Cutaneous leishmaniasis (Leishmania major infection) in Dutch troops deployed in northern Afghanistan: epidemiology, clinical aspects, and treatment.
Cutaneous leishmaniasis caused by Leishmania major infection affected 172 (18.3%) of 938 Dutch military troops deployed in northern Afghanistan in 2005. The high attack rate was a result of initial insufficient availability of means of prevention and insufficient adherence to preventive measures. At presentation, the lymphatic system was involved in 24.8%. Treatment with intralesional injections of antimony with or without cryotherapy was satisfactory, but 19.5% of patients received secondary treatment with miltefosine. Six months after treatment, 128 (77.1%) of 166 treated patients were cured, 16 (9.6%) were lost to follow-up, and 22 (13.3%) already experienced cure at six weeks but were not seen at six months. Natural evolution played a role in this observational study, which showed cure of all patients seen at six months. In general, management of cutaneous leishmaniasis was feasible under field conditions.
Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. p.p.vanthiel@amc.uva.nl
Pieter-Paul
PP
van Thiel
Tjalling
T
Leenstra
Henry J
HJ
de Vries
Allard
A
van der Sluis
Tom
T
van Gool
Alex C
AC
Krull
Michèle
M
van Vugt
Peter J
PJ
de Vries
Jimmy E
JE
Zeegelaar
Aldert
A
Bart
Wendy F
WF
van der Meide
Henk D F H
HD
Schallig
William R
WR
Faber
Piet A
PA
Kager
D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D017679:Cryotherapy; D006801:Humans; D018320:Leishmania major; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control; D008297:Male; D008889:Military Personnel; D009426:Netherlands; D010767:Phosphorylcholine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors
D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine