title: Novel low-cost thermotherapy for cutaneous leishmaniasis in Peru.
abstract: Thermotherapy is an accepted alternative therapy for new-world cutaneous leishmaniasis, but current heat-delivery modalities are too costly to be made widely available to endemic populations. We adapted a low-cost heat pack named the HECT-CL device that delivers safe, reliable, and renewable conduction heat. 25 patients with cutaneous leishmaniasis completed treatment with the device at an initial temperature of 52°C ± 2°C for 3 minutes to each lesion, repeated daily for 7 days, and were followed up for 6 months by direct observation. The overall definitive clinical cure rate was 60%. Concurrently, 13 patients meeting minimally significant exclusion criteria received identical compassionate use treatment with a cumulative definitive cure rate of 68.4%, 75% for those who had experienced CL relapse after prior antimonial treatment. Therapy was well tolerated. Reversible second-degree burns occurred in two patients and no bacterial super-infections were observed. HECT-CL is a promising treatment and deserves further study to verify its safety and efficacy as adjuvant and mono- therapy.
authors: Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru. braulio.valencia@upch.pe
authors: Braulio M
authors: BM
authors: Valencia
authors: David
authors: D
authors: Miller
authors: Richard S
authors: RS
authors: Witzig
authors: Andrea K
authors: AK
authors: Boggild
authors: Alejandro
authors: A
authors: Llanos-Cuentas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000453:epidemiology / Q000473:pathology; D002648:Child; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D016773:Leishmaniasis, Cutaneous / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010568:Peru; D010865:Pilot Projects; D016896:Treatment Outcome; D055815:Young Adult
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