Trypanocidal drugs for late stage, symptomatic Chagas disease (Trypanosoma cruzi infection)

Vallejo, Maité; Reyes, Pedro Pa; Garcia, Mireya Martinez; Garay, Alejandro G Gonzalez

doi:10.1002/14651858.cd004102.pub2

Cited by 29 publications

(11 citation statements)

References 33 publications

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“…With Chagas disease, early treatment suppressed acute symptoms more effectively than when treatment was administered after chronic symptoms began (Vallejo & Reyes, 2005;Jannin & Villa, 2007). With Chagas disease, early treatment suppressed acute symptoms more effectively than when treatment was administered after chronic symptoms began (Vallejo & Reyes, 2005;Jannin & Villa, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Our result that timing plays a role in disease management is consistent with studies using other trypanosomes that cause Chagas disease and African sleeping sickness in humans. With Chagas disease, early treatment suppressed acute symptoms more effectively than when treatment was administered after chronic symptoms began (Vallejo & Reyes, 2005;Jannin & Villa, 2007). Early intervention is crucial for African sleeping sickness (Legros et al, 2002) and is necessary to prevent late-stage progression, which requires a combination of medicines to ensure drug resistance does not occur (Priotto et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

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Effect of timing and exposure of sunflower pollen on a common gut pathogen of bumble bees

LoCascio

Pasquale

Amponsah

et al. 2019

Ecological Entomology

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1. Several bee species are declining due to multiple factors, including pathogens. Ingestion of sunflower (Helianthus annuus) pollen can dramatically reduce the bumble bee gut pathogen Crithidia bombi, but little is known about how timing and exposure to sunflower pollen consumption affects pathogen load.2. Two experiments were carried out to investigate how exposure to sunflower pollen relative to pathogen exposure affects Crithidia bombi in Bombus impatiens. Foraging trials with pollen-producing and male-sterile (pollen absent) sunflower lines were performed to investigate whether sunflower pollen affected pathogen transmission in a single foraging bout, and 7-day laboratory trials were done to investigate whether timing and duration of exposure to sunflower pollen after infection affected C. bombi.3. In foraging trials, pollen presence on inflorescences inoculated with C. bombi did not affect transmission (pathogen cell counts of foraging workers) 1 week later, suggesting that a brief experience with sunflower pollen concurrent with pathogen exposure is insufficient to reduce infection. In laboratory trials, consuming sunflower pollen for the first 3.5 days or all 7 days after infection reduced cell counts compared with a negative control pollen, but consuming sunflower pollen starting 3.5 days after infection did not. Consuming sunflower pollen for 7 days was significantly and substantially more effective than any other treatment. Thus, both duration and timing of exposure to sunflower pollen may affect pathogen load.4. These results are important for understanding ecological disease dynamics in natural settings with free-flying bumble bees, and may inform decisions about using medicinal diets to manage bumble bee health commercially.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of timing and exposure of sunflower pollen on a common gut pathogen of bumble bees

LoCascio

Pasquale

Amponsah

et al. 2019

Ecological Entomology

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“…Unfortunately, these drugs are limited to the treatment of children with acute infection and early chronic disease (<12 years old) [24], with growing evidence for treatment in indeterminate disease [25],[26],[27]. For the chronic phase with target organ involvement, few studies support their use as parasitological therapy [27],[28], but the BENEFIT trial supported by the Special Programme for Research and Training in Tropical Diseases (TDR) is expected to fill this knowledge gap [29]. Even in children, who are known to better tolerate treatment with these nitroheterocyclic compounds than adults, the cure rate for chronic indeterminate cases is up to 62% at 2 year follow-up [24],[25],[30], and it may vary according to population and geographical location [25],[26],[27],[31].…”

Section: The Need For New Improved Treatmentsmentioning

confidence: 99%

“…Few rigorous clinical trials have been conducted in CD [24],[26],[28]. For years, one of the important challenges in drug development for CD has been the evaluation of drug efficacy in the population representing the highest disease burden, patients with chronic indeterminate CD.…”

Section: Barriers To Development and Evaluation Of Treatmentsmentioning

confidence: 99%

New, Improved Treatments for Chagas Disease: From the R&D Pipeline to the Patients

et al. 2009

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“…Anti-trypanosomal drug therapy can cure 60% or more of infected children aged < 13 years [4] , [5] , [6] , however treatment efficacy apparently decreases with the duration of infection and side effects to anti-trypanosomal drugs increase with age [7] . Without timely diagnosis, children infected with T. cruzi prior to implementation of vector control may miss the window of opportunity for effective chemotherapy, and the Peruvian health system may be burdened with a generation of individuals aging with Chagas disease as has occurred in other countries [8] .…”

Section: Introductionmentioning

confidence: 99%

Targeted Screening Strategies to Detect Trypanosoma cruzi Infection in Children

Levy

Kawai²,

Bowman³

et al. 2007

PLoS Negl Trop Dis

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BackgroundMillions of people are infected with Trypanosoma cruzi, the causative agent of Chagas disease in Latin America. Anti-trypanosomal drug therapy can cure infected individuals, but treatment efficacy is highest early in infection. Vector control campaigns disrupt transmission of T. cruzi, but without timely diagnosis, children infected prior to vector control often miss the window of opportunity for effective chemotherapy.Methods and FindingsWe performed a serological survey in children 2–18 years old living in a peri-urban community of Arequipa, Peru, and linked the results to entomologic, spatial and census data gathered during a vector control campaign. 23 of 433 (5.3% [95% CI 3.4–7.9]) children were confirmed seropositive for T. cruzi infection by two methods. Spatial analysis revealed that households with infected children were very tightly clustered within looser clusters of households with parasite-infected vectors. Bayesian hierarchical mixed models, which controlled for clustering of infection, showed that a child's risk of being seropositive increased by 20% per year of age and 4% per vector captured within the child's house. Receiver operator characteristic (ROC) plots of best-fit models suggest that more than 83% of infected children could be identified while testing only 22% of eligible children.ConclusionsWe found evidence of spatially-focal vector-borne T. cruzi transmission in peri-urban Arequipa. Ongoing vector control campaigns, in addition to preventing further parasite transmission, facilitate the collection of data essential to identifying children at high risk of T. cruzi infection. Targeted screening strategies could make integration of diagnosis and treatment of children into Chagas disease control programs feasible in lower-resource settings.

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Trypanocidal drugs for late stage, symptomatic Chagas disease (Trypanosoma cruzi infection)

Cited by 29 publications

References 33 publications

Effect of timing and exposure of sunflower pollen on a common gut pathogen of bumble bees

Effect of timing and exposure of sunflower pollen on a common gut pathogen of bumble bees

New, Improved Treatments for Chagas Disease: From the R&D Pipeline to the Patients

Targeted Screening Strategies to Detect Trypanosoma cruzi Infection in Children

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