Publications by authors named "Jacob Bezemer"

We describe a group of four travelers returning to the United States and Canada who acquired infection in the Peruvian Amazon. Pentavalent antimonials are the preferred treatment option for cutaneous leishmaniasis (CL) in most endemic countries in Central and South America. However, we initially treated our patients with liposomal amphotericin B (LAB) and miltefosine since these are the only two available Food and Drug Administration approved drugs in the United States.

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Background: Clinical and laboratory diagnosis of cutaneous leishmaniasis (CL) is hampered by under-ascertainment of direct microscopy.

Methods: This study compared the diagnostic accuracy of qPCR on DNA extracted from filter paper to the accuracy of direct smear slide microscopy in participants presenting with a cutaneous lesion suspected of leishmaniasis to 16 rural healthcare centers in the Ecuadorian Amazon and Pacific regions, from January 2019 to June 2021. We used Bayesian latent class analysis to estimate test sensitivity, specificity, likelihood ratios (LR), and predictive values (PV) with their 95% credible intervals (95%CrI).

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Previous research on the stigma associated with cutaneous leishmaniasis, a vector-transmitted parasitic disease, focuses on aesthetic appearance affectation as the leading cause of stigmatisation. However, Indigenous populations in the hinterland of Amazonian Ecuador trigger stigma expressions by recognising (muco)cutaneous leishmaniasis, primarily through atypical smell, followed by the odd voice sound, appearance and taste. This empirical way of recognising symptoms relies on embodied forms of identifying a disease, contrasting the Western supremacy of visuality and demanding to be understood multi-sensorial anthropology.

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Background: Yearly, up to 1 million patients worldwide suffer from cutaneous leishmaniasis (CL). In Ecuador, CL affects an estimated 5000 patients annually. CL leads to reduced Health Related Quality of Life (HRQL) as a result of stigma in the Asian and Mediterranean contexts, but research is lacking for Ecuador.

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Background: Mucosal Leishmaniasis (ML), a neglected tropical disease caused by Leishmania parasites, impairs the quality of life of under-resourced populations in South America. If not treated promptly, this disease progresses to facial deformities and death. The low sensitivity of microscopy results and the unavailability of other accurate tests hamper the diagnosis.

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Tungiasis occurs in tropical and subtropical areas in Central and South America and sub-Saharan Africa and is a Neglected Tropical Disease. We diagnosed three cases of tungiasis in a Dutch family visiting indigenous communities in the Amazon basin of Ecuador. Eight days after returning, they presented papular, pruritic, and painful lesions on the feet, with a whitish halo and a blackish central point with abundant whitish eggs upon extraction.

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Article Synopsis
  • Cutaneous and mucocutaneous leishmaniasis affects approximately one million people annually, causing painful skin lesions and potentially serious disfigurement, highlighting an urgent need for effective treatments.
  • Current treatment options carry significant side effects, prompting a review of allylamine drugs like terbinafine, which are considered safer alternatives, including for pregnant patients.
  • The review identified 22 relevant studies, concluding that allylamine monotherapy lacks sufficient evidence of efficacy for these types of leishmaniasis, with further research needed to explore its potential and optimal use.
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Background: Even in circumstances where optimal antimalarial and supportive treatment is available, severe Plasmodium falciparum malaria is still associated with a significant case fatality. Although exchange transfusion (ET) has been considered as a controversial adjunct therapy, we have not encountered any case fatality since ET was introduced as a standard adjunct therapy for patients with severe malaria.

Study Design And Methods: In this retrospective cohort study of 25 patients with severe malaria, the efficacy and safety of ET as an adjunct to parenteral antimalarial treatment (which was implemented in our hospital starting in 1998) were evaluated and compared with 31 historical control patients who were treated with conventional parenteral antimalarial treatment in the period before ET was added to the standard of care for severe malaria (generally before 1997).

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