Effectiveness of melarsoprol and eflornithine as first-line regimens for gambiense sleeping sickness in nine Médecins Sans Frontières programmes.

Hdl Handle:
http://hdl.handle.net/10144/41787
Title:
Effectiveness of melarsoprol and eflornithine as first-line regimens for gambiense sleeping sickness in nine Médecins Sans Frontières programmes.
Authors:
Balasegaram, M; Young, H; Chappuis, F; Priotto, G; Raguenaud, M E; Checchi, F
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
This paper describes the effectiveness of first-line regimens for stage 2 human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense infection in nine Médecins Sans Frontières HAT treatment programmes in Angola, Republic of Congo, Sudan and Uganda. Regimens included eflornithine and standard- and short-course melarsoprol. Outcomes for 10461 naïve stage 2 patients fitting a standardised case definition and allocated to one of the above regimens were analysed by intention-to-treat analysis. Effectiveness was quantified by the case fatality rate (CFR) during treatment, the proportion probably and definitely cured and the Kaplan-Meier probability of relapse-free survival at 12 months and 24 months post admission. The CFR was similar for the standard- and short-course melarsoprol regimens (4.9% and 4.2%, respectively). The CFR for eflornithine was 1.2%. Kaplan-Meier survival probabilities varied from 71.4-91.8% at 1 year and 56.5-87.9% at 2 years for standard-course melarsoprol, to 73.0-91.1% at 1 year for short-course melarsoprol, and 79.9-97.4% at 1 year and 68.6-93.7% at 2 years for eflornithine. With the exception of one programme, survival at 12 months was >90% for eflornithine, whilst for melarsoprol it was <90% except in two sites. Eflornithine is recommended where feasible, especially in areas with low melarsoprol effectiveness.
Affiliation:
Médecins Sans Frontières-United Kingdom, 67-74 Saffron Hill, London EC1N 8QX, UK.
Issue Date:
21-Oct-2008
URI:
http://hdl.handle.net/10144/41787
DOI:
10.1016/j.trstmh.2008.09.005
PubMed ID:
18947846
Language:
en
ISSN:
0035-9203
Appears in Collections:
Trypanosomiasis/Sleeping Sickness

Full metadata record

DC FieldValue Language
dc.contributor.authorBalasegaram, M-
dc.contributor.authorYoung, H-
dc.contributor.authorChappuis, F-
dc.contributor.authorPriotto, G-
dc.contributor.authorRaguenaud, M E-
dc.contributor.authorChecchi, F-
dc.date.accessioned2008-12-03T15:18:13Z-
dc.date.available2008-12-03T15:18:13Z-
dc.date.issued2008-10-21-
dc.identifier.citationEffectiveness of melarsoprol and eflornithine as first-line regimens for gambiense sleeping sickness in nine Médecins Sans Frontières programmes. 2008: Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid18947846-
dc.identifier.doi10.1016/j.trstmh.2008.09.005-
dc.identifier.urihttp://hdl.handle.net/10144/41787-
dc.description.abstractThis paper describes the effectiveness of first-line regimens for stage 2 human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense infection in nine Médecins Sans Frontières HAT treatment programmes in Angola, Republic of Congo, Sudan and Uganda. Regimens included eflornithine and standard- and short-course melarsoprol. Outcomes for 10461 naïve stage 2 patients fitting a standardised case definition and allocated to one of the above regimens were analysed by intention-to-treat analysis. Effectiveness was quantified by the case fatality rate (CFR) during treatment, the proportion probably and definitely cured and the Kaplan-Meier probability of relapse-free survival at 12 months and 24 months post admission. The CFR was similar for the standard- and short-course melarsoprol regimens (4.9% and 4.2%, respectively). The CFR for eflornithine was 1.2%. Kaplan-Meier survival probabilities varied from 71.4-91.8% at 1 year and 56.5-87.9% at 2 years for standard-course melarsoprol, to 73.0-91.1% at 1 year for short-course melarsoprol, and 79.9-97.4% at 1 year and 68.6-93.7% at 2 years for eflornithine. With the exception of one programme, survival at 12 months was >90% for eflornithine, whilst for melarsoprol it was <90% except in two sites. Eflornithine is recommended where feasible, especially in areas with low melarsoprol effectiveness.en
dc.languageENG-
dc.language.isoenen
dc.rightsPublished by Elsevier Archived on this site with the kind permission of Elsevier Ltd. ([url]http://www.sciencedirect.com/science/journal/00359203[/url]) and the Royal Society of Tropical Medicine and Hygiene ([url]http://www.rstmh.org/transactions.asp[/url])en
dc.titleEffectiveness of melarsoprol and eflornithine as first-line regimens for gambiense sleeping sickness in nine Médecins Sans Frontières programmes.en
dc.contributor.departmentMédecins Sans Frontières-United Kingdom, 67-74 Saffron Hill, London EC1N 8QX, UK.en
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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