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Treatment of acute Old World cutaneous leishmaniasis: A systematic review of the randomized controlled trials - 19/08/11

Doi : 10.1016/j.jaad.2007.01.016 
Alireza Khatami, MD, Alireza Firooz, MD , Farzam Gorouhi, MD, Yahya Dowlati, MD, PhD
From the Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences 

Reprint requests: Alireza Firooz, MD, Associate Professor of Dermatology, Center for Research and Training in Skin Diseases and Leprosy, 79, Taleqani Ave, Tehran 14166 I.R. Iran.

Tehran, Iran

Abstract

Background

Cutaneous leishmaniasis (CL) is caused by different species of Leishmania and transmitted by the bite of infected sand flies. It is a health problem in many countries.

Objective

This study was performed to assess the evidence for the efficacy of different therapeutic modalities for acute Old World CL, which is usually caused by L major and L tropica.

Methods

Evidence was reviewed according to the hierarchy of evidence. Because there have been no published systematic reviews on this topic to date, the primary source of evidence was individual randomized controlled trials (RCTs). Multiple databases were systematically searched. Using independent double review and published quality review criteria, articles were rated as good, fair, or poor. Treatment benefit data were tabulated, and conclusions were based on the rated strength of published evidence.

Results

In all, 50 RCTs met inclusion criteria consisting of 5515 patients in 119 study arms. Reviewed trials were highly variable in quality and methods and generally provide weak evidence for treatment of acute Old World CL.

Limitations

The quality of included studies was generally poor.

Conclusions

Well-designed randomized, double-blind, controlled trials should be designed and conducted to find better evidence for the treatment of acute Old World CL.

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Abbreviations used : ACL, ARR, CL, PDT, RCT, SSG, ZCL, Z-HE, ZnSO4


Plan


 Funding sources: None. No funding source or sponsor had any role in study design, data collection, data analysis, data interpretation, or the writing of the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Conflicts of interest: None declared.
Preliminary results of this review were presented at the 7th International Gulf Cooperation Council. Congress of Dermatology and Venereology, Doha, Qatar, December 16-19, 2003. Some parts of this study have been presented at 14th European Academy of Dermatology and Venereology Congress, London, United Kingdom, October 12-16, 2005 and at the 10th Pan Arab League of Dermatologists (PALD) Congress, Taiz, Yemen, August 30 to September 3, 2006. In addition, it was awarded a scholarship grant under the International Scholarship Program of the 18th World Congress of Dermatology Fund to attend the 62nd Annual Meeting of the American Academy of Dermatology, Washington, DC, February 6-11, 2004.


© 2007  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 57 - N° 2

P. 335.e1-335.e29 - août 2007 Retour au numéro
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