Review: Thermotherapy for treatment of cutaneous leishmaniasis in Sri Lanka
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2015
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Faculty of Medicine, University of Kelaniya
Abstract
Leishmaniasis is a neglected tropical disease caused by a protozoan parasite and
transmitted by phlebotomine sand flies. In Sri Lanka, Cutaneous Leishmaniasis
(CL) is caused by Leishmania donovani, a usually virsceralizing strain in other
parts of the world. Thus it is important to study the treatment methods available
for treatment of CL.
Commonly used treatment for leishmaniasis in Sri Lanka is Intra-Lesional (IL),
intramuscular or intravenous sodium stibogluconate. Thermotherapy is currently
studied as an alternative treatment. Several clinical trials have been carried out in
the world to see the efficacy and safety of thermotherapy versus intralesional SSG
for treatment of CL. A device generating heat using radio waves had been used in
these studies. This device is costly and is not freely available in Sri Lanka. A
device with a lower cost would be better for Sri Lanka.
A pilot study conducted in Peru looked into the use of a novel low-cost
thermotherapy for CL using a hand Held Exothermic Crystallization
Thermotherapy (HECT) device. 25 patients enrolled in the pilot study and 13
patients treated on compassionate grounds showed a definitive clinical cure rate
of 68.4%. Another study conducted in Pakistan using a HECT device had a 83%
cure rate by Day180.
Aforementioned studies show the efficacy and safety of thermotherapy with
HECT device is comparable with SSG, well tolerated by patients and the only side
effect experienced was reversible burns which healed without a scar. On the
contrary, conventional treatment with IL-SSG is painful, requires many hospital
visits, have adverse effects, high treatment cost and poor patient compliance. Thus
thermotherapy using HECT device might be considered as a better alternative
treatment method for CL patients in a developing country like Sri Lanka.
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Silva, Hermali and Karunaweera, Nadira D., 2015. Review: Thermotherapy for treatment of cutaneous leishmaniasis in Sri Lanka. Proceedings of the International Workshop on Molecular Biology Techniques Related to Infectious/Genetic Diseases & Human Identification, Molecular Medicine Unit, Faculty of Medicine, University of Kelaniya.