A cross-sectional study on sociodemographic, clinical, and therapeutic characteristics of a pediatric population with cutaneous leishmaniasis

Objective: To characterize the pediatric population with cutaneous leishmaniasis treated at a research center and to determine the therapeutic response and safety of the treatment. Methods: A cross-sectional study was designed, in which data related to sociodemographic information, history of leishmaniasis, clinical characteristics, treatment, therapeutic response and adverse events were collected from the review of the clinical records. Results: The analysis was conducted in 156 pediatric patients with median age of 10.5 (6-14) years. Regarding clinical and therapeutic characteristics, the lesions in these patients were mostly single ulcers, primarily located on the upper and lower extremities. A total of 114 patients were managed at Programa de Estudio y Control de Enfermedades Tropicales (PECET), and 26 of them received more than one treatment. Upon administration of the first therapeutic option, intralesional meglumine antimoniate had a cure rate of 43.18% (19/44 patients), followed by systemic meglumine antimoniate with a cure rate of 40% (8/20) and topical investigational medication with a cure rate of 25% (5/20). The most frequent adverse events were: arthralgia and myalgia for systemic meglumine antimoniate; nausea and vomiting for miltefosine; and local pain, edema, erythema and rash for topical treatment. Conclusions: Although more prospective studies are needed to generate evidence-based recommendations and management protocols, miltefosine appears to be a favorable, safe and well- tolerated therapeutic option for the pediatric population. Despite the high percentage of loss to follow-up, the success achieved in pediatric patients with local treatments suggests that local therapies could also be considered for managing this condition in this population.