Treatment Success in Patients with Cutaneous Leishmaniasis Treated with Inj. Glucantime 5 Ml (Meglumine Antimoniate) Dir Lower

Abstract

Background: The dogma of Leishmania parasites is a widespread parasitic disease in tropical and subtropical areas, transmitted through the bite of sandflies, which is known as the cutaneous leishmaniasis (CL). This condition causes skin lesions that are either ulcerative, nodular or papular and in most cases causes great morbidity since disfigurement as well as functional impairment results. Meglumine antimoniate (Glucantime (meglumine antimoniate) is a common first-line drug but its effect on the treatment depends on the type of lesions, route of administration and demographics of the patient. Objective: The purpose of the study was to estimate predictors of the success of treatment in the patients with cutaneous leishmaniasis treated using Glucantime (meglumine antimoniate, with regard to the characteristics of the lesions, the route of administration, and the demographics of the patient. Methods: The study was done through a prospective, observational study over six treatment centers in District Dir Lower, Pakistan, in the 2022-2024 period. There was a total of 1,231 patients with cutaneous leishmaniasis, who were diagnosed by either PCR or microscopy. Glucantime (meglumine antimoniate as per the national guidelines) was used in intradermal or intramuscular form on patients. Successful treatment outcomes were those cases where lesions healed without relapses or even complications. Their effects included gender, age, number, size, and morphology of the lesion analyzed to determine their influence on treatment success. The analysis of data was performed based on descriptive statistics, chi-square tests, and logistic regression, with a level of significance of p < 0.05. Results: The overall results of the treatment were 66.9, and the failure was 33.1. Successful treatment among females (74.5) was higher when compared to male (58.4) (p = 0.002). The success rate of 72.8 in patients with single lesions and that of 52.1 with multiple lesions were a significant difference (p < 0.001). The morphology of lesions also impacted the results with vesicular lesions reporting the best success rate (81.3) and ulcerative lesions reporting the lowest (59.2). By way of the administration route, the intradermal route was more successful (88.6) versus the intramuscular route which was 45.9 (p < 0.001). The success rate of the treatment remained insignificantly high throughout the years of the study, with an increase of 65.8 in 2022 to 68.5 in 2024. Conclusion: The research has determined some of the critical predictors of success of treatment in cutaneous leishmaniasis. There was increased treatment success in female gender, single lesions, and intradermal administration of Glucantime (meglumine antimoniate. The results imply that there should be treatment measures that consider these factors to achieve the best results in the patients with cutaneous leishmaniasis. More studies are still required in the investigation of other factors like immune response and genetic tendencies to enhance treatment regimes