Novel Low-Cost Thermotherapy for Cutaneous Leishmaniasis in Peru

作者:Valencia Braulio M*; Miller David; Witzig Richard S; Boggild Andrea K; Llanos Cuentas Alejandro
来源:PLoS Neglected Tropical Diseases, 2013, 7(5): e2196.
DOI:10.1371/journal.pntd.0002196

摘要

Thermotherapy is an accepted alternative therapy for new-world cutaneous leishmaniasis, but current heat-delivery modalities are too costly to be made widely available to endemic populations. We adapted a low-cost heat pack named the HECT-CL device that delivers safe, reliable, and renewable conduction heat. 25 patients with cutaneous leishmaniasis completed treatment with the device at an initial temperature of 52 degrees C +/- 2 degrees C for 3 minutes to each lesion, repeated daily for 7 days, and were followed up for 6 months by direct observation. The overall definitive clinical cure rate was 60%. Concurrently, 13 patients meeting minimally significant exclusion criteria received identical compassionate use treatment with a cumulative definitive cure rate of 68.4%, 75% for those who had experienced CL relapse after prior antimonial treatment. Therapy was well tolerated. Reversible second-degree burns occurred in two patients and no bacterial super-infections were observed. HECT-CL is a promising treatment and deserves further study to verify its safety and efficacy as adjuvant and mono-therapy.