title: Control of mucocutaneous leishmaniasis, a neglected disease: results of a control programme in Satipo Province, Peru.
abstract: Mucocutaneous leishmaniasis (MCL) is an important health problem in many rural areas of Latin America, but there are few data on the results of programmatic approaches to control the disease. We report the results of a control programme in San Martin de Pangoa District, which reports one of the highest prevalences of MCL in Peru. For 2 years (2001--2002), the technicians at the health post were trained in patient case management, received medical support and were supplied with antimonials. An evaluation after 2 years showed the following main achievements: better diagnosis of patients, who were confirmed by microscopy in 34% (82/240) of the cases in 2001 and 60% of the cases (153/254) in 2002; improved follow-up during treatment: 237 of 263 (90%) patients who initiated an antimonial therapy ended the full treatment course; improved follow-up after treatment: 143 of 237 (60%) patients who ended their full treatment were correctly monitored during the required period of 6 (cutaneous cases) or 12 (mucosal cases) months after the end of treatment. These achievements were largely due to the human and logistical resources made available, the constant availability of medications and the close collaboration between the Ministry of Health, a national research institute and an international non-governmental organization. At the end of this period, the health authorities decided to register a generic brand of sodium stibogluconate, which is now in use. This should allow the treatment of a significant number of additional patients, while saving money to invest in other facets of the case management.
authors.affiliation: Epicentre, Paris, France. jguthmann@epicentre.msf.org
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Guthmann
authors.forename: Doris
authors.initials: D
authors.lastname: Arlt
authors.forename: Luis Miguel Leon
authors.initials: LM
authors.lastname: Garcia
authors.forename: Milena
authors.initials: M
authors.lastname: Rosales
authors.forename: Juan
authors.initials: J
authors.lastname: de Jesus Sanchez
authors.forename: Eugenia
authors.initials: E
authors.lastname: Alvarez
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Lonlas
authors.forename: Mado
authors.initials: M
authors.lastname: Conte
authors.forename: Guillermo
authors.initials: G
authors.lastname: Bertoletti
authors.forename: Christophe
authors.initials: C
authors.lastname: Fournier
authors.forename: Roberto
authors.initials: R
authors.lastname: Huari
authors.forename: Els
authors.initials: E
authors.lastname: Torreele
authors.forename: Alejandro
authors.initials: A
authors.lastname: Llanos-Cuentas
mesh_terms: D000965:Antimony / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D017048:Health Care Costs; D006297:Health Services Accessibility; D006801:Humans; D007897:Leishmaniasis, Mucocutaneous / Q000453:epidemiology / Q000517:prevention & control*; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D015397:Program Evaluation / Q000191:economics / Q000379:methods*; D012423:Rural Health; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents; D000965:Antimony