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R Reithinger

Publications and source records attributed to R Reithinger.

12 recordsLinked to original sources
PubMed2005

Efficacy of thermotherapy to treat cutaneous leishmaniasis caused by Leishmania tropica in Kabul, Afghanistan: a randomized, controlled trial.

BACKGROUND: Pentavalent antimony is the agent recommended for treatment of cutaneous leishmaniasis (CL). Its use is problematic, because it is expensive and because of the potential for drug-associated adverse effects during a lengthy and painful treatment course. METHODS: We tested the efficacy of thermotherapy for the treatment of CL due to Leishmania tropica in a randomized, controlled trial in Kabul, Afghanistan. We enrolled 401 patients with a single CL lesion and administered thermotherapy using radio-frequency waves (1 treatment of >or=1 consecutive application at 50 degrees C for 30 s) or sodium stibogluconate (SSG), administered either intralesionally (a total of 5 injections of 2-5 mL every 5-7 days, depending on lesion size) or intramuscularly (20 mg/kg daily for 21 days). RESULTS: Cure, defined as complete reepithelialization at 100 days after treatment initiation, was observed in 75 (69.4%) of 108 patients who received thermotherapy, 70 (75.3%) of 93 patients who received intralesional SSG, and 26 (44.8%) of 58 patients who received intramuscular SSG. The OR for cure with thermotherapy was 2.80 (95% confidence interval [CI], 1.45-5.41), compared with intramuscular SSG treatment (P=.002). No statistically significant difference was observed in the odds of cure in comparison of intralesional SSG and thermotherapy treatments. The OR for cure with intralesional SSG treatment was 3.75 (95% CI, 1.86-7.54), compared with intramuscular SSG treatment (P<.001). The time to cure was significantly shorter in the thermotherapy group (median, 53 days) than in the intralesional SSG or intramuscularly SSG group (median, 75 days and >100 days, respectively; P=.003). CONCLUSIONS: Thermotherapy is an effective, comparatively well-tolerated, and rapid treatment for CL, and it should be considered as an alternative to antimony treatment.

Adolescent↗
PubMed2002

American cutaneous leishmaniasis in domestic dogs: an example of the use of the polymerase chain reaction for mass screening in epidemiological studies.

Domestic dogs (Canis familiaris) are firmly incriminated as reservoir hosts of zoonotic visceral leishmaniasis. As an increasing number of studies have reported high infection rates with American cutaneous leishmaniasis (ACL) in dogs, it is suggested that they should also be incriminated as reservoir hosts of ACL. The evidence to incriminate dogs as ACL reservoir hosts is reviewed, and we conclude that there is, as yet, only circumstantial evidence to support that claim, one of the reasons being that diagnostic tests (mainly serology) used in the studies underestimate the true rate of infection. We report results from the first large-scale study to measure ACL infection rates using the polymerase chain reaction (PCR). A high prevalence of ACL was detected in blood and bone marrow of dogs surveyed in an area of Peru endemic for Leishmania braziliensis and L. peruviana, providing further evidence for their suspected role as ACL reservoir hosts. However, the relatively low ACL prevalence detected in symptomatic dogs (i.e., dogs with ACL lesions or scars) demonstrated that PCR alone cannot be the diagnostic 'gold standard' for mass screening of samples in epidemiological studies.

Animals↗
PubMed2000

Use of PCR to detect Leishmania (Viannia) spp. in dog blood and bone marrow.

A PCR-based protocol for the detection of Leishmania (Viannia) parasites in canine blood, buffy coat, and bone marrow was developed and was then tested with field samples taken from a random sample of 545 dogs from villages in Peru where Leishmania (Viannia) braziliensis and Leishmania (Viannia) peruviana are endemic. Comparative tests with cultured parasites mixed with dog blood showed that the PCR assay's sensitivity was significantly dependent on the DNA extraction protocol and the PCR primers used. Mass screening of field samples by the preferred PCR protocol detected American cutaneous leishmaniasis (ACL) in 44 of 545 (8.1%) dogs; 31 of 402 (7.7%), 20 of 223 (9.0%), and 8 of 46 (17.4%) were PCR positive when whole blood, buffy coat, and bone marrow aspirates, respectively, were tested. The high prevalence of Leishmania in both asymptomatic (7.6%) and symptomatic (18.0%) dogs provides further circumstantial evidence for their suspected role as reservoir hosts of ACL and indicates that hematogenous dissemination of parasites may be a more common pathological phenomenon than has previously been acknowledged. However, unlike for zoonotic visceral leishmaniasis, the comparatively low prevalence of Leishmania (Viannia) in the blood of symptomatic dogs indicates that PCR with blood cannot be the "gold standard" for the (mass) screening of samples in epidemiological studies.

Animals↗
PubMed1999

Is the domestic dog (Canis familiaris) a reservoir host of American cutaneous leishmaniasis? A critical review of the current evidence.

Originally associated with forested areas, the transmission cycle of American cutaneous leishmaniasis (ACL) has now adapted to the domestic environment in at least 9 Latin American countries. Several studies have suggested that the domestic dog (Canis familiaris), which is already incriminated as the primary reservoir host of zoonotic visceral leishmaniasis (ZVL), may have a reservoir role in the domestic transmission of human ACL caused by Leishmania braziliensis, L. panamensis, and L. peruviana. This article reviews more than 90 studies reporting ACL infections in dogs, and concludes that as yet there is only circumstantial evidence to support that claim. Almost no data are available on the infectiousness of dogs to sandfly vectors of ACL, and there are few indications that either dog ownership or dog abundance are risk factors for ACL. Nevertheless, it has been proposed that incidence of ACL in humans could be reduced by targeting infected dogs. While this control strategy has been used for many decades against ZVL in Latin America, Europe, and Asia, there is little evidence to demonstrate its effectiveness either in theory or in practice. Particular concerns over the sensitivity and specificity of diagnostic tools, low compliance rates among dog owners, and cost-effectiveness are likely to apply equally to ACL control.

Animals↗
PubMed1997

Evaluation of the fungus Beauveria bassiana as a potential biological control agent against phlebotomine sand flies in Colombian coffee plantations.

In Colombia, the entomopathogenic fungus Beauveria bassiana (Deuteromycotina: Hyphomycetes) is widely used to control the coffee berry borer Hypothenemus hampei (Coleoptera: Scolytidae) in coffee plantations. Recent studies suggested that this fungus is also pathogenic to several important vectors of disease, including Phlebotomus papatasi and Lutzomyia longipalpis (Diptera: Psychodidae). The present study evaluated the use of B. bassiana as a potential biological control agent against phlebotomine sand flies in Colombian coffee plantations. Histopathologic examination indicates that B. bassiana is unable to infect sand flies under natural conditions, although dead sand flies were shown to be readily infected. In addition, laboratory bioassays where flies were exposed to the fungus applied onto coffee plants (though not filter paper) showed lower mean survival times than the control.

Animals↗
PubMedDate not supplied

The epidemiology and control of leishmaniasis in Andean countries.

This paper reviews the current knowledge of leishmaniasis epidemiology in Venezuela, Colombia, Ecuador, Peru, and Bolivia. In all 5 countries leishmaniasis is endemic in both the Andean highlands and the Amazon basin. The sandfly vectors belong to subgenera Helcocyrtomyia, Nyssomiya, Lutzomyia, and Psychodopygus, and the Verrucarum group. Most human infections are caused by Leishmania in the Viannia subgenus. Human Leishmania infections cause cutaneous lesions, with a minority of L. (Viannia) infections leading to mucocutaneous leishmaniasis. Visceral leishmaniasis and diffuse cutaneous leishmaniasis are both rare. In each country a significant proportion of Leishmania transmission is in or around houses, often close to coffee or cacao plantations. Reservoir hosts for domestic transmission cycles are uncertain. The paper first addresses the burden of disease caused by leishmaniasis, focusing on both incidence rates and on the variability in symptoms. Such information should provide a rational basis for prioritizing control resources, and for selecting therapy regimes. Secondly, we describe the variation in transmission ecology, outlining those variables which might affect the prevention strategies. Finally, we look at the current control strategies and review the recent studies on control.

Animals↗
PubMedDate not supplied

Topical insecticide treatments to protect dogs from sand fly vectors of leishmaniasis.

We compared the susceptibility of sand fly vectors to four topical insecticide treatments applied to domestic dogs, a reservoir of human leishmaniasis. Dogs were exposed to sand flies pretreatment and at 1 week, 1 month, and 2 months posttreatment. Sand fly bloodfeeding and survival rate of both fed and unfed flies were significantly reduced by the permethrin, deltamethrin, and fenthion treatments, but diazinon had no effect. The survival rate of bloodfed sand flies was reduced by up to 86% with deltamethrin collars. The antifeeding effect suggests that deltamethrin collars may be recommended to dog owners to protect their pets from sandfly- borne diseases. The combined effects on sand fly feeding and survival indicate that epidemiologic, community-based trials are warranted to test whether deltamethrin collars could reduce the incidence of canine and, hence, human leishmaniasis.

Administration, Topical↗