{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:29:13Z","timestamp":1788510553529,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,17]],"date-time":"2014-01-17T00:00:00Z","timestamp":1389916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to report the patient profile and treatment outcomes, including relapses, of patients with visceral leishmaniasis (<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>) treated with liposomal amphotericin B (AmBisome) in Gedaref, Sudan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AmBisome was offered to two groups of patients: primary <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> patients with specific criteria (age \u22642 or \u226545\u00a0years, advanced clinical disease, pregnancy, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> co\u2010infection and contraindications for antimonials) and <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> relapses. AmBisome was given at a total dose of 30\u00a0mg\/kg, over 10\u00a0days. Slow responders received up to 50\u00a0mg\/kg. Treatment failure was confirmed parasitologically. Standardised treatment outcomes were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between March 2010 and June 2012, a total of 281 (74%) patients with primary <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> and 98 (26%) patients with <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> relapses received AmBisome (54% male, median age\u00a0=\u00a011\u00a0years, interquartile range 2\u201330). End\u2010of\u2010treatment outcomes for primary <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> were 260 (92%) initial cure including three (1%) slow responders, three (1%) treatment failures, 14 (5%) deaths and four (1%) unknown outcomes. Outcomes for <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> relapses were 92 (94%) initial cure with five (5%) slow responders, four (4%) treatment failures, one (1%) death and one (1%) unknown outcome. At 6\u00a0months, there were 19 (7%) relapses amongst primary <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> and 10 (10%) <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> relapses had a new relapse. Loss to follow\u2010up in both groups was 38%. None of the deaths that occurred during the study period was attributed to AmBisome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>AmBisome appears to be effective for initial cure of <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> and the drug seems safe, but is expensive (400\u00a0<jats:styled-content style=\"fixed-case\">USD<\/jats:styled-content>\/treatment). Sustained mechanisms to allow improved access of this expensive drug particularly in East Africa are urgently needed. Relapses and losses to follow\u2010up require specific investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12238","type":"journal-article","created":{"date-parts":[[2014,1,17]],"date-time":"2014-01-17T12:10:55Z","timestamp":1389960655000},"page":"146-152","source":"Crossref","is-referenced-by-count":38,"title":["Liposomal amphotericin B for complicated visceral leishmaniasis (kala\u2010azar) in eastern Sudan: how effective is treatment for this neglected disease?"],"prefix":"10.1111","volume":"19","author":[{"given":"Niven A.","family":"Salih","sequence":"first","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res\u2010Switzerland North Sudan mission Gedaref Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"van Griensven","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine Antwerp 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