGeneral practitionersInter-rater reliabilityMedical attentionParasitological diagnosisRisk scoreEvaluation of specificityHealthcare personnelMHealth toolsMunicipality of Tumaco