A. D.M. BrycesonJ. D. ChulayMay HoM. MugambiiJ. B. WereR. MuigaiC. ChungeG. GachihiJ. MemeG. AnabwaniS. BhattKenya Medical Research InstituteArmy Medical Research UnitCASE School of MedicineUniversity of Nairobi Medical SchoolUCLWalter Reed Army Institute of ResearchMahidol University2018-10-122018-10-121985-01-01Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.79, No.5 (1985), 700-70418783503003592032-s2.0-0022179138https://repository.li.mahidol.ac.th/handle/20.500.14594/30797Ten Kenyan patients with visceral leishmaniasis, unresponsive to sodium stibogluconate at a dose of 16 to 20 mg Sb/kg/day given for 30 to 98 days, have been studied clinically and immunologically and compared with 57 antimony-responsive patients. Pulmonary tuberculosis and previous treatment with antimonial drugs were the only factors which were more common in unresponsive patients. The degree of immunosuppression and rate of recovery of immunoreactivity did not differ between antimony-responsive and -unresponsive patients. Only one patient had never been treated before (primary unresponsiveness). In the other nine patients secondary unresponsiveness occurred after one or more treatment courses, suggesting that the parasite developed resistance to antimony. Antimony-unresponsiveness in visceral leishmaniasis is a serious problem numerically, clinically and economically. A plea is made that the initial treatment of visceral leishmaniasis should be adequate in dose and duration. © Oxford University Press.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.1016/0035-9203(85)90197-X