Safety and Efficacy Study of Paromomycin to Treat Visceral Leishmaniasis

Inclusion Criteria: Age between 5-55 years (inclusive) of either gender. Newly diagnosed VL or VL treatment failure confirmed by spleen or bone marrow aspirate. Clinical signs and symptoms compatible with VL: fever of over two weeks duration and splenomegaly. Biochemical and haematological test values as follows: Haemoglobin > 5.0g/100mL White blood cell count > 1 x109/L Platelet count > 50 x 109/L AST, ALT and alkaline phosphatase < 3 times upper normal limit Prothrombin time < 5 seconds above control Serum creatinine levels within normal limits Serum potassium levels within normal limits HIV negative Exclusion Criteria: A history of intercurrent or concurrent diseases (e.g. chronic alcohol consumption or drug addiction; renal, hepatic, cardiovascular or central nervous system disease; diabetes; tuberculosis or other infectious or major psychiatric diseases) that may introduce variables affecting the outcome of the study. Any condition which the investigator thinks may prevent the patient from completing the study therapy and subsequent follow-up. An abnormal baseline audiogram (presentation with 75 dB or higher at 8KHz or below) and/or a history of significant vestibular or auditory dysfunction. Proteinuria (> 2+). A history of allergy or hypersensitivity to aminoglycosides. A history of major surgery within the last two weeks. Pregnancy or lactation. [Note: women of childbearing age must use an adequate form of contraception (documented) or agree to a period of sexual abstinence during the treatment phase of the study.] Previous treatment for VL within two weeks of enrolment into the study. Prior treatment failures with paromomycin or amphotericin B.