title: Challenges in the therapy of visceral leishmaniasis in Brazil: a public health perspective.
abstract: Over 3,000 yearly cases of Visceral Leishmaniasis (VL) are reported in Brazil. Brazilian Public Health System provides universal free access to antileishmania therapeutic options: Meglumine Antimoniate, Amphotericin B deoxycholate, and Liposomal Amphotericin B. Even though Amphotericin formulations have been advised for severe disease, this recommendation is mostly based on the opinion of experts and on analogy with studies conducted in other countries. Presently, there are two ongoing multicenter clinical trials comparing the efficacy and safety of the available therapeutic options. Some other issues require further clarification, such as severity markers and the approach to VL/AIDS coinfection. Brazil is facing the challenge of providing access to diagnosis and adequate treatment, in order to avoid VL-related deaths.
authors.affiliation: Hospital Estadual Bauru, Secretaria de Estado da Saúde de São Paulo, 17033-360 Bauru, SP, Brazil ; Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), 18618-970 Botucatu, SP, Brazil.
authors.forename: Edson Carvalho
authors.initials: EC
authors.lastname: de Melo
authors.affiliation: Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), 18618-970 Botucatu, SP, Brazil.
authors.forename: Carlos Magno Castelo Branco
authors.initials: CM
authors.lastname: Fortaleza