Lack of efficacy of mefloquine in the treatment of New World cutaneous leishmaniasis in Colombia.

In a nonblinded, therapeutic trial conducted in Colombia, 1.25-1.5 grams of mefloquine base given as a single oral dose or as 250 mg a day for 5-6 consecutive days was not efficacious in the treatment of New World cutaneous leishmaniasis. The drug had cured only 30.8 % of patients with leishmaniasis skin lesions by the 10th week after start of therapy as compared with a 27.9% complete cicatrization rate in historical controls treated with placebo tablets and an 86.3% cicatrization rate in historical controls who received meglumine antimoniate, 20 mg/ kg/day intramuscularly for 20 days, with no upper limit to daily dose. It is concluded that a single course treatment with mefloquine is not indicated as monotherapy in the treatment of Colombian cutaneous leishmaniasis primarily due to L. panamensis.

Leishmaniasis eco-epidemiology in the Alpujarra region (Granada Province, southern Spain).

An eco-epidemiological study was carried out in the region of the Alpujarras (southern Spain, Granada province). Nine villages were chosen at random in 5 bioclimatic zones. A study of leishmaniasis in the canine and human populations, was carried out concentrating especially upon schoolchildren. A total of 615 dogs were screened, which represents almost 100% of the canine census. Of the screened dogs, 33 showed an antibody titer > or = 1/160 when tested by IFA (seroprevalence of 5.3%). Age, sex, activity, and clinical symptoms of each dog were taken into account. Among the human population, infection from Leishmania was studied using the Leishmanin skin test (LST). Of 1286 people who were tested, 568 (44.16%) were positive. Most of the subjects were schoolchildren (878; practically 100% of the pupils), of whom 288 (32.8%) tested positive. A close relation was seen to exist between the percentage of positive LST's and age. Finally, a close relationship was also observed between canine seroprevalence and percentage of schoolchildren who tested positive in the LST, in the 5 bioclimatic zones under consideration.