ABSTRACT
The standard of care for cutaneous leishmaniasis includes the intramuscular/intravenous administration of pentavalent antimonials that are toxic and poorly tolerated. Primary health care usually lacks trained health staff for the diagnosis and treatment of leishmaniasis in Cochabamba Bolivia. Taking these aspects into account, a Bolivian consortium set out to explore the intralesional administration of meglumine antimoniate to treat cutaneous leishmaniasis during primary care under programmatic conditions. A four-step strategy consisting of clinical training for intralesional treatment and the promotion and periodic follow-up of health staff was carried out. The training process was applied in situ to personnel of nine primary health care centres. The intralesional treatment was applied five times every other day. Clinical follow-up after six-months of treatment showed a 77% healing proportion and 5% of therapeutic failure among 152 enrolled patients. The drug volume used in the intralesional procedure was on average 1.7 mL/ulcer treated. In conclusion, the strategy used was successful and effective, accomplishing a healing proportion similar to the long standardized treatment with a reduced time of administration, no severe side effects, and it is feasible to conduct by trained health staff. Our study supports the current PAHO/WHO recommendation for the intralesional administration of pentavalent antimonials for the treatment of cutaneous leishmaniasis.
ABSTRACT
El SECI es un sistema de movilización comunitaria en torno a la salud, que permite informar a la comunidad sobre el estado de sus propios habitantes y facilita la toma de decisiones de la comunidad en el tema de salud, al mismo tiempo que provee información al Distrito de salud. Los objetivos que persigue son: superar la escasa participación de las comunidades en la planificación de las actividades de salud. Mejorar la comunicación entre el personal de salud y usuarios/as. Promover el usos de servicios de salud en el área rural
