Epidemiology and Health

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Efficacy of miltefosine compared with glucantime for the treatment of cutaneous leishmaniasis: a systematic review and meta-analysis: Sohrab Iranpour, Ali Hosseinzadeh, Abbas Alipour; Epidemiol Health. 2019;41:e2019011. Published online March 31, 2019; DOI: https://doi.org/10.4178/epih.e2019011

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Abstract

Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I2 index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.

Summary

Citations

Citations to this article as recorded by

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Original Article

Preventive Efficacy of Influenza Vaccination against to Influenza-like Illness among Eldery.: Byung Chul Chun, Heung Jeong Woo, Seung Chul Park; Korean J Epidemiol. 1999;21(2):205-219.

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Abstract PDF: Abstract
BACKGROUND
Influenza is a highly infectious viral illness. The epidemics of influenza occur from the late fall to the early spring nearly every year and are responsible for several hundred thousand death per year all over the world. Influenza vaccine is the primary method for preventing influenza and its more severe complications. The efficacy of influenza vaccination have been well known in developed countries. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 - 8 million doses of influenza vaccine were used in a winter season. PURPOSE: To assess the clinical efficacy of influenza vaccine against influenza-like illness(ILI) among Korean elderly(age over 65).
METHODS
Primary study design - a prospective field trial. Study subjects and method - We prospectively observed the 1,488 vaccinee and 1,425 non-vaccinee in a community(Nonsan city) from November 1 1998 to March 31 1999. The vaccinee were those who randomly selected 100-200 per 13 sub-region(Myon) in Nonsan city, and the non-vaccinee were those who had not vaccinated until January 1999 among the Nonsan city elderly cohort. This cohort was consisted of 5,787 elderly(over 1/3 of total elderly population) who had ever visited the community health center or 13 public health offices in Nonsan city in 1998. We followed up these two groups two times-in January and April 1999 - by telephone survey. The questionnaire included the questions about the health behaviors, medical history, socioeconomic condition, medical security type, physical function status, medical facility utilization in the season, symptom and signs of influenza-like illness, number and type of the flu, hospitalization or not. We did throat swap to isolate the virus of 490 patient who had influenza -like symptoms in the same period.
RESULTS
Influenza vaccination was significantly reduced the incidence of influenza -like illness(fever or chilling sensation and cough or sore throat) in the vaccinated. The preventive effect of influenza-like illness among influenza risk group was about 32%(95% CI, 20%-44%). The illness duration of main symptoms of influenza-like illness(fever, cough) was significantly shorter in the vaccinee. The consistency of the survey was noted quite high from the analysis of the result of test-retest(104 person).
CONCLUSION
Influenza vaccination significantly reduced the incidence of influenza-like illness(32%) among elderly.; Summary

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