Effectiveness of a 10-day melarsoprol schedule for the treatment of late-stage human African trypanosomiasis: confirmation from a multinational study (IMPAMEL II).
Bilenge, C M M
Manthelot, C R
AffiliationSwiss Tropical Institute, Basel.
MetadataShow full item record
JournalJournal of Infectious Diseases
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.
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- Authors: Bisser S, N'Siesi FX, Lejon V, Preux PM, Van Nieuwenhove S, Miaka Mia Bilenge C, Būscher P
- Issue date: 2007 Feb 1
- [Therapeutic failure of melarsoprol among patients treated for late stage T.b. gambiense human African trypanosomiasis in Uganda].
- Authors: Legros D, Fournier C, Gastellu Etchegorry M, Maiso F, Szumilin E
- Issue date: 1999 Jul
- Eflornithine is safer than melarsoprol for the treatment of second-stage Trypanosoma brucei gambiense human African trypanosomiasis.
- Authors: Chappuis F, Udayraj N, Stietenroth K, Meussen A, Bovier PA
- Issue date: 2005 Sep 1
- Treatment of late stage sleeping sickness caused by T.b. gambiense: a new approach to the use of an old drug.
- Authors: Blum J, Burri C
- Issue date: 2002 Feb 9
- Efficacy of new, concise schedule for melarsoprol in treatment of sleeping sickness caused by Trypanosoma brucei gambiense: a randomised trial.
- Authors: Burri C, Nkunku S, Merolle A, Smith T, Blum J, Brun R
- Issue date: 2000 Apr 22