Heat therapy shown effective in treating cutaneous leishmaniasis among US soldiers in Iraq

A single session of heat therapy using the ThermoMed™ device appears to be as effective as a 10-day intravenous course of sodium stibogluconate (Pentostam) for the treatment of Leishmania major skin lesions, according to a new study by Naomi Aronson and her colleagues at the Uniformed Services University of the Health Sciences and Walter Reed Army Medical Center (WRAMC). Results from the randomized treatment trial, which involved 56 military personnel who contracted L. major while serving in Iraq, are reported March 5 in the open-access journal PLoS Neglected Tropical Diseases.

Cutaneous leishmaniasis is endemic to Iraq and Afghanistan, and more than 1,300 American military and civilian personnel have developed the parasitic skin infection since operations have commenced in these countries. Initially, the primary treatment option was evacuation to WRAMC for sodium stibogluconate treatment under an investigational drug protocol. Aronson and colleagues therefore tested the efficacy of the ThermoMed device, a potential tool for on-site treatment.

The patients treated in the study received either a single session with the ThermoMed device or a daily intravenous infusion of sodium stibogluconate, a pentavalent antimony drug, over a period of 10 days. They were then checked at two-, six-, and 12-month intervals to assess the healing process. Both treatments resulted in comparable rates of healing and, though the number and severity of the side effects were greater with sodium stibogluconate treatment, these resolved over time without long-term effect.

Aronson and colleagues suggest that a rugged, battery-operated device such as the ThermoMed, which could be forward-deployed in the field to effectively treat L. major skin lesions, is not just operationally significant for the military, but may offer non-governmental agencies another method of treatment for cutaneous leishmaniasis.

FINANCIAL DISCLOSURE: This trial was supported by Walter Reed Army Medical Center, The North Atlantic Regional Medical Command, and the US Army Medical and Materiel Development Agency. The study sponsor (US Army Medical Materiel and Development Agency) reviewed the study protocol during development, provided the study drug (SSG) and trial monitoring, and approved this manuscript.

COMPETING INTERESTS: The authors have declared that no competing interests exist.

PLEASE ADD THIS LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.plos.org/10.1371/journal.pntd.0000628 (link will go live upon embargo lift)

CITATION: Aronson NE, Wortmann GW, Byrne WR, Howard RS, Bernstein WB, et al. (2010) A Randomized Controlled Trial of Local Heat Therapy Versus Intravenous Sodium Stibogluconate for the Treatment of Cutaneous Leishmania major Infection. PLoS Negl Trop Dis 4(3): e628. doi:10.1371/journal.pntd.0000628

CONTACT:

Kenneth Frager
Director, Media Affairs Division
Uniformed Services University of the Health Sciences
4301 Jones Bridge Road
Bldg B-1009
Bethesda MD 20814
301-295-3981
kenneth.frager@usuhs.mil

This press release refers to an upcoming article in PLoS Neglected Tropical Diseases. The release is provided by the article authors. Any opinions expressed in these releases or articles are the personal views of the journal staff and/or article contributors, and do not necessarily represent the views or policies of PLoS. PLoS expressly disclaims any and all warranties and liability in connection with the information found in the releases and articles and your use of such information.

PLoS Neglected Tropical Diseases (http://www.plosntds.org/) is a peer-reviewed, open-access journal devoted to the pathology, epidemiology, prevention, treatment, and control of the neglected tropical diseases, as well as public policy relevant to this group of diseases. All works published in PLoS Neglected Tropical Diseases are open access, which means that everything is immediately and freely available subject only to the condition that the original authorship and source are properly attributed. The Public Library of Science uses the Creative Commons Attribution License, and copyright is retained by the authors.

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit http://www.plos.org.