This document focuses on making recommendations for the diagnosis and treatment of Chagas disease, an infection caused by Trypanosoma cruzi, the protozoan agent of a systemic parasitic disease. Methodology: These clinical practice guidelines were prepared following the WHO handbook for guideline dev...elopment (5). A multidisciplinary development group was formed, comprised of thematic experts, epidemiologists, methodologists, and users. Since there were no existing guidelines that could be adapted, the guidelines were developed from scratch.
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This report provides an update on the key facets of HIV treatment access, including the latest HIV treatment guidelines from World Health Organization (WHO), an overview on pricing for first-line, second-line, and salvage regimens, and a summary of the opportunities for – and threats to – expand...ing access to affordable antiretroviral therapy (ART).
The report is supplemented by 11 drug profiles that contain more detailed information on pricing trends and patent barriers for key antiretroviral drugs and fixed-dose combinations. Also included is an annex of conditions that define eligibility for reduced prices from 15 pharmaceutical companies.
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Glob Heart . 2020 Oct 13;15(1):69. doi: 10.5334/gh.891.
2nd edition. These guidelines include several notable changes from the first edition. For cutaneous leishmaniasis, ketoconazole has been removed from the list of treatment options; the number of Leishmania species for which there is strong evidence for the efficacy of miltefosine has increased from ...two to four; and the recommendation for intralesional antimonials is now strong. For mucosal leishmaniasis there is now a strong recommendation for use of pentavalent antimonials with or without oral pentoxifylline. For visceral leishmaniasis, the strong recommendations for use of pentavalent antimonials and amphotericin B deoxycholate are now conditional.
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PLoS Neglected Tropical diseases August 16, 2021 https://doi.org/10.1371/journal.pntd.0009697
Chagas disease, also known as American trypanosomiasis, is a neglected tropical disease transmitted by triatomine insects, first identified in 1909. Chagas disease affects approximately 6–7 million peop...le globally and is highly prevalent in Latin America where most cases are reported. However, there is increasing evidence that Chagas disease is now an important public health issue outside the “classical” endemic countries due to population migration. Our understanding of Chagas disease, including its pathologies and factors relating to progression, remains to date limited, and is also challenged by lack of diagnosis and highly effective treatment. This systematic review aims to describe studies with Chagas patients receiving antiparasitic treatment. Databases were searched for relevant studies published after 1997, and the results of these searches were screened.
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Rev. Panam Salud Publica. 2017;41:e153. doi: 10.26633/RPSP.2017.153
Worldwide, over 6 million people are infected with Trypanosoma cruzi, the pathogen that causes Chagas disease (CD). In the Americas, CD creates the greatest burden in disability-adjusted life years of any parasitic infection. In Co...lombia, 437 000 people are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy. Colombia’s annual costs for treating patients with advanced CD reach US$ 175 016 000. Although timely etiological treatment can significantly delay or prevent development of cardiomyopathy—and costs just US$ 30 per patient—fewer than 1% of people with CD in Colombia and elsewhere receive it.
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Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease. Endemic in 21 Latin American countries, the disease can be transmitted by vector insects called triatomines — also known as “kissing bugs” —, foods or beverages contaminated with th...e parasite, blood transfusions, organ transplants, or congenitally during pregnancy or delivery.
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Not long ago, on the occasion of the 100th anniversary of the discovery of Chagas disease, several campaigns denounced the scant progress has been made in diffrent spheres- medical, scientific and politcal- but major challanges still remain. This is an appropriate time to celebrate what has been ach...ieved and to take the next step.
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Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease
(CD). T. cruzi is transmitted by triatomine insects, congenitally, through uncontrolled blood donations and organ transplants,
and via consumption of food or drink contaminated by triatomi...nes.
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Chagas is a complex, multidimensional phenomenon in which political, economic, environmental, biomedical, epidemiological, psychological, and sociocultural factors intersect. Nonetheless, the hegemonic conceptualisation has long envisioned Chagas as primarily a biomedical question, while ignoring or... downplaying the other dimensions, and this limited view has reinforced the disease’s long neglect. Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness, increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.
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To support its R&D activities on Chagas disease, DNDi launched the Chagas Clinical Research Platform (CCRP). The platform brings together partners, experts, and stakeholders to provide support for evaluation and development of new treatments for Chagas disease. The patient-centred platform aims to f...acilitate clinical research, provide a forum for technical discussions, develop a critical mass of expertise, and strengthen institutional research capacities. In addition, it identifies and reviews priority needs, works towards standardization of methodology to assess drug efficacy and reviews alternatives for using current approved drugs (new schemes, doses, combination) and special scenarios (resistance).
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The World Health Organization (WHO) and the global community of countries, partners, donors, technical experts, scientists and field implementation teams continue to work towards the ultimate goal of a world free of the burden of neglected tropical diseases (NTDs). This work is described in the NTD ...road map 2021–2030, WHO’s blueprint to drive global efforts in the fight against NTDs in the context of the United Nations Sustainable Development Goals. These goals encompass a vision of a world population for whom equality of opportunity and of health are fundamental.
Within this context, and during the two years since the launch of the road map (2021–2022), progress has been made. Nevertheless, hindrances towards achieving the targets for 2030 have arisen and work to overcome these obstacles continues. These endeavours have also revealed the scale of the task still facing the global NTD community.
Disruption as a result of the COVID-19 pandemic has continued to afflict longstanding and new programmes alike, while other entrenched issues have re-emerged in new and challenging ways. The global NTD community is also confronted with a changing, multi-dimensional funding landscape as donors reassess priorities and adapt to new ways of working, as well as a challenging and unpredictable international context. As a result, progress in controlling, eliminating or eradicating NTDs has not been as far-reaching as expected.
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Chagas is a parasitic disease that affects over 6 million people in the
world. As the disease typically remains asymptomatic for years, new cases
often go unnoticed and unreported, and most people with the disease
are unaware of their condition. Less than 10% of people affected are
diagnosed and... the vast majority do not receive the treatment they need.
If not treated, Chagas may cause irreversible, life-threatening damage to
the heart and other vital organs.
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he Pan American Health Organization (PAHO) would like to thank the group that developed these guidelines for the tremendous work, quick response, and commitment they demonstrated in this process. We would like to especially recognize the following doctors: Roberto Chuit, Jaime Altcheh, Alejandro Luq...uetti, Faustino Torrico, and Juan Carlos Villar, for sharing their extensive expertise on the subject; Ariel Izcovich, Juan Criniti, Ana Marcela Torres, and Ludovic Reveiz, for methodological coordination; and Roberto Salvatella and Luis Castellanos for promoting this initiative.
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La enfermedad de Chagas es parasitaria y afecta a más de 6 millones
de personas en el mundo. Como normalmente es asintomática durante
años, los nuevos casos suelen no detectarse ni reportarse y la mayoría
de las personas con la enfermedad no tiene conciencia de su condición.
Se diagnostica ...a menos del 10% de las personas afectadas, y en su gran
mayoría estas no reciben el tratamiento que necesitan. Sin tratamiento,
la enfermedad de Chagas puede causar daños irreversibles al corazón y
otros órganos vitales, o la muerte.
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Leishmaniasis is a climate-sensitive disease. Changes in
temperature, rainfall, and humidity can have strong impacts on
the sandfly vector, altering their distribution and influencing their
survival and population sizes. Increased temperatures shorten
vector development time, reduce Leishmania p...arasite incubation
time, and increase vector biting rates, allowing transmission
in areas not previously endemic for the disease. Poor and
marginalized communities will be hit disproportionately harder by
the effects of climate change, and droughts, famines, and floods
can also lead to displacement and migration of immunologically
naive people to areas where leishmaniasis is endemic, posing a
threat of leishmaniasis outbreaks.
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Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects ~6–7 million people worldwide. Significant limitations still exist in our understanding of CD. Harnessing individual participant data (IPD) from studies could support more in-depth analyses to address the many outstanding resea...rch questions. This systematic review aims to describe the characteristics and treatment practices of clinical studies in CD and assess the breadth and availability of research data for the potential establishment of a data-sharing platform.
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A group of enzootic and zoonotic protozoan infections, the leishmaniases constitute among the most severely neglected tropical diseases (NTDs) and are found in all continents except Oceania. Representing the most common infectious diseases, NTDs comprise an open-ended list of some 20 parasitic, bact...erial, viral, protozoan and helminthic infections. Called “diseases of the poor,” because of their characteristic prevalence in poor populations regardless of a country's income status, they infect over one billion people in over 140 countries, with about 90% of the global burden in Africa. While NTDs do not contribute significantly to global deaths, they are debilitating and remain the most common infections among the poor worldwide, preventing them from escaping poverty by impacting livelihoods such as agriculture and livestock, and affecting cognitive, developmental and education outcomes.
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Accessed on 04.04.2023
The Drugs for Neglected Diseases initiative (DNDi) is an international
non-profit organization that discovers, develops, and delivers safe,
effective, and affordable treatments for the most neglected patients
Accessed on 04.04.2023
A Iniciativa Medicamentos para Doenças Negligenciadas (DNDi) é uma organização
internacional sem fins lucrativos que disponibiliza medicamentos seguros, eficazes
e acessíveis para doenças negligenciadas, desde o laboratório até sua chegada às
mãos das popula...ções mais vulneráveis do mundo.
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