Treatment-Based Strategy for the Management of Post-Kala-Azar Dermal Leishmaniasis Patients in the Sudan

Table 1

Published and unpublished data on PKDL in Sudan.

Treatment	Dose/duration	Number of patients	Efficacy	Safety	Total cost^1	Reference	Route
Published studies
Pentostam	20 mg/kg/d/30–60 d	>100	Efficacious	++	US$249.6–499.2	[1]	im/iv
Ketoconazole	10 mg/kg/d/30 d	>20	Not efficacious	+	US$55.00	[1]	oral
Itraconazole and	200 mg/d/30 d	9	Not efficacious	+	US$250	[23]	oral
Terbinafine	250 mg/d/30 d
AmBisome	3 mg/kg/d/30 d	2	Efficacious	Safe	US$1,350	[26]	iv
AmBisome	2.5 mg/kg/d/ 20 d	12	Efficacious	Safe	US$756	[28]	iv
Immunochemotherapy	20 mg/kg/d/40 d (SSG) (wkly id Alum-ALM dose/4 weeks)	35	Efficacious	+	US$100.0	[16, 27]	iv/im
Unpublished studies
AmBisome	2.5 mg/kg/d/ 20 d	27	Efficacious	Safe	US$756	Khalil et al.
SSG	20 mg/kg/d/60 d	>100	Efficacious	++	US$121.03	Khalil and Musa
Amphotericin B	0.5 mg/kg/d/ 30 d	7	Efficacious	+++	US$90	Musa et al.

SSG: sodium stibogluconate; d: day; wk: week. Alum-ALM: alum-precipitated autoclaved L. major plus BCG.
Toxicity graded as: +: acceptable side effects; ++: moderately toxic; +++: highly toxic.
¹The total cost was calculated for a patient of 40 kg; almost all expenses are the same for a single patient regardless of the regimen except the cost of drug. The unit prices of injectable drugs and oral drugs were obtained from the WHO records and National Medicines and Poisons Board (NMPB, Sudan), respectively.