{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:39:46Z","timestamp":1767969586466,"version":"3.49.0"},"reference-count":36,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,4,8]]},"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Post-kala-azar dermal leishmaniasis (PKDL) is a dermatological complication that occurs primarily among treated visceral leishmaniasis (VL) patients, and sporadically in a few without a history of VL. It mostly affects children and adolescents but is also common in adults. The conventional treatment with 120 intramuscular injections of sodium stibogluconate (SSG) is phasing out. Miltefosine (MF) is the only eventual alternative to SSG; however, its efficacy and safety profiles for treatment of children and adolescents with PKDL are lacking. In addition, risk factors for PKDL are poorly investigated. Host genetic, nutritional and environmental factors could be potential risk factors. As such, here we propose to evaluate the efficacy and safety of MF for 12\u2005weeks at an allometric dose for children and adolescents with PKDL, and also to explore potential risk factors for PKDL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A cross-sectional survey will look for suspected participants with PKDL among treated VL children and adolescents, a subsequent open clinical trial with MF at allometric dose, with a follow-up at 12\u2005months. A case\u2013control study will be carried out for PKDL risk factors. Assuming 95% cure rate, 95% CI and \u03b1=0.05, a sample size of 73 children with PKDL is needed. Considering an attrition rate of 10%, the final sample size is 80 children in each group. Descriptive and analytical analyses will be performed. Primary outcome is safety and cure rate of 12\u2005weeks of treatment with MF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) Ethical Review Committee (ERC) approved the protocol (PR#013045). Written informed consent will be taken from all participants and their guardians (in case of minor). A Data and Safety Monitoring Board (DSMB) of ICDDR,B ERC will monitor all study activities to ensure the safety of the participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NCT02193022; Pre-results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-010050","type":"journal-article","created":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T00:09:56Z","timestamp":1463530196000},"page":"e010050","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Study on the safety and efficacy of miltefosine for the treatment of children and adolescents with post-kala-azar dermal leishmaniasis in Bangladesh, and an association of serum vitamin E and exposure to arsenic with post-kala-azar dermal leishmaniasis: an open clinical trial and case\u2013control study protocol"],"prefix":"10.1136","volume":"6","author":[{"given":"D","family":"Mondal","sequence":"first","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M G","family":"Hasnain","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M S","family":"Hossain","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Hossain","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Baker","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Nath","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Haque","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Matlashewski","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, McGill University, Montreal, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Hamano","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Nagasaki University, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"2025121221495109000_6.5.e010050.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00517-6"},{"key":"2025121221495109000_6.5.e010050.2","doi-asserted-by":"crossref","unstructured":"Desjeux P , Ramesh V . Post-kala-azar dermal leishmaniasis: facing the challenges of eliminating kala-azar from South Asia. Kala-azar in South Asia. In: Jha TK , Noiri E, eds . Kala-azar in South-Asia. New York: Springer-Verlag, 2011:111\u201344; Chapter 11.","DOI":"10.1007\/978-94-007-0277-6_11"},{"key":"2025121221495109000_6.5.e010050.3","unstructured":"Be-Nazir Ahmed, Chief Editor. National Guideline for Kala-azar Case Management, May, 2013. 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