scholarly journals Innovative Partnerships for the Elimination of Human African Trypanosomiasis and the Development of Fexinidazole

2020 ◽  
Vol 5 (1) ◽  
pp. 17 ◽  
Author(s):  
Philippe Neau ◽  
Heinz Hänel ◽  
Valérie Lameyre ◽  
Nathalie Strub-Wourgaft ◽  
Luc Kuykens
Keyword(s):  
Human African Trypanosomiasis ◽  
Oral Treatment ◽  
Treatment Options ◽  
European Medicines Agency ◽  
Neglected Diseases ◽  
African Trypanosomiasis ◽  
African Countries ◽  
Scientific Opinion ◽  
Sub Saharan ◽  
New Treatments

Human African Trypanosomiasis (HAT or sleeping sickness) is a life-threatening neglected tropical disease that is endemic in 36 sub-Saharan African countries. Until recently, treatment options were limited and hampered by unsatisfactory efficacy, toxicity, and long and cumbersome administration regimens, compounded by infrastructure inadequacies in the remote rural regions worst affected by the disease. Increased funding and awareness of HAT over the past two decades has led to a steady decline in reported cases (<1000 in 2018). Recent drug development strategies have resulted in development of the first all-oral treatment for HAT, fexinidazole. Fexinidazole received European Medicines Agency positive scientific opinion in 2018 and is now incorporated into the WHO interim guidelines as one of the first-line treatments for HAT, allowing lumbar puncture to become non-systematic. Here, we highlight the role of global collaborations in the effort to control HAT and develop new treatments. The long-standing collaboration between the WHO, Sanofi and the Drugs for Neglected Diseases initiative (Geneva, Switzerland) was instrumental for achieving the control and treatment development goals in HAT, whilst at the same time ensuring that efforts were led by national authorities and control programs to leave a legacy of highly trained healthcare workers and improved research and health infrastructure.

scholarly journals Human african trypanosomiasis: current standing and challenges

2020 ◽  
Vol 49 (3) ◽  
Author(s):  
Isabel Theresa Holanda-Freitas ◽  
Marli Do Carmo Cupertino ◽  
Elizária C. dos Santos ◽  
Lisa Oliveira ◽  
Mauro Geller ◽  
...  
Keyword(s):  
Trypanosoma Brucei ◽  
Human African Trypanosomiasis ◽  
Vaccine Development ◽  
Neglected Tropical Diseases ◽  
Tsetse Fly ◽  
World Health ◽  
Clinical Aspects ◽  
Neglected Diseases ◽  
African Trypanosomiasis ◽  
African Countries

Human African trypanosomiasis (HAT) caused by the protozoan Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, and transmitted by the tsetse fly (genus Glossina), affects 36 Sub-Saharan African countries with considerable public health impact.  Despite approximately 15,000 infected individuals and 70 million at risk, in recent years the World Health Organization has mentioned removal of HAT from the list of Neglected Tropical Diseases by 2020, due to the decrease in cases over the last two decades. When untreated, the disease presents high lethality rates and the available treatments are complicated to administer, highly toxic, and do not guarantee cure, especially in the advanced stages of the disease. Further, there is no prospect for vaccine development in the near future. The present review compiles information on the history of the clinical aspects of HAT, as well as its epidemiology, diagnosis, therapy, and prophylaxis, as well as updating information on the current panorama and perspectives regarding the disease.KEY WORDS: African Trypanosomiasis; neglected diseases; Trypanosoma brucei.

scholarly journals Chemotherapy of Human African Trypanosomiasis

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Cyrus J. Bacchi
Keyword(s):  
Combination Chemotherapy ◽  
Human African Trypanosomiasis ◽  
Economic Loss ◽  
Chemotherapeutic Agents ◽  
Sub Saharan Africa ◽  
African Trypanosomiasis ◽  
Physical Suffering ◽  
Rural Clinics ◽  
Sub Saharan

Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

Pathways to faster access to medicines

2018 ◽  
Vol 56 (8) ◽  
pp. 93-96 ◽  
Keyword(s):  
Treatment Options ◽  
Clinical Trial Data ◽  
Access To Medicines ◽  
Trial Data ◽  
European Medicines Agency ◽  
The European Union ◽  
Life Threatening ◽  
The Uk ◽  
New Treatments ◽  
The Impact

Before a medicine can be marketed in the UK, marketing authorisation approval is needed from the European Medicines Agency (EMA) or the Medicines and Healthcare products Regulatory Agency (MHRA). However, the time it takes to appraise a medicine is considered by some to delay access to new treatments for people with serious or life-threatening conditions who have no other treatment options. Also, the standard regulatory process may be less suitable for medicines for rare conditions in which it is difficult to gather a large amount of clinical trial data. Here we look at a range of new regulatory and access pathways that have been developed to respond to these challenges and consider some of their potential pitfalls. In a future article we will review the impact that the UK’s departure from the European Union (EU) will have on licensing processes.

scholarly journals Treatment options for second-stage gambiense human African trypanosomiasis

2014 ◽  
Vol 12 (11) ◽  
pp. 1407-1417 ◽  
Author(s):  
Gilles Eperon ◽  
Manica Balasegaram ◽  
Julien Potet ◽  
Charles Mowbray ◽  
Olaf Valverde ◽  
...  
Keyword(s):  
Human African Trypanosomiasis ◽  
Treatment Options ◽  
African Trypanosomiasis ◽  
Second Stage

scholarly journals Nodding Syndrome: A Scoping Review

2021 ◽  
Vol 6 (4) ◽  
pp. 211
Author(s):  
Gasim Omer Elkhalifa Abd-Elfarag ◽  
Arthur Wouter Dante Edridge ◽  
René Spijker ◽  
Mohamed Boy Sebit ◽  
Michaël B. van Hensbroek
Keyword(s):  
Scoping Review ◽  
Treatment Options ◽  
Original Data ◽  
Current Evidence ◽  
Future Research ◽  
African Countries ◽  
Comprehensive Overview ◽  
Severe Condition ◽  
Nodding Syndrome ◽  
Sub Saharan

Nodding syndrome (NS) is a debilitating yet often neglected neurological disease affecting thousands of children in several sub-Saharan African countries. The cause of NS remains unknown, and effective treatment options are lacking. Moreover, knowledge regarding NS is scarce and is based on a limited number of publications, with no comprehensive overview published to date. Therefore, the aim of this scoping review was to summarise the current evidence and identify existing knowledge gaps in order to help clinicians, scientists, and policymakers develop guidelines for prioritising this severe condition. We searched the Medline (Ovid), Embase (Ovid), Scopus, and Global Health Library databases in accordance with the PRISMA extension for scoping review guidance and in accordance with the Joanna Briggs Institute guidelines and methodology for a scoping review, using keywords describing NS. We then extracted and presented the original data regarding the epidemiology, aetiology, pathophysiology, clinical features, diagnosis, management, and outcomes of NS, as well as community perceptions and the psychosocial and economic impact of NS. Out of 1470 identified articles, a total of 69 were included in this scoping review. Major gaps exist in understanding the aetiology and pathogenesis of NS. Future research is urgently needed not only to address these gaps, but also to study the treatment options, epidemiology, and psychosocial and economic impacts of NS. Innovative interventions and rehabilitation programmes designed to address the psychosocial and economic burdens associated with NS are also urgently needed.

scholarly journals Generation of neuroinflammation in human African trypanosomiasis

2019 ◽  
Vol 6 (6) ◽  
pp. e610 ◽  
Author(s):  
Jean Rodgers ◽  
Israel Steiner ◽  
Peter G. E Kennedy
Keyword(s):  
Human African Trypanosomiasis ◽  
Clinical Symptoms ◽  
Parasite Burden ◽  
Brain Inflammation ◽  
Sub Saharan Africa ◽  
African Trypanosomiasis ◽  
Peripheral Tissues ◽  
Neuroinflammatory Response ◽  
Proinflammatory Mediators ◽  
Sub Saharan

Human African trypanosomiasis (HAT) is caused by infection due to protozoan parasites of the Trypanosoma genus and is a major fatal disease throughout sub-Saharan Africa. After an early hemolymphatic stage in which the peripheral tissues are infected, the parasites enter the CNS causing a constellation of neurologic features. Although the CNS stage of HAT has been recognized for over a century, the mechanisms generating the neuroinflammatory response are complex and not well understood. Therefore a better understanding of the mechanisms utilized by the parasites to gain access to the CNS compartment is critical to explaining the generation of neuroinflammation. Contrast-enhanced MRI in a murine model of HAT has shown an early and progressive deterioration of blood-CNS barrier function after trypanosome infection that can be reversed following curative treatment. However, further studies are required to clarify the molecules involved in this process. Another important determinant of brain inflammation is the delicate balance of proinflammatory and counterinflammatory mediators. In mouse models of HAT, proinflammatory mediators such as tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and CXCL10 have been shown to be crucial to parasite CNS invasion while administration of interleukin (IL)-10, a counter inflammatory molecule, reduces the CNS parasite burden as well as the severity of the neuroinflammatory response and the clinical symptoms associated with the infection. This review focuses on information, gained from both infected human samples and animal models of HAT, with an emphasis on parasite CNS invasion and the development of neuroinflammation.

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