Short Course Regimens for Treatment of PKDL (Sudan)
Short Course Regimens for Treatment of PKDL (Sudan)
This is an open label, randomized non comparative phase II clinical trial conducted on
 parallel groups, to assess the safety and efficacy of the combination of Paromomycin (20
 mg/kg/d) IM for 14 days and Miltefosine (allometric dosing) oral for 42 days, and a
 combination of AmBisome® (20 mg/kg total dose) IV over 7 days and Miltefosine oral for 28
 days (allometric dosing) for the treatment of PKDL patients in Sudan.
Inclusion Criteria:

 -  Confirmed PKDL case by clinical presentation and demonstration of parasites by
 microscopy in a skin smear or by PCR, with documented stable or progressive disease
 for at least 6 months or grade 3 PKDL

 -  Male or Female patients aged 6 to 60 years

 -  Written voluntarily informed consent is obtained from the patient, or his guardian if
 the patient is < 18 years old. In the case of minors aged >12 to <18, assent from the
 children is also needed in addition to the guardian's consent.

 Exclusion Criteria:

 -  Patients who had prior treatment of PKDL within the last 1 year

 -  Pregnant and lactating women and women of childbearing age (12 to 55 years) who do not
 accept to have a pregnancy test and who do not agree to use contraception during
 treatment period and for 5 months after the end of treatment.

 -  Patients with signs and symptoms of severe diseases: defined as suffering from a
 concomitant severe infection such as TB or any other serious known underlying disease
 (cardiac, renal, hepatic),

 -  Severe malnutrition defined by BMI for age WHO reference curves for gender, Z score <
 -3 for subjects 6 to < 19 years; BMI < 16 for subjects > 19 years old

 -  Patients with haemoglobin < 5g/dL

 -  Patients with known skin disease

 -  Patients with abnormal liver function (ALT and AST) tests of more than three times the
 normal range.

 -  Patients with total bilirubin levels >1.5 times the upper normal range

 -  Patients with serum creatinine above the upper limit of normal range

 -  Patients with serum potassium < 3.5 mmol/L

 -  Patients with pre-existing clinical hearing loss based on audiometry at baseline

 -  Patients with a positive HIV test as applicable

 -  Patients / guardian not willing to participate

 -  Patients with history of allergy or hypersensitivity to the relevant study drug

 -  Patients on immunomodulators therapy