Centro Internacional de Entrenamiento e Investigaciones Medicas-CIDEIM (International Center for Medical Research and Training), Cali, Colombia.
Am J Trop Med Hyg. 2013 Aug;89(2):359-64. doi: 10.4269/ajtmh.12-0784. Epub 2013 Jun 24.
Treatment alternatives have seldom been evaluated in children with cutaneous leishmaniasis (CL). We examine the clinical/epidemiological profile of children with CL considering international guidelines for local treatment. Descriptive analyses were conducted using International Center for Medical Research and Training (CIDEIM) case reports of parasitologically diagnosed patients ≤ 14 years of age from 2004 to 2010. Eligibility for local treatment based on World Health Organization/Pan American Health Organization (WHO/PAHO) criteria was determined. Among 380 children, 90% presented lesions of < 3 months duration, 54% presented single lesions < 30 mm in diameter, and 45% were ≤ 5 years old. Lesions on the head and neck were more frequent among children 0-5 years, and lesions below the head/neck were more frequent among 11- to 14-year-old children (P = 0.004). Using PAHO and WHO criteria, 26% and 53% of children, respectively, were eligible for local treatment. Recommended local treatments for New World CL have potential but limited applicability in children. Individual risk-benefit assessment and effectiveness data in children may increase eligibility.
在患有皮肤利什曼病（CL）的儿童中，很少评估治疗选择。我们根据当地治疗的国际指南，检查了患有 CL 的儿童的临床/流行病学特征。使用国际医学研究与培训中心（CIDEIM）2004 年至 2010 年寄生虫学诊断为≤14 岁患者的病例报告进行描述性分析。根据世界卫生组织/泛美卫生组织（WHO/PAHO）标准确定是否有资格进行局部治疗。在 380 名儿童中，90％的病变持续时间<3 个月，54％的病变直径<30mm，45％的病变年龄≤5 岁。0-5 岁儿童头部和颈部的病变更为常见，而 11-14 岁儿童头部/颈部以下的病变更为常见（P=0.004）。根据 PAHO 和 WHO 标准，分别有 26％和 53％的儿童有资格进行局部治疗。新的世界 CL 的推荐局部治疗具有一定的潜在适用性，但在儿童中有限。儿童的个体风险-效益评估和有效性数据可能会增加资格。
