Criteria of Soto et al for Therapeutic Response in Mucosal Leishmaniasis

 

Parameters:

(1) initial mucosal severity score (MSS, see previous section)

(2) mucosal severity score after therapy

(3) initial improvement to therapy

 

change in MSS =

= 100% - (((initial MSS) - (post therapy MSS)) / (initial MSS) * 100%)

 

Mucosal Severity Score	Relapse After Improvement	Clinical Status
0 - 9%	NA	cure
10 - 50%	NA	improvement
51% - 125%	NA	no change
> 125%	NA	worse
NA	present	worse

 

where:

• A relapse may range from minor to marked. For the implementation I will define it as > 50% and relapse after initial improvement.

• A clinical cure requires persistence for 12 months after the end of therapy (page 354).

 

Limitations:

• Using a cumulative score allows for masking, with one or more sites progressing while others regress. However, an antiparasitic agent should impact lesions in the same way although perhaps not to the same degree.