Effectiveness of a 10-day melarsoprol schedule for the treatment of late-stage human African trypanosomiasis: confirmation from a multinational study (IMPAMEL II).

Hdl Handle:
http://hdl.handle.net/10144/33073
Title:
Effectiveness of a 10-day melarsoprol schedule for the treatment of late-stage human African trypanosomiasis: confirmation from a multinational study (IMPAMEL II).
Authors:
Schmid, C; Richer, M; Bilenge, C M M; Josenando, T; Chappuis, F; Manthelot, C R; Nangouma, A; Doua, F; Asumu, P; Simarro, P; Burri, C
Journal:
The Journal of Infectious Diseases
Abstract:
BACKGROUND: Treatment of late-stage human African trypanosomiasis (HAT) with melarsoprol can be improved by shortening the regimen. A previous trial demonstrated the safety and efficacy of a 10-day treatment schedule. We demonstrate the effectiveness of this schedule in a noncontrolled, multinational drug-utilization study. METHODS: A total of 2020 patients with late-stage HAT were treated with the 10-day melarsoprol schedule in 16 centers in 7 African countries. We assessed outcome on the basis of major adverse events and the cure rate after treatment and during 2 years of follow-up. RESULTS: The cure rate 24 h after treatment was 93.9%; 2 years later, it was 86.2%. However, 49.3% of patients were lost to follow-up. The overall fatality rate was 5.9%. Of treated patients, 8.7% had an encephalopathic syndrome that was fatal 45.5% of the time. The rate of severe bullous and maculopapular eruptions was 0.8% and 6.8%, respectively. CONCLUSIONS: The 10-day treatment schedule was well implemented in the field and was effective. It reduces treatment duration, drug amount, and hospitalization costs per patient, and it increases treatment-center capacity. The shorter protocol has been recommended by the International Scientific Council for Trypanosomiasis Research and Control for the treatment of late-stage HAT caused by Trypanosoma brucei gambiense.
Affiliation:
Swiss Tropical Institute, Basel.
Publisher:
Infectious Diseases Society of America and University of Chicago Press
Issue Date:
1-Jun-2005
URI:
http://hdl.handle.net/10144/33073
DOI:
10.1086/429929
PubMed ID:
15871127
Additional Links:
http://www.journals.uchicago.edu/toc/jid
Language:
en
ISSN:
0022-1899
Appears in Collections:
Trypanosomiasis/Sleeping Sickness

Full metadata record

DC FieldValue Language
dc.contributor.authorSchmid, C-
dc.contributor.authorRicher, M-
dc.contributor.authorBilenge, C M M-
dc.contributor.authorJosenando, T-
dc.contributor.authorChappuis, F-
dc.contributor.authorManthelot, C R-
dc.contributor.authorNangouma, A-
dc.contributor.authorDoua, F-
dc.contributor.authorAsumu, P-
dc.contributor.authorSimarro, P-
dc.contributor.authorBurri, C-
dc.date.accessioned2008-07-24T15:14:48Z-
dc.date.available2008-07-24T15:14:48Z-
dc.date.issued2005-06-01-
dc.identifier.citationEffectiveness of a 10-day melarsoprol schedule for the treatment of late-stage human African trypanosomiasis: confirmation from a multinational study (IMPAMEL II). 2005, 191 (11):1922-31 J. Infect. Dis.en
dc.identifier.issn0022-1899-
dc.identifier.pmid15871127-
dc.identifier.doi10.1086/429929-
dc.identifier.urihttp://hdl.handle.net/10144/33073-
dc.description.abstractBACKGROUND: Treatment of late-stage human African trypanosomiasis (HAT) with melarsoprol can be improved by shortening the regimen. A previous trial demonstrated the safety and efficacy of a 10-day treatment schedule. We demonstrate the effectiveness of this schedule in a noncontrolled, multinational drug-utilization study. METHODS: A total of 2020 patients with late-stage HAT were treated with the 10-day melarsoprol schedule in 16 centers in 7 African countries. We assessed outcome on the basis of major adverse events and the cure rate after treatment and during 2 years of follow-up. RESULTS: The cure rate 24 h after treatment was 93.9%; 2 years later, it was 86.2%. However, 49.3% of patients were lost to follow-up. The overall fatality rate was 5.9%. Of treated patients, 8.7% had an encephalopathic syndrome that was fatal 45.5% of the time. The rate of severe bullous and maculopapular eruptions was 0.8% and 6.8%, respectively. CONCLUSIONS: The 10-day treatment schedule was well implemented in the field and was effective. It reduces treatment duration, drug amount, and hospitalization costs per patient, and it increases treatment-center capacity. The shorter protocol has been recommended by the International Scientific Council for Trypanosomiasis Research and Control for the treatment of late-stage HAT caused by Trypanosoma brucei gambiense.en
dc.language.isoenen
dc.publisherInfectious Diseases Society of America and University of Chicago Pressen
dc.relation.urlhttp://www.journals.uchicago.edu/toc/jiden
dc.rightsArchived on this site with permission and copyright 2005 by the Infectious Diseases Society of Americaen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshDrug Administration Scheduleen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMaleen
dc.subject.meshMelarsoprolen
dc.subject.meshMiddle Ageden
dc.subject.meshTime Factorsen
dc.subject.meshTrypanocidal Agentsen
dc.subject.meshTrypanosomiasis, Africanen
dc.titleEffectiveness of a 10-day melarsoprol schedule for the treatment of late-stage human African trypanosomiasis: confirmation from a multinational study (IMPAMEL II).en
dc.contributor.departmentSwiss Tropical Institute, Basel.en
dc.identifier.journalThe Journal of Infectious Diseasesen

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