Page 179 - Learnwell EVS
P. 179
shmaniases

+ miltefosine P O for 2 8 d ays:
C h ild ren 2 to 1 1 years: 2 .5 m g / kg / d ay
C h ild ren > 1 1 years and < 2 5 kg : 5 0 m g / d ay
C h ild ren and ad ults 2 5 to 5 0 kg : 1 0 0 m g / d ay
A d ults > 5 0 kg : 1 5 0 m g / d ay
– Visceral leishmaniasis in South Asia
• F irst-line treatm ent:
liposomal amphotericin B IV infusion: 3 to 5 m g / kg / d ay for 3 to 5 d ays up to a total
d ose of 1 5 m g / kg
or
liposomal amphotericin B IV infusion: 1 0 m g / kg as a sing le d ose
• Second -line treatm ent for relapse:
liposomal amphotericin B IV infusion: 3 to 5 m g / kg / d ay for 5 to 8 d ays up to a total
d ose of 2 5 m g / kg
F or all patients w ith v isceral leish m aniasis, h yd ration, nutritional support and
treatm ent of intercurrent infections ( m alaria, d ysentery, pneum onia, etc.) are
essential.
T uberculosis and / or H I V infection m ay also be present and sh ould be suspected if
relapse occurs m ore th an once or in th e ev ent of treatm ent failure.

Post-kala azar dermal leishmaniasis (PKDL)
O nly patients w ith sev ere or d isfig uring d isease or w ith lesions rem aining for > 6
m onth s,
and young ch ild ren w ith oral lesions th at interfere w ith feed ing , are treated .
– PKDL in East Africa

a pentavalent antimonial IM or slow IV : 2 0 m g / kg / d ay for 1 7 to 6 0 d ays
+ paromomycin IM : 1 5 m g (1 1 m g base)/ kg / d ay for 1 7 d ays
loiprosomal amphotericin B I V infusion: 2 .5 m g / kg / d ay for 2 0 d ays
omriltefosine P O for 2 8 d ays (as for v isceral leish m aniasis) m ay be beneficial in H IV co-

infected patients
– PKDL in South Asia

liposomal amphotericin B I V infusion: 5 m g / kg / d ay tw ice w eekly up to a total d ose of
3 0 m g / kg

Prevention

– Insecticid e-treated m osquito nets.
– V ector control and elim ination of anim al reserv oir h osts.

146
   174   175   176   177   178   179   180   181   182   183   184