antimony-sodium-gluconate and Malaria

Topics: Animals; Antimony; Antimony Sodium Gluconate; Antiprotozoal Agents; Disease Models, Animal; Glycolipids; Humans; Leishmaniasis; Leishmaniasis, Visceral; Liposomes; Lysosomes; Malaria; Meglumine; Meglumine Antimoniate; Organometallic Compounds; Primaquine; Protozoan Infections; Trypanosomiasis

In a comparative trial of treatment in southern Sudan, visceral leishmaniasis was diagnosed by the following symptoms: fever for > 1 month, splenomegaly, and antileishmanial direct agglutination test (DAT) titer of > or = 1:25,600. Patients (200) were randomized to receive sodium stibogluconate (Sbv) at 20 mg/kg/day for 30 days (groups S, n = 99) or Sbv at 20 mg/kg/day plus aminosidine at 15 mg/kg/day for 17 days (group AS, n = 101). Of 192 patients who had spleens or lymph nodes aspirated at entry, 134 (70%) were positive for parasites. During treatment, 7% in group S and 4% in group AS died. All 184 patients who completed treatment were clinically cured. At days 15-17, microscopy of aspirates showed that 57 (95%) of 60 in group AS were negative for parasites compared with 47 (81%) of 58 in group S (P = .018). At day 30, 57 (93.4%) of 61 group S aspirates were negative.

Topics: Adolescent; Adult; Antimony Sodium Gluconate; Child; Child, Preschool; Disease Outbreaks; Drug Therapy, Combination; Female; Giardiasis; Humans; Infant; Leishmaniasis, Visceral; Malaria; Male; Middle Aged; Nutrition Disorders; Paromomycin; Pregnancy; Sudan; Weight Loss

A Leishmania donovani species-specific monoclonal antibody (monoclonal antibody D2) was evaluated for its diagnostic and prognostic potential by a competitive enzyme-linked immunosorbent assay (C-ELISA) in sera from Indian patients with visceral leishmaniasis (VL) and seven patients with post-kala-azar dermal leishmaniasis (PKDL). These results were compared with those obtained by microscopy with Giemsa-stained tissue smears and a direct enzyme-linked immunosorbent assay (direct ELISA) with crude parasite antigen. Of 121 patients with clinically diagnosed VL examined, 103 (85.1%) were positive and 11 (9.1%) were negative by all three methods. An additional 7 (5.8%) who were negative by microscopy were positive by both C-ELISA and direct ELISA. Seven PKDL patients were also examined and were found to be positive by all three methods. Analysis of the chemotherapeutic response to sodium antimony gluconate of these 110 serologically positive VL patients showed that 57 (51.8%) were drug responsive and 53 (48.2%) were drug resistant. The C-ELISA with sera from 20 longitudinally monitored VL patients before and after chemotherapy showed a significant decrease in percent inhibition of monoclonal antibody D2 in drug-responsive patients. However, in drug-unresponsive patients, the percent inhibition of D2 was unchanged or was slightly increased. Our results therefore indicate (i) the applicability of L. donovani species-specific monoclonal antibody D2 for sensitive and specific serodiagnosis by C-ELISA, (ii) that the C-ELISA is more sensitive than microscopy, especially for early diagnosis, (iii) that L. donovani is still the main causative agent of VL, irrespective of the chemotherapeutic response, and (iv) that the C-ELISA can be used to evaluate the success of drug treatment.

Topics: Animals; Antibodies, Monoclonal; Antibodies, Protozoan; Antimony Sodium Gluconate; Antiprotozoal Agents; Cross Reactions; Enzyme-Linked Immunosorbent Assay; Humans; India; Leishmania donovani; Leishmaniasis, Cutaneous; Leishmaniasis, Visceral; Leprosy; Malaria; Prognosis; Tuberculosis

BALB/c mice were infected with Leishmania mexicana amazonensis and/or Plasmodium yoelii in order to determine the impact of multiple parasitic infection on the efficacy of chemotherapeutic agents. Uninfected, P. yoelii-infected, L.m. amazonensis-infected, and L.m. amazonensis and P. yoelii-infected mice were inoculated with cimetidine (80 mg kg-1 day-1) or pentostam (200 mg kg-1 day-1) once a day for an initial 20-day period, and once a week thereafter. Leishmania mexicana amazonensis lesion development and P. yoelii parasitaemia were the criteria used to assay disease severity. Mice infected with both P. yoelii and L.m. amazonensis developed more severe disease than did animals infected with either parasite alone. Cimetidine and pentostam each slowed the development of L.m. amazonensis in animals infected with only that parasite and in animals infected with both P. yoelli and L.m. amazonensis. However, mice treated with pentostam developed more severe P. yoelii infections than did control animals, whereas cimetidine significantly reduced P. yoelii parasitaemia in all instances.

Topics: Animals; Antimony Sodium Gluconate; Cimetidine; Female; Gluconates; Leishmania mexicana; Leishmaniasis; Malaria; Mice; Mice, Inbred BALB C; Plasmodium yoelii