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7. Involving patients in drug development for Neglected Tropical Diseases (NTDs): A qualitative study exploring and incorporating preferences of patients with cutaneous leishmaniasis into Target Product Profile development

Author

Castro, María del Mar, primary, Erber, Astrid C., additional, Arana, Byron, additional, Cota, Gláucia, additional, Denkinger, Claudia M., additional, Harrison, Nicole, additional, Kutyi, Julia, additional, López-Carvajal, Liliana, additional, Plugge, Emma, additional, Walochnik, Julia, additional, and Olliaro, Piero, additional

Published
2024
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10. ChimLeish, a new recombinant chimeric protein evaluated as a diagnostic and prognostic marker for visceral leishmaniasis and human immunodeficiency virus coinfection

Author

Galvani, Nathalia C., Machado, Amanda S., Lage, Daniela P., Freitas, Camila S., Vale, Danniele L., de Oliveira, Daysiane, Ludolf, Fernanda, Ramos, Fernanda F., Fernandes, Bruna B., Luiz, Gabriel P., Mendonça, Débora V. C., Oliveira-da-Silva, João A., Reis, Thiago A. R., Tavares, Grasiele S. V., Chaves, Ana T., Guimarães, Nathalia S., Tupinambás, Unaí, Cota, Gláucia F., Humbert, Maria V., Martins, Vívian T., Christodoulides, Myron, Coelho, Eduardo A. F., and Machado-de-Ávila, Ricardo A.

Published
2021
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15. Efficacy and safety of therapeutic strategies for human brucellosis: A systematic review and network meta-analysis.

Author

Silva, Sarah Nascimento, Cota, Gláucia, Xavier, Diego Mendes, de Souza, Glaciele Maria, Souza, Marina Rocha Fonseca, Gonçalves, Moisés Willian Aparecido, Tuon, Felipe Francisco Bondan, and Galvão, Endi Lanza

Subjects
*BRUCELLA, *BRUCELLOSIS, *RANDOM effects model, *FREQUENTIST statistics, *THERAPEUTICS, *CLINICAL trials
Abstract

Background: Human brucellosis is a neglected, re-emerging, and endemic zoonosis in many countries. The debilitating and disabling potential of the disease is a warning about its morbidity, generating socioeconomic impact. This review aims to update the current evidence on the efficacy and safety of therapeutic options for human brucellosis using the network meta-analysis (NMA). Methodology: A systematic search was conducted in four different databases by independent reviewers to assess overall therapy failure, adverse events, and time to defervescence associated with different therapies. Randomized clinical trials (RCTs) evaluating any therapeutic drug intervention were selected, excluding non-original studies or studies related to localized forms of the disease or with less than 10 participants. Data were analyzed by frequentist statistics through NMA by random effects model. The risk of bias and certainty of evidence was assessed, this review was registered at PROSPERO. Results: Thirty-one (31) RCTs involving 4167 patients were included. Three networks of evidence were identified to evaluate the outcomes of interest. Triple therapy with doxycycline + streptomycin + hydroxychloroquine for 42 days (RR: 0.08; CI 95% 0.01–0.76) had a lower failure risk than the doxycycline + streptomycin regimen. Doxycycline + rifampicin had a higher risk of failure than doxycycline + streptomycin (RR: 1.96; CI 95% 1.27–3.01). No significant difference was observed between the regimens when analyzing the incidence of adverse events and time to defervescence. In general, most studies had a high risk of bias, and the results had a very low certainty of evidence. Conclusions: This review confirmed the superiority of drugs already indicated for treating human brucellosis, such as the combination of doxycycline and aminoglycosides. The association of hydroxychloroquine to the dual regimen was identified as a potential strategy to prevent overall therapy failure, which is subject to confirmation in future studies. Author summary: Human brucellosis it is a disease with transmission associated with the handling of animals and ingestion of contaminated products. The disease usually presents with a subacute to chronic febrile condition characterized by nonspecific symptoms such weight loss, and sudoresis. Therapeutic regimens combining two or more drugs have been shown to be superior to monotherapy. The debilitating and disabling potential of the disease is a warning about its morbidity, whose symptoms can persist for weeks or months, generating socioeconomic impact. So far, the accumulated evidence is based on clinical trials that compared the interventions of interest against different comparators. The authors this reviewed all published studies and performed an analysis was capable of comparing the effect of therapeutic regimens to identify the best combinations to treat human brucellosis. The combination of three medicines (doxycycline + streptomycin + hydroxychloroquine) showed the best results compared to the option previously identified as more effective (doxycycline + streptomycin), so this research points to new perspectives for the treatment of brucellosis. This result point that more studies dedicated to studying this combination must be developed to confirm this trend and enable the adoption of new practices in the treatment of this disease. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Quality of life of patients with cutaneous leishmaniasis: A comparative analysis of the EQ-5D-3L and CLIQ questionnaires.

Author

Galvão, Endi Lanza, de Pina Carvalho, Janaína, Machado de Assis, Tália Santana, Freire, Mariana Lourenço, Cota, Gláucia, and Nascimento Silva, Sarah

Subjects
CUTANEOUS leishmaniasis, END of treatment, COMPARATIVE studies, QUALITY of life, RANK correlation (Statistics)
Abstract

Purpose: To evaluate the performance of the Cutaneous Leishmaniasis Impact Questionnaire (CLIQ) using the EuroQol-5 Dimension (EQ-5D-3L) as a reference standard (criterion validation); to evaluate the responsiveness of the instruments and estimate a cut-off point for the CLIQ to be able to discriminate between high and low impacts of cutaneous leishmaniasis on patients. Methods: Between 2020 and 2022, a longitudinal validation study was conducted at a reference centre for leishmaniasis in Brazil. The EQ-5D-3L and CLIQ questionnaires were administered before, during and after treatment for cutaneous leishmaniasis. The correlation between the instruments was assessed using Spearman's correlation coefficient, responsiveness was assessed using the Wilcoxon test, and CLIQ cut-off points were proposed based on results of the EQ-5Q-3L, dichotomized between patients reporting no problems' and 'some or extreme problems'. Results: There were satisfactory correlation coefficients between the two instruments before (-0.596) and during treatment (-0.551) and a low correlation between the instruments after the end of treatment (-0.389). In general, the responsiveness of the instruments was satisfactory. The CLIC scores that maximized sensitivity and specificity for recognizing impaired health status before and during treatment were 7 points and 17 points, respectively. However, at the end of treatment, based on the results for the EQ-5D-3L, the CLIC was not able to discriminate between individuals with high and low impacts of the disease. Conclusion: The CLIQ corresponds well with the EQ-5D-3L when applied before and during treatment but does not seem to be appropriate for follow-up evaluations after the end of treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Implementation of health technologies in Brazil: analysis of federal guidelines for the public health system.

Author

Nascimento Silva, Sarah, Freitas de Mello, Nicole, Raquel Ribeiro, Laís, Estéfane da Silva, Rosiana, and Cota, Gláucia

Abstract

This study aimed to identify the regulatory framework and federal guidelines that support the process of implementing health technologies in the Unified Health System (SUS) through analysis of documents and legislation related to the National Health Technology Management Policy, published between 2009 and 2021. The search and selection of documents and subsequent data extraction were carried out. The documents were grouped into three categories: structural regulatory documents, recommendations on evaluation of technologies, and recommendations on clinical guidelines. In 38.8% of the regulatory documents, citations to implementation related mainly to SUS clinical guidelines were identified; however, no document dedicated to guiding implementation actions was identified. Recommendations related to implementations were identified in 27.1% of the reports and 66.1% of the guidelines, although without standardization and, in general, in little detail, focusing on resources and actions needed for making technology available rather than on methods and interventions for its implementation. The results evidence a gap in formal guidelines to guide the implementation process in Brazil, representing an opportunity for the development of models aligned with the reality of the SUS. [ABSTRACT FROM AUTHOR]

Published
2024
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19. A randomized, controlled, non-inferiority, multicenter trial of systemic versus intralesional treatment with meglumine antimoniate for cutaneous leishmaniasis in Brazil

Author

Lyra, Marcelo R, primary, Oliveira, Liliane F A, additional, Schubach, Armando O, additional, Sampaio, Raimunda N, additional, Rodrigues, Bruna C, additional, Hueb, Márcia, additional, Cota, Gláucia, additional, Silva, Rosiana E, additional, Francesconi, Fábio, additional, Pompilio, Maurício A, additional, Oliveira, Adriana F, additional, Amato, Valdir S, additional, Souza, Regina M, additional, Oliveira, Raquel V C, additional, Rosalino, Cláudia M V, additional, and Pimentel, Maria I F, additional

Published
2023
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21. A Randomized, Controlled, Noninferiority, Multicenter Trial of Systemic vs Intralesional Treatment With Meglumine Antimoniate for Cutaneous Leishmaniasis in Brazil.

Author

Lyra, Marcelo R, Oliveira, Liliane F A, Schubach, Armando O, Sampaio, Raimunda N R, Rodrigues, Bruna C, Hueb, Marcia, Cota, Gláucia, Silva, Rosiana E, Francesconi, Fabio, Pompilio, Maurício A, França, Adriana O, Amato, Valdir S, Souza, Regina M, Oliveira, Raquel V C, Valete, Cláudia M, and Pimentel, Maria I F

Subjects
ANTIPROTOZOAL agents, DRUG efficacy, RESEARCH, WOUND healing, LEISHMANIASIS, CONFIDENCE intervals, RANDOMIZED controlled trials, COMPARATIVE studies, RESEARCH funding, DESCRIPTIVE statistics, ELECTROCARDIOGRAPHY, STATISTICAL sampling, DRUG toxicity, PHARMACODYNAMICS, EVALUATION
Abstract

Background Meglumine antimoniate (MA) remains the main treatment for cutaneous leishmaniasis (CL). Uncontrolled studies suggest that intralesional MA (IL-MA) may be noninferior and safer than systemic MA (S-MA). Methods Multicenter, randomized, controlled, open-label, phase 3 clinical trial to evaluate the efficacy and toxicity of IL-MA in 3 infiltrations at 14-day intervals compared with S-MA (10–20 mg Sb5+/kg/day, 20 days) for CL, with noninferiority margin of 20%. Primary and secondary outcomes were definitive cure at day 180 and epithelialization rate at day 90 of treatment, respectively. A 2-year follow-up was performed to assess relapses and emergence of mucosal lesions. Adverse events (AEs) were monitored according to the Division of AIDS AE grading system. Results We evaluated 135 patients. The cure rates (95% confidence interval) for IL-MA and S-MA treatment were, respectively, 82.8% (70.5–91.4) and 67.8% (53.3–78.3) per protocol (PP) and 70.6% (58.3–81.0) and 59.7% (47.0–71.5) per intention to treat (ITT). The epithelialization rates of the IL-MA and S-MA treatment were, respectively, 79.3% (66.6–88 + 8) and 71.2% (57.9–82.2) PP and 69.1% (55.2–78.5) and 64.2% (50.0–74.2) ITT. AEs in the IL-MA and S-MA groups were, respectively, clinical, 45.6% and 80.6%; laboratory, 26.5% and 73.1%; and electrocardiogram, 8.8% and 25.4%. Ten participants in the S-MA group and 1 in the IL-MA group were discontinued due to severe or persistent AEs. Conclusions IL-MA provides a similar cure rate and results in less toxicity compared with S-MA and may be used as first-line therapy for CL patients. Clinical Trials Registration REBEC: RBR-6mk5n4. [ABSTRACT FROM AUTHOR]

Published
2023
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22. Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study

Author

Castro, Maria del Mar, primary, Rode, Joelle, additional, Machado, Paulo R. L., additional, Llanos-Cuentas, Alejandro, additional, Hueb, Marcia, additional, Cota, Gláucia, additional, Rojas, Isis Valentina, additional, Orobio, Yenifer, additional, Oviedo Sarmiento, Oscar, additional, Rojas, Ernesto, additional, Quintero, Juliana, additional, Pimentel, Maria Inês Fernandes, additional, Soto, Jaime, additional, Suprien, Carvel, additional, Alvarez, Fiorela, additional, Ramos, Ana Pilar, additional, Arantes, Rayssa Basílio dos Santos, additional, da Silva, Rosiana Estéfane, additional, Arenas, Claudia Marcela, additional, Vélez, Ivan Darío, additional, Lyra, Marcelo Rosandiski, additional, Saravia, Nancy Gore, additional, Arana, Byron, additional, and Alexander, Neal, additional

Published
2023
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25. Performance differences among commercially available antigen rapid tests for COVID-19 in Brazil

Author

Freire, Mariana Lourenço, primary, Alves, Lindicy Leidicy, additional, de Souza, Carolina Senra, additional, Saliba, Juliana Wilke, additional, Faria, Verônica, additional, Pedras, Mariana Junqueira, additional, Carvalho, Nara de Oliveira, additional, Andrade, Gláucia Queiroz, additional, Rabello, Ana, additional, Avelar, Daniel Moreira, additional, and Cota, Gláucia, additional

Published
2022
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26. Anti-mitochondrial Tryparedoxin Peroxidase Monoclonal Antibody-Based Immunohistochemistry for Diagnosis of Cutaneous Leishmaniasis

Author

Freire, Mariana Lourenço, primary, Rego, Felipe Dutra, additional, Lopes, Karine Ferreira, additional, Coutinho, Lucélia Antunes, additional, Grenfell, Rafaella Fortini Queiroz, additional, Avelar, Daniel Moreira, additional, Cota, Gláucia, additional, Pascoal-Xavier, Marcelo Antônio, additional, and Oliveira, Edward, additional

Published
2022
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29. A phase IV, prospective, observational study of the clinical safety of snake antivenoms

Author

Nogueira, Denise Christie Souto, Calil, Iara Pinheiro, dos Santos, Roberta Márcia Marques, de Andrade, Adebal, and Cota, Gláucia

Subjects
Adult, Aged, 80 and over, Male, Adolescent, Antivenins, RC955-962, Snake Bites, Snakes, Middle Aged, Snakebites, complex mixtures, Young Adult, Child, Preschool, Arctic medicine. Tropical medicine, Animals, Humans, Original Article, Prospective Studies, Safety, Child, Aged, Snake Venoms, Antivenoms, Snake envenoming
Abstract

Snake envenoming is a neglected tropical disease that affects more than 2.7 million people worldwide. The treatment is based on the administration of antivenom composed of heterologous immunoglobulins, species-specific therapy involving the possibility of adverse reactions due to activation of the immune system. Considering the scarcity of prospective studies evaluating the safety of snake antivenoms, this study aimed to describe and characterize adverse events after antivenom infusion in an observational, prospective, single-centre investigation conducted in a referral centre in Brazil. A total of 47 victims of snake envenoming were included in the study, who were mostly men (75%), with ages ranging from 2 to 83 years. Twenty-two participants (47%) presented manifestations compatible with infusion-related reactions (IRRs) during or up to two hours after F(ab’)2 heterologous immunoglobulin infusion. The most common clinical manifestation related to the infusion was a diffuse cutaneous rash (82%), followed by respiratory manifestations (46%) and facial swelling (23%). In four cases (9%), IRR were considered serious adverse events (SAE), characterized by haemodynamic instability, airway obstruction or hypoxia. Only one patient developed symptoms compatible with serum sickness. Although almost half of the patients treated with antivenom sera experienced IRRs, the SAE rate was 9%; in all cases, the adverse reaction was reversible by using supportive treatment, and there were no deaths. The results have shown that there is much to improve in the antivenom production process to obtain a more purified and specific product. Even so, a timely antivenom serum administration managed by well-trained health teams is safe and prevents complications after snake-related accidents.

Published
2021

30. Potential of recombinant LiHyQ, a novel Leishmania infantum protein, for the diagnosis of canine visceral leishmaniasis and as a diagnostic and prognostic marker for human leishmaniasis and human immunodeficiency virus co-infection: A preliminary study

Author

Santos, Thaís T.O., primary, Ramos, Fernanda F., additional, Gonçalves, Isabela A.P., additional, Tavares, Grasiele S.V., additional, Ludolf, Fernanda, additional, Bandeira, Raquel S., additional, Silva, Alessandra M., additional, Oliveira-da-Silva, João A., additional, Reis, Thiago A.R., additional, Machado, Amanda S., additional, Lage, Daniela P., additional, Freitas, Camila S., additional, Vale, Danniele L., additional, Martins, Vívian T., additional, Alves, Livia A., additional, Guimarães, Nathalia S., additional, Chaves, Ana Thereza, additional, Chávez-Fumagalli, Miguel A., additional, Cota, Gláucia F., additional, Silveira, Julia A.G., additional, Tupinambás, Unaí, additional, Gonçalves, Denise U., additional, Christodoulides, Myron, additional, and Coelho, Eduardo A.F., additional

Published
2021
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31. Diagnostic application of sensitive and specific phage-exposed epitopes for visceral leishmaniasis and human immunodeficiency virus coinfection

Author

Ramos, Fernanda F., primary, Tavares, Grasiele S. V., additional, Ludolf, Fernanda, additional, Machado, Amanda S., additional, Santos, Thaís T. O., additional, Gonçalves, Isabela A. P., additional, Dias, Ana C. S., additional, Alves, Patrícia T., additional, Fraga, Vanessa G., additional, Bandeira, Raquel S., additional, Oliveira-da-Silva, João A., additional, Reis, Thiago A. R., additional, Lage, Daniela P., additional, Martins, Vívian T., additional, Freitas, Camila S., additional, Chaves, Ana T., additional, Guimarães, Nathalia S., additional, Chávez-Fumagalli, Miguel A., additional, Tupinambás, Unaí, additional, Rocha, Manoel O. C., additional, Cota, Gláucia F., additional, Fujiwara, Ricardo T., additional, Bueno, Lílian L., additional, Goulart, Luiz Ricardo, additional, and Coelho, Eduardo A. F., additional

Published
2021
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34. Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety

Author

Clemente, Wanessa T., Faria, Luciana C., Cota, Gláucia F., Amado, Leandro Ricardo de Navarro, Oliveira, Jaqueline G. F., Miranda, Silvana Spíndola de, Cançado, Omar LopesJr., Romanelli, Roberta M. C., Lima, Agnaldo S., Frade, Luiza Bastos, Lucas, FernandoJr., and Sanches, Marcelo Dias

Subjects
Article Subject
Abstract

Donor-derived tuberculosis (DD-TB) accounts for less than 5% of TB cases and is considered a rare event. In the transplant setting, the frequency of active TB is estimated to be 20 to 74 times higher than that in the general population, and it is associated with high mortality. In this context, the main strategy to minimize the risk of DD transmission is to identify high-risk donors. Despite screening recommendations, failures may result in a breakdown of safety that ends in the transmission of potentially fatal diseases. This report describes a case of DD-TB and emphasizes communication gaps that may occur between organ procurement organizations and transplant centers. Failure in reporting results, lack of exchanging information regarding recipients from the same donor, and inefficient communication between organ procurement organizations and transplant centers are lacks that may be prevented by a more efficient approach towards screening protocols and communication.

Published
2021
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41. An immunoproteomics approach to identifyLeishmania infantumproteins to be applied for the diagnosis of visceral leishmaniasis and human immunodeficiency virus co-infection

Author

Machado, Amanda S., primary, Ramos, Fernanda F., additional, Oliveira-da-Silva, João A., additional, Santos, Thaís T. O., additional, Tavares, Grasiele S. V., additional, Costa, Lourena E., additional, Lage, Daniela P., additional, Teixeira-Ferreira, André, additional, Perales, Jonas, additional, Fernandes, Ana Paula, additional, Moreira, Ricardo L. F., additional, Duarte, Mariana C., additional, Tupinambás, Unaí, additional, Caligiorne, Rachel B., additional, Cota, Gláucia F., additional, Coelho, Eduardo A. F., additional, and Ludolf, Fernanda, additional

Published
2020
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43. Patients’ preferences of cutaneous leishmaniasis treatment outcomes: Findings from an international qualitative study

Author

Erber, Astrid C., primary, Arana, Byron, additional, Ben Salah, Afif, additional, Bennis, Issam, additional, Boukthir, Aicha, additional, Castro Noriega, María del Mar, additional, Cissé, Mamoudou, additional, Cota, Gláucia Fernandes, additional, Handjani, Farhad, additional, López-Carvajal, Liliana, additional, Marsh, Kevin, additional, Medina, Dalila Martínez, additional, Plugge, Emma, additional, Lang, Trudie, additional, and Olliaro, Piero, additional

Published
2020
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50. Impacto presupuestario de las pruebas diagnósticas para la leishmaniosis visceral en Brasil

Author

Assis, Tália Santana Machado de, Azeredo-da-Silva, André Luís Ferreira de, Oliveira, Diana, Cota, Gláucia, Werneck, Guilherme Loureiro, and Rabello, Ana

Subjects
Visceral Leishmaniasis, Controle Orçamentário, Leishmaniasis Visceral, Diagnóstico, Budgetary Control, Diagnosis, Leishmaniose Visceral, Control Presupuestario
Abstract

The aim of the present study was to estimate the financial costs of the incorporation and/or replacement of diagnostic tests for human visceral leishmaniasis (VL) in Brazil. The analysis was conducted from the perspective of the Brazilian Unified National Health System (SUS) over a period of three years. Six diagnostic tests were evaluated: the indirect immunofluorescence antibody test (IFAT), the IT LEISH rapid test, the parasitological examination of bone marrow aspirate, the direct agglutination test (DAT-LPC) standardized in the Clinical Research Laboratory, René Rachou Institute of the Oswaldo Cruz Foundation, the Kalazar Detect rapid test, and polymerase chain reaction (PCR). The assumptions used were the number of suspected cases of VL reported to the Brazilian Ministry of Health in 2014 and the direct cost of diagnostic tests. The costs to diagnose suspected cases of VL over three years using the IFAT and the DAT-LPC were estimated at USD 280,979.91 and USD 121,371.48, respectively. The analysis indicated that compared with the use of the IFAT, the incorporation of the DAT-LPC into the SUS would result in savings of USD 159,608.43. With regard to the budgetary impact of rapid tests, the use of IT LEISH resulted in savings of USD 21.708,72 over three years. Compared with a parasitological examination, diagnosis using PCR resulted in savings of USD 3,125,068.92 over three years. In this study, the replacement of the IFAT with the DAT-LPC proved financially advantageous. In addition, the replacement of the Kalazar Detect rapid test with the IT LEISH in 2015 was economically valuable, and the replacement of parasitological examination with PCR was indicated. Resumo: O estudo teve como objetivo estimar os custos financeiros da incorporação e/ou substituição dos testes diagnósticos para a leishmaniose visceral (LV) humana no Brasil. A análise foi realizada na perspectiva do Sistema Único de Saúde (SUS) ao longo de três anos. Foram avaliados seis testes diagnósticos: reação de imunofluorescência indireta (RIFI), teste rápido IT LEISH, exame parasitológico de aspirado de medula óssea, teste de aglutinação direta DAT-LPC padronizado pelo Laboratório de Pesquisas Clínicas do Instituto René Rachou, Fundação Oswaldo Cruz, teste rápido Kalazar Detect e reação em cadeia da polimerase (PCR). Os parâmetros utilizados foram o número de casos suspeitos de LV notificados ao Ministério da Saúde em 2014 e o custo direto dos testes diagnósticos. Os custos do diagnóstico de casos suspeitos de LV ao longo de três anos usando o RIFI e DAT-LPC foram estimados em USD 280.979,91 e USD 121.371,48, respectivamente. De acordo com a análise, comparado ao uso do RIFI, a incorporação do DAT-LPC pelo SUS resultaria numa economia de USD 159.608,43. Com relação ao impacto dos testes rápidos, o uso do IT LEISH resultou em economia de USD 21.708,72 ao longo de três anos. Comparado ao exame parasitológico, o diagnóstico com PCR resultou em economia de USD 3.125.068,92 ao longo de três anos. Neste estudo, a substituição do RIFI pelo DAT-LPC mostrou ser financeiramente vantajosa. Além disso, a substituição do teste rápido Kalazar Detect com o IT LEISH em 2015 foi economicamente apropriada, e a substituição do exame parasitológico pela PCR está economicamente indicada. Resumen: El objetivo del estudio fue estimar los costes financieros de la incorporación y/o sustitución de las pruebas diagnósticas para la leishmaniasis visceral (LV) humana en Brasil. El análisis se realizó desde la perspectiva del Sistema Único de Salud (SUS) a lo largo de tres años. Se evaluaron seis pruebas diagnósticas: reacción de inmunofluorescencia indirecta (RIFI), test rápido IT LEISH, examen parasitológico de aspirado de medula ósea, test de aglutinación directa DAT-LPC, estandarizado por el Laboratorio de Investigación Clínica del Centro de Investigación René Rachou, Fundación Oswaldo Cruz, test rápido Kalazar Detect y la reacción en cadena de la polimerasa (PCR). Los parámetros utilizados fueron el número de casos sospechosos de LV notificados al Ministerio de Salud en 2014 y el coste directo de los test diagnósticos. Los costes del diagnóstico de casos sospechosos de LV a lo largo de tres años, usando el RIFI y DAT-LPC, se estimaron en USD 280.979,91 y USD 121.371,48, respectivamente. De acuerdo con el análisis, comparado con el uso del RIFI, la incorporación del DAT-LPC por el SUS resultaría en un ahorro de USD 159.608,43. En relación con el impacto de los test rápidos, el uso del IT LEISH aportaba un ahorro de USD 21.708,72 a lo largo de tres años. Comparado con el examen parasitológico, el diagnóstico con PCR suponía un ahorro de USD 3.125.068,92 a lo largo de tres años. De acuerdo con el estudio, la sustitución del RIFI con el DAT-LPC mostró ser financieramente ventajosa. Asimismo, la sustitución del test rápido Kalazar Detect con el IT LEISH en 2015 representó un ahorro económico, y los resultados favorecieron la sustitución del examen parasitológico con PCR.

Published
2017

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