1
|
Ramos LG, de Souza KR, Júnior PAS, Câmara CC, Castelo-Branco FS, Boechat N, Carvalho SA. Tackling the challenges of human Chagas disease: A comprehensive review of treatment strategies in the chronic phase and emerging therapeutic approaches. Acta Trop 2024; 256:107264. [PMID: 38806090 DOI: 10.1016/j.actatropica.2024.107264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/30/2024]
Abstract
Chagas disease (CD), caused by the flagellated protozoan Trypanosoma cruzi (T. cruzi), affects approximately 7 million people worldwide and is endemic in Latin America, especially among socioeconomically disadvantaged populations. Since the 1960s, only two drugs have been commercially available for treating this illness: nifurtimox (NFX) and benznidazole (BZN). Although these drugs are effective in the acute phase (AP) of the disease, in which parasitemia is usually high, their cure rates in the chronic phase (CP) are low and often associated with several side effects. The CP is characterized by a subpatent parasitaemia and absence of clinical symptoms in the great majority of infected individuals. However, at least 30 % of the individuals will develop potentially lethal symptomatic forms, including cardiac and digestive manifestations. For such reason, in the CP the treatment is usually symptomatic and typically focuses on managing complications such as arrhythmias, heart failure, or digestive problems. Therefore, the need for new drugs or therapeutic approaches using BZN or NFX is extremely urgent. This review presents the main clinical trials, especially in the CP, which involve BZN and NFX in different treatment regimens. Additionally, other therapies using combinations of these drugs with other substances such as allopurinol, itraconazole, ravuconazole, ketoconazole, posaconazole and amiodarone are also reported. The importance of early diagnosis, especially in pediatric patients, is also discussed, emphasizing the need to identify the disease in its early stages to improve the chances of successful treatment.
Collapse
Affiliation(s)
- Laís Gomes Ramos
- Laboratorio de Sintese de Farmacos -LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, RJ 21041-250, Brazil; Laboratório de Físico-Química de Materiais, Seção de Engenharia Química, Instituto Militar de Engenharia, Praça General Tibúrcio 80, Rio de Janeiro, RJ 22290-270, Brazil
| | - Kátia Regina de Souza
- Laboratório de Físico-Química de Materiais, Seção de Engenharia Química, Instituto Militar de Engenharia, Praça General Tibúrcio 80, Rio de Janeiro, RJ 22290-270, Brazil
| | - Policarpo Ademar Sales Júnior
- Laboratório de Imunopatologia e Biologia Molecular, Departamento de Imunologia, Instituto Ageu Magalhães, Fundação Oswaldo Cruz, Recife, PE 50670-420, Brazil
| | - Camila Capelini Câmara
- Laboratorio de Sintese de Farmacos -LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, RJ 21041-250, Brazil; Laboratório de Físico-Química de Materiais, Seção de Engenharia Química, Instituto Militar de Engenharia, Praça General Tibúrcio 80, Rio de Janeiro, RJ 22290-270, Brazil
| | - Frederico S Castelo-Branco
- Laboratorio de Sintese de Farmacos -LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, RJ 21041-250, Brazil
| | - Nubia Boechat
- Laboratorio de Sintese de Farmacos -LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, RJ 21041-250, Brazil
| | - Samir Aquino Carvalho
- Laboratorio de Sintese de Farmacos -LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, RJ 21041-250, Brazil.
| |
Collapse
|
2
|
Moon M, Wu HW, Jiz M, Maldonado S, Kurtis JD, Friedman JF, Jarilla B, Park S. Evaluation of sensitivity and specificity of Kato-Katz and circulating cathodic antigen in terms of Schistosoma japonicum using latent class analysis. Sci Rep 2024; 14:8164. [PMID: 38589377 PMCID: PMC11001968 DOI: 10.1038/s41598-024-57863-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/22/2024] [Indexed: 04/10/2024] Open
Abstract
Schistosoma japonicum is endemic in the Philippines. The Kato-Katz (KK) method was used to diagnose S. japonicum. This is impractical, particularly when the sample size is limited. Knowledge on point-of-care circulating cathodic antigen (CCA) test performance for S. japonicum is limited. Determining the sensitivity and specificity of new diagnostics is difficult when the gold standard test is less effective or absent. Latent class analysis (LCA) can address some limitations. A total of 484 children and 572 adults from the Philippines were screened for S. japonicum. We performed Bayesian LCA to estimate the infection prevalence, sensitivity and specificity of each test by stratifying them into two age groups. Observed prevalence assessed by KK was 50.2% and 31.8%, and by CCA was 89.9% and 66.8%, respectively. Using Bayesian LCA, among children, the sensitivity and specificity of CCA were 94.8% (88.7-99.4) and 21.5% (10.5-36.1) while those of KK were 66.0% (54.2-83.3) and 78.1% (61.1-91.3). Among adults, the sensitivity and specificity of CCA were 86.4% (76.6-96.9) and 62.8% (49.1-81.1) while those of KK were 43.6% (35.1-53.9) and 85.5% (75.8-94.6). Overall, CCA was more sensitive than KK, regardless of the age group at diagnosis, as KK was more specific. KK and CCA have different diagnostic performance, which should inform their use in the planning and implementation of S. japonicum control programs.
Collapse
Affiliation(s)
- Mugyeom Moon
- Food and Agriculture Organization of the United Nations, Regional Office for Asia and Pacific, Bangkok, Thailand
| | - Hannah W Wu
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Mario Jiz
- Department of Health, Research Institute for Tropical Medicine, Manila, Philippines
| | | | - Jonathan D Kurtis
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jennifer F Friedman
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Blanca Jarilla
- Department of Health, Research Institute for Tropical Medicine, Manila, Philippines
| | - Sangshin Park
- The Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Tabo Z, Breuer L, Fabia C, Samuel G, Albrecht C. A machine learning approach for modeling the occurrence of the major intermediate hosts for schistosomiasis in East Africa. Sci Rep 2024; 14:4274. [PMID: 38383705 PMCID: PMC10881506 DOI: 10.1038/s41598-024-54699-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/15/2024] [Indexed: 02/23/2024] Open
Abstract
Schistosomiasis, a prevalent water-borne disease second only to malaria, significantly impacts impoverished rural communities, primarily in Sub-Saharan Africa where over 90% of the severely affected population resides. The disease, majorly caused by Schistosoma mansoni and S. haematobium parasites, relies on freshwater snails, specifically Biomphalaria and Bulinus species, as crucial intermediate host (IH) snails. Targeted snail control is advisable, however, there is still limited knowledge about the community structure of the two genera especially in East Africa. Utilizing a machine learning approach, we employed random forest to identify key features influencing the distribution of both IH snails in this region. Our results reveal geography and climate as primary factors for Biomphalaria, while Bulinus occurrence is additionally influenced by soil clay content and nitrogen concentration. Favorable climate conditions indicate a high prevalence of IHs in East Africa, while the intricate connection with geography might signify either dispersal limitations or environmental filtering. Predicted probabilities demonstrate non-linear patterns, with Bulinus being more likely to occur than Biomphalaria in the region. This study provides foundational framework insights for targeted schistosomiasis prevention and control strategies in the region, assisting health workers and policymakers in their efforts.
Collapse
Affiliation(s)
- Zadoki Tabo
- Department of Animal Ecology and Systematics, Justus Liebig University Giessen, Heinrich-Buff-Ring 26 (iFZ), 35392, Giessen, Germany.
- Institute for Landscape Ecology and Resource Management, Justus Liebig University Giessen, Heinrich-Buff-Ring 26 (iFZ), 35392, Giessen, Germany.
| | - Lutz Breuer
- Institute for Landscape Ecology and Resource Management, Justus Liebig University Giessen, Heinrich-Buff-Ring 26 (iFZ), 35392, Giessen, Germany
- Centre for International Development and Environmental Research (ZEU), Justus Liebig University Giessen, Senckenbergstrasse 3, 35390, Giessen, Germany
| | - Codalli Fabia
- Institute for Landscape Ecology and Resource Management, Justus Liebig University Giessen, Heinrich-Buff-Ring 26 (iFZ), 35392, Giessen, Germany
| | - Gorata Samuel
- Institute for Landscape Ecology and Resource Management, Justus Liebig University Giessen, Heinrich-Buff-Ring 26 (iFZ), 35392, Giessen, Germany
- Department of Environmental Science, Faculty of Science, University of Botswana, P/Bag UB00704, Gaborone, Botswana
| | - Christian Albrecht
- Department of Animal Ecology and Systematics, Justus Liebig University Giessen, Heinrich-Buff-Ring 26 (iFZ), 35392, Giessen, Germany
| |
Collapse
|
4
|
Duguay C, Mosha JF, Lukole E, Mangalu D, Thickstun C, Mallya E, Aziz T, Feng C, Protopopoff N, Mosha F, Manjurano A, Krentel A, Kulkarni MA. Assessing risk factors for malaria and schistosomiasis among children in Misungwi, Tanzania, an area of co-endemicity: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002468. [PMID: 37992045 PMCID: PMC10664891 DOI: 10.1371/journal.pgph.0002468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/16/2023] [Indexed: 11/24/2023]
Abstract
Malaria and schistosomiasis are two major parasitic vector-borne diseases that are a particular threat to young children in Sub-Saharan Africa. In the present study, we investigated factors that are associated with malaria, schistosomiasis, and co-infection among school-aged children, using an explanatory sequential mixed-methods approach. A cross-sectional study was conducted in January 2022 in Misungwi, Tanzania, that sampled 1,122 children aged 5 to 14 years old for malaria and schistosomiasis infection. Mixed-effect logistic regression models were used to assess the association between infection prevalence or seroprevalence, and environmental determinants that create favorable conditions for vectors and parasites and social determinants that relate to disease exposure. Community mapping combined with direct field observations were conducted in August 2022 in three selected villages from the cross-sectional study to understand specific water use behaviors and to identify potential malaria mosquito larval breeding sites and freshwater snail habitat. The prevalence of malaria, seroprevalence of schistosomiasis, and co-infection in this study were 40.4%, 94.3%, and 38.1%, respectively. Individual-level factors emerged as the primary determinants driving the association with infection, with age (every one-year increase in age) and sex (boys vs girls) being statistically and positively associated with malaria, schistosomiasis, and co-infection (P<0.05 for all). Community maps identified many unimproved water sources in all three villages that were used by humans, cattle, or both. We found that children primarily fetched water, and that unprotected wells were dedicated for drinking water whereas ponds were dedicated for other domestic uses and cattle. Although not identified in the community maps, we found hand pumps in all three villages were not in use because of unpleasant taste and high cost. This study improves our understanding of individual, social and environmental factors that are associated with malaria, schistosomiasis, and co-infection, which can inform potential entry points for integrated disease prevention and control.
Collapse
Affiliation(s)
- Claudia Duguay
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Jacklin F. Mosha
- National Institute of Medical Research Tanzania, Mwanza Research Centre, Mwanza, Tanzania
| | - Eliud Lukole
- National Institute of Medical Research Tanzania, Mwanza Research Centre, Mwanza, Tanzania
| | - Doris Mangalu
- National Institute of Medical Research Tanzania, Mwanza Research Centre, Mwanza, Tanzania
| | - Charles Thickstun
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Elizabeth Mallya
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Tatu Aziz
- National Institute of Medical Research Tanzania, Mwanza Research Centre, Mwanza, Tanzania
| | - Cindy Feng
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Natacha Protopopoff
- Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Franklin Mosha
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Alphaxard Manjurano
- National Institute of Medical Research Tanzania, Mwanza Research Centre, Mwanza, Tanzania
| | - Alison Krentel
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Manisha A. Kulkarni
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| |
Collapse
|
5
|
Feng J, Wang X, Zhang X, Hu H, Xue J, Cao C, Xu J, Yang P, Li S. Effect of Health Education on Schistosomiasis Control Knowledge, Attitude, and Practice after Schistosomiasis Blocking: Results of a Longitudinal Observational Study in the Field. Trop Med Infect Dis 2023; 8:tropicalmed8050267. [PMID: 37235315 DOI: 10.3390/tropicalmed8050267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES Schistosomiasis is a zoonotic infectious disease that seriously harms people's physical and mental health. As early as 1985, the WHO suggested that health education and health promotion should be the focus of schistosomiasis prevention work. This study aimed to explore the effect of health education on controlling the risk of schistosomiasis transmission after schistosomiasis blocking and to provide a scientific basis for the further improvement of intervention strategies after schistosomiasis interruption in China and other endemic countries. METHODS In Jiangling County, Hubei Province, China, one severe, one moderate, and one mildly endemic village were selected as the intervention group; two severe, two moderate, and two mildly endemic villages were selected as the control group. In towns with different epidemic types, a primary school was randomly selected for intervention. In September 2020, a baseline survey was carried out through a questionnaire survey to understand the knowledge, attitudes, and practices (KAP) of adults and students concerning schistosomiasis control. Next, two rounds of health education interventions for schistosomiasis control were carried out. The evaluation survey was conducted in September 2021 and the follow-up survey conducted in September 2022. RESULTS Compared with the baseline survey, the qualified rate of the KAP on schistosomiasis prevention of the control group in the follow-up survey increased from 79.1% (584/738) to 81.0% (493/609) (p > 0.05); in the intervention group, the qualified rate of the KAP on schistosomiasis control increased from 74.9% (286/382) to 88.1% (260/295) (p < 0.001). In the baseline survey, the qualified rate of the KAP of the intervention group was lower than that of the control group, and in the follow-up survey, the qualified rate of the KAP of the intervention group was 7.2% higher than that of the control group (p < 0.05). Compared with the baseline survey, the accuracy rates of the KAP of the intervention group's adults were higher than those of the control group, with statistical significance (p < 0.001). Compared with the baseline survey, the qualified rate of the students' KAP in the follow-up survey increased from 83.8% (253/302) to 97.8% (304/311) (p < 0.001). In the follow-up survey, the accuracy rate of the knowledge, attitudes, and practices of the students was significantly different from the baseline accuracy (p < 0.001). CONCLUSION a health education-led risk control model of schistosomiasis can significantly improve schistosomiasis control knowledge among adults and students, establishing correct attitudes and leading to the development of correct hygiene habits.
Collapse
Affiliation(s)
- Jiaxin Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Xinyi Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Xia Zhang
- Jiangling Center for Disease Control and Prevention, Jingzhou 434000, China
| | - Hehua Hu
- Jiangling Center for Disease Control and Prevention, Jingzhou 434000, China
| | - Jingbo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Chunli Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Pin Yang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Shizhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| |
Collapse
|
6
|
Ravazi A, de Oliveira J, Madeira FF, Nunes GM, dos Reis YV, de Oliveira ABB, Azevedo LMS, Galvão C, de Azeredo-Oliveira MTV, da Rosa JA, Alevi KCC. Climate and Environmental Changes and Their Potential Effects on the Dynamics of Chagas Disease: Hybridization in Rhodniini (Hemiptera, Triatominae). INSECTS 2023; 14:378. [PMID: 37103193 PMCID: PMC10143345 DOI: 10.3390/insects14040378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 06/19/2023]
Abstract
Chagas disease affects about eight million people. In view of the issues related to the influence of anthropogenic changes in the dynamics of the distribution and reproductive interaction of triatomines, we performed experimental crosses between species of the Rhodniini tribe in order to evaluate interspecific reproductive interactions and hybrid production capacity. Reciprocal crossing experiments were conducted among Rhodnius brethesi × R. pictipes, R. colombiensis × R. ecuadoriensis, R. neivai × R. prolixus, R. robustus × R. prolixus, R. montenegrensis × R. marabaensis; R. montenegrensis × R. robustus, R. prolixus × R. nasutus and R. neglectus × R. milesi. With the exception of crosses between R. pictipes ♀ × R. brethesi ♂, R. ecuadoriensis ♀ × R. colombiensis ♂ and R. prolixus ♀ × R. neivai ♂, all experimental crosses resulted in hybrids. Our results demonstrate that both allopatric and sympatric species produce hybrids, which can generate concern for public health agencies in the face of current anthropogenic events. Thus, we demonstrate that species of the Rhodniini tribe are capable of producing hybrids under laboratory conditions. These results are of great epidemiological importance and raise an important discussion about the influence of climatic and environmental interactions on Chagas disease dynamics.
Collapse
Affiliation(s)
- Amanda Ravazi
- Instituto de Biociências de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Dr. Antônio Celso Wagner Zanin, 250, Distrito de Rubião Junior, Botucatu 18618-689, SP, Brazil
| | - Jader de Oliveira
- Laboratório de Entomologia em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo (USP), Av. Dr. Arnaldo 715, São Paulo 01246-904, SP, Brazil
| | - Fernanda Fernandez Madeira
- Laboratório de Biologia Celular, Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Cristóvão Colombo 2265, São José do Rio Preto 15054-000, SP, Brazil
| | - Giovana Menezes Nunes
- Laboratório de Biologia Celular, Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Cristóvão Colombo 2265, São José do Rio Preto 15054-000, SP, Brazil
| | - Yago Visinho dos Reis
- Instituto de Biociências de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Dr. Antônio Celso Wagner Zanin, 250, Distrito de Rubião Junior, Botucatu 18618-689, SP, Brazil
| | - Ana Beatriz Bortolozo de Oliveira
- Laboratório de Biologia Celular, Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Cristóvão Colombo 2265, São José do Rio Preto 15054-000, SP, Brazil
| | - Luísa Martins Sensato Azevedo
- Laboratório de Biologia Celular, Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Cristóvão Colombo 2265, São José do Rio Preto 15054-000, SP, Brazil
| | - Cleber Galvão
- Laboratório Nacional e Internacional de Referência em Taxonomia de Triatomíneos, Instituto Oswaldo Cruz (FIOCRUZ), Av. Brazil 4365, Pavilhão Rocha Lima, Sala 505, Rio de Janeiro 21040-360, RJ, Brazil
| | - Maria Tercília Vilela de Azeredo-Oliveira
- Laboratório de Biologia Celular, Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Cristóvão Colombo 2265, São José do Rio Preto 15054-000, SP, Brazil
| | - João Aristeu da Rosa
- Laboratório de Parasitologia, Faculdade de Ciências Farmacêuticas, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14801-902, SP, Brazil
| | - Kaio Cesar Chaboli Alevi
- Instituto de Biociências de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Dr. Antônio Celso Wagner Zanin, 250, Distrito de Rubião Junior, Botucatu 18618-689, SP, Brazil
- Laboratório de Entomologia em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo (USP), Av. Dr. Arnaldo 715, São Paulo 01246-904, SP, Brazil
- Laboratório Nacional e Internacional de Referência em Taxonomia de Triatomíneos, Instituto Oswaldo Cruz (FIOCRUZ), Av. Brazil 4365, Pavilhão Rocha Lima, Sala 505, Rio de Janeiro 21040-360, RJ, Brazil
| |
Collapse
|
7
|
Wirth M, Gálvez RI, Jochum J, Strauss R, Kristensen K, Stich A, Stegemann M, Stahl P, Puchner KP, Strasen J, Parisi S, Braasch T, Bender M, Hörning A, Hanke M, Störk S, Jacobs T, Pritsch M, Zoller T. Knowledge, attitudes, behaviors, and serological status related to Chagas disease among Latin American migrants in Germany: A cross-sectional study in six German cities. Front Cell Infect Microbiol 2023; 12:1047281. [PMID: 36760233 PMCID: PMC9905718 DOI: 10.3389/fcimb.2022.1047281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/23/2022] [Indexed: 01/26/2023] Open
Abstract
Background Little is known about knowledge, attitudes and behaviors concerning Chagas disease (CD) among Latin American migrants in Germany to inform public health decision making. Methods A cross-sectional, questionnaire-based study was conducted between March 2014 and October 2019 among Latin American migrants in six cities in Germany to obtain information on migration history, socioeconomic and insurance status, knowledge about CD, potential risk factors for Trypanosoma cruzi infection, and willingness to donate blood or organs. Results 168 participants completed the questionnaire. The four countries with the highest proportion of participants contributing to the study population were Colombia, Mexico, Peru and Ecuador. Before migrating to Europe, the majority of the study population resided in an urban setting in houses made of stone or concrete, had higher academic education and was integrated into the German healthcare and healthcare insurance system. The majority of all study participants were also willing to donate blood and organs and a quarter of them had donated blood previously. However, many participants lacked basic knowledge about symptoms and modes of transmission of Chagas disease. One out of 56 serologic tests (1.8%) performed was positive. The seropositive female participant born in Argentina had a negative PCR test and no signs of cardiac or other organ involvement. Conclusions The study population does not reflect the population structure at risk for T. cruzi infection in endemic countries. Most participants had a low risk profile for infection with T. cruzi. Although the sample size was small and sampling was not representative of all persons at risk in Germany, the seroprevalence found was similar to studies previously conducted in Europe. As no systematic screening for T. cruzi in Latin American blood and organ donors as well as in women of child-bearing age of Latin American origin is implemented in Germany, a risk of occasional transmission of T. cruzi remains.
Collapse
Affiliation(s)
- Margit Wirth
- Department of Tropical Medicine, Missioklinik, Klinikum Würzburg Mitte, Würzburg, Germany
| | - Rosa Isela Gálvez
- Protozoa Immunology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Johannes Jochum
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany,I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ricardo Strauss
- Infectious Disease Epidemiology Department, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Kaja Kristensen
- Infectious Disease Epidemiology Department, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,Faculty of Life Sciences, Hamburg University of Applied Sciences, Hamburg, Germany
| | - August Stich
- Department of Tropical Medicine, Missioklinik, Klinikum Würzburg Mitte, Würzburg, Germany
| | - Miriam Stegemann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin, Berlin, Germany
| | - Philipp Stahl
- Department of Internal Medicine, Section of Gastroenterology and Infectious Diseases, University Hospital Gießen and Marburg, Marburg, Germany
| | - Karl Philipp Puchner
- Laboratory of Primary Health Care, General Medicine and Health Services Research, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Jörn Strasen
- Department of Pulmonary Medicine, Missioklinik, Klinikum Würzburg Mitte, Würzburg, Germany,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Sandra Parisi
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Trixi Braasch
- Department of Internal Medicine, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Marion Bender
- Medical Department of the worldwide air ambulance Unicair GmbH, Idstein, Germany,Department of Occupational Medicine, B.A.D, Health Center, Koblenz, Germany
| | - Anna Hörning
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Monika Hanke
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany,Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany
| | - Stefan Störk
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany,Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Jacobs
- Protozoa Immunology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Thomas Zoller
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin, Berlin, Germany,*Correspondence: Thomas Zoller,
| |
Collapse
|
8
|
Xu M, Chang N, Tu T, Sun J, Jiang J, Xia Y, Tang W, Ji H, Zhao X, Zhu J, Qi L, Liu X, Liu Q. Economic burden of dengue fever in China: A retrospective research study. PLoS Negl Trop Dis 2022; 16:e0010360. [PMID: 35594296 PMCID: PMC9162330 DOI: 10.1371/journal.pntd.0010360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/02/2022] [Accepted: 03/25/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dengue fever has been a significant public health challenge in China. This will be particularly important in the context of global warming, frequent international travels, and urbanization with increasing city size and population movement. In order to design relevant prevention and control strategies and allocate health resources reasonably, this study evaluated the economic burden of dengue fever in China in 2019. METHODS The economic burden of dengue fever patients was calculated from both family and the organisation perspectives. A survey was conducted among 1,027 dengue fever patients in Zhejiang, Chongqing, and Yunnan Provinces. Treatment expenses, lost working days, and insurance reimbursement expenses information were collected to estimate the total economic burden of dengue fever patients in 2019. The expenditures related to dengue fever prevention and control from government, Center for Disease Control and Prevention (CDC), communities and subdistrict offices of 30 counties (or districts) in Zhejiang Province and Chongqing City were also collected. RESULTS The direct, indirect and total economic burden for dengue fever patients in 2019 in the three Provinces were about 36,927,380.00 Chinese Yuan (CNY), 10,579,572.00 CNY and 46,805,064.00 CNY, respectively. The costs for prevention and control of dengue fever for the counties (or districts) without cases, counties (or districts) with imported cases, and counties (or districts) with local cases are 205,800.00 CNY, 731,180.00 CNY and 6,934,378.00 CNY, respectively. The total investment of dengue fever prevention and control in the 30 counties in China in 2019 was approximately 3,166,660,240.00 CNY. CONCLUSION The economic burden of dengue fever patients is relatively high, and medical insurance coverage should be increased to lighten patients' direct medical economic burden. At the same time, the results suggests that China should increase funding for primary health service institutions to prevent dengue fever transmission.
Collapse
Affiliation(s)
- Meng Xu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nan Chang
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Taotian Tu
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Jimin Sun
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jinyong Jiang
- Yunnan Institute of Parasitic Diseases, Pu’er, Yunnan, China
| | - Yu Xia
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Wenge Tang
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Hengqing Ji
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Xiaotao Zhao
- Yunnan Institute of Parasitic Diseases, Pu’er, Yunnan, China
| | - Jin Zhu
- Xishuangbanna Dai Autonomous Prefecture Center for Disease Control and Prevention, Xishuangbanna, Yunnan, China
| | - Li Qi
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Xiaobo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- University College London, London, United Kingdom
| |
Collapse
|
9
|
Ravaynia PS, Biendl S, Grassi F, Keiser J, Hierlemann A, Modena MM. Real-time and automated monitoring of antischistosomal drug activity profiles for screening of compound libraries. iScience 2022; 25:104087. [PMID: 35378863 PMCID: PMC8976133 DOI: 10.1016/j.isci.2022.104087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/02/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022] Open
Abstract
Schistosomiasis is a neglected tropical disease that affects over 200 million people annually. As the antischistosomal drug pipeline is currently empty, repurposing of compound libraries has become a source for accelerating drug development, which demands the implementation of high-throughput and efficient screening strategies. Here, we present a parallelized impedance-based platform for continuous and automated viability evaluation of Schistosoma mansoni schistosomula in 128 microwells during 72 h to identify antischistosomal hits in vitro. By initially screening 57 repurposed compounds against larvae, five drugs are identified, which reduce parasite viability by more than 70%. The activity profiles of the selected drugs are then investigated via real-time dose-response monitoring, and four compounds reveal high potency and rapid action, which renders them suitable candidates for follow-up tests against adult parasites. The study shows that our device is a reliable tool for real-time drug screening analysis of libraries to identify new promising therapeutics against schistosomiasis. Scalable, plastic microwell chip with integrated platinum electrodes Automated impedance-based recording of 128 microwell units in parallel Continuous monitoring of in vitro drug library efficacy on schistosomula for 72 h Identification of four fast-acting antischistosomal drugs for in vivo testing
Collapse
Affiliation(s)
- Paolo S Ravaynia
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, 4058 Basel, Switzerland
| | - Stefan Biendl
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, 4051 Basel, Switzerland
| | - Francesco Grassi
- Centre for Microsystems Technology, Department of Electronics and Information Systems, Ghent University, Technologiepark-Zwijnaarde 126, 9052 Gent, Belgium
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, 4051 Basel, Switzerland
| | - Andreas Hierlemann
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, 4058 Basel, Switzerland
| | - Mario M Modena
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, 4058 Basel, Switzerland
| |
Collapse
|
10
|
Lascano F, García Bournissen F, Altcheh J. Review of pharmacological options for the treatment of Chagas disease. Br J Clin Pharmacol 2022; 88:383-402. [PMID: 33314266 DOI: 10.1111/bcp.14700] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/09/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022] Open
Abstract
Chagas disease (CD) is a worldwide problem, with over 8 million people infected in both rural and urban areas. CD was first described over a century ago, but only two drugs are currently available for CD treatment: benznidazole (BZN) and nifurtimox (NF). Treating CD-infected patients, especially children and women of reproductive age, is vital in order to prevent long-term sequelae, such as heart and gastrointestinal dysfunction, but this aim is still far from being accomplished. Currently, the strongest data to support benefit-risk considerations come from trials in children. Treatment response biomarkers need further development as serology is being questioned as the best method to assess treatment response. This article is a narrative review on the pharmacology of drugs for CD, particularly BZN and NF. Data on drug biopharmaceutical characteristics, safety and efficacy of both drugs are summarized from a clinical perspective. Current data on alternative compounds under evaluation for CD treatment, and new possible treatment response biomarkers are also discussed. Early diagnosis and treatment of CD, especially in paediatric patients, is vital for an effective and safe use of the available drugs (i.e. BZN and NF). New biomarkers for CD are urgently needed for the diagnosis and evaluation of treatment efficacy, and to guide efforts from academia and pharmaceutical companies to accelerate the process of new drug development.
Collapse
Affiliation(s)
- Fernanda Lascano
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Gobierno de la Ciudad de la Nación Argentina, Buenos Aires, Argentina.,Servicio de Parasitología y Chagas, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Facundo García Bournissen
- Division of Pediatric Clinical Pharmacology, Department of Pediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, Canada
| | - Jaime Altcheh
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Gobierno de la Ciudad de la Nación Argentina, Buenos Aires, Argentina.,Servicio de Parasitología y Chagas, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| |
Collapse
|
11
|
The Colombian Strain of Trypanosoma cruzi Induces a Proinflammatory Profile, Neuronal Death, and Collagen Deposition in the Intestine of C57BL/6 Mice Both during the Acute and Early Chronic Phase. Mediators Inflamm 2022; 2022:7641357. [PMID: 35069009 PMCID: PMC8769873 DOI: 10.1155/2022/7641357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022] Open
Abstract
The objective of this study was to evaluate the histopathological changes caused by infection with the Colombian strain of Trypanosoma cruzi (T. cruzi) in the acute and chronic experimental phases. C57Bl/6 mice were infected with 1000 trypomastigote forms of the Colombian strain of T. cruzi. After 30 days (acute phase) and 90 days (early chronic phase) of infection, the animals were euthanized, and the colon was collected and divided into two parts: proximal and distal. The distal portion was used for histopathological analysis, whereas the proximal portion was used for quantification of pro- and anti-inflammatory cytokines. In addition, the weight of the animals and parasitemia were assessed. The infection induced gradual weight loss in the animals. In addition, the infection induced an increase in interferon gamma (IFNγ) and tumor necrosis factor-alpha (TNF-α) in the intestine in the acute phase, in which this increase continued until the early chronic phase. The same was observed in relation to the presence of intestinal inflammatory infiltrates. In relation to interleukin (IL)-10, there was an increase only in the early chronic phase. The Colombian strain infection was also able to induce neuronal loss in the myenteric plexus and deposition of the collagen fibers during the acute phase. The Colombian strain of T. cruzi is capable of causing histopathological changes in the intestine of infected mice, especially in inducing neuronal destructions. Thus, this strain can also be used to study the intestinal form of Chagas disease in experimental models.
Collapse
|
12
|
Simpson H, Konan DO, Brahima K, Koffi JD, Kashindi S, Edmiston M, Weiland S, Halliday K, Pullan RL, Meite A, Koudou BG, Timothy J. Effectiveness of community-based burden estimation to achieve elimination of lymphatic filariasis: A comparative cross-sectional investigation in Côte d'Ivoire. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000760. [PMID: 36962795 PMCID: PMC10022321 DOI: 10.1371/journal.pgph.0000760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/23/2022] [Indexed: 11/19/2022]
Abstract
For lymphatic filariasis (LF) elimination, endemic countries must document the burden of LF morbidity (LFM). Community-based screening (CBS) is used to collect morbidity data, but evidence demonstrating its reliability is limited. Recent pilots of CBS for LFM alongside mass drug administration (MDA) in Côte d'Ivoire suggested low LFM prevalence (2.1-2.2 per 10,000). We estimated LFM prevalence in Bongouanou District, Côte d'Ivoire, using a comparative cross-sectional design. We compared CBS implemented independently of MDA, adapted from existing Ministry of Health protocols, to a population-based prevalence survey led by formally trained nurses. We evaluated the reliability of case identification, coverage, equity, and cost of CBS. CBS identified 87.4 cases of LFM per 10,000; the survey identified 47.5 (39.4-56.3; prevalence ratio [PR] 1.84; 95% CI 1.64-2.07). CBS identified 39.7 cases of suspect lymphoedema per 10,000; the survey confirmed 35.1 (29.2-41.5) filarial lymphoedema cases per 10,000 (PR 1.13 [0.98-1.31]). CBS identified 96.5 scrotal swellings per 10,000; the survey found 91.3 (83.2-99.8; PR 1.06 [0.93-1.21]); including 33.9 (27.7-38.8) filarial hydrocoele per 10,000 (PR of suspect to confirmed hydrocele 2.93 [2.46-3.55]). Positive predictive values for case identification through CBS were 65.0% (55.8-73.5%) for filarial lymphoedema; 93.7% (89.3-96.7%) for scrotal swellings; and 34.0% (27.3-41.2%) for filarial hydrocoele. Households of lower socioeconomic status and certain minority languages were at risk of exclusion. Direct financial costs were $0.17 per individual targeted and $69.62 per case confirmed. Our community-based approach to LFM burden estimation appears scalable and provided reliable prevalence estimates for LFM, scrotal swellings and LF-lymphoedema. The results represent a step-change improvement on CBS integrated with MDA, whilst remaining at programmatically feasible costs. Filarial hydrocoele cases were overestimated, attributable to the use of case definitions suitable for mass-screening by informal staff. Our findings are broadly applicable to countries aiming for LF elimination using CBS. The abstract is available in French in the S1 File.
Collapse
Affiliation(s)
- Hope Simpson
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Daniele O Konan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Kouma Brahima
- Ministère de la Sante et de l'Hygiène Publique, Programme national de lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive (PNLMTN-CP) en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jeanne d'Arc Koffi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Saidi Kashindi
- American Leprosy Missions, Greenville, South Carolina, United States of America
- AIM Initiative, Accra, Ghana
| | - Melissa Edmiston
- American Leprosy Missions, Greenville, South Carolina, United States of America
- AIM Initiative, Accra, Ghana
| | - Stefanie Weiland
- American Leprosy Missions, Greenville, South Carolina, United States of America
- AIM Initiative, Accra, Ghana
| | - Katherine Halliday
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rachel L Pullan
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Aboulaye Meite
- Ministère de la Sante et de l'Hygiène Publique, Programme national de lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive (PNLMTN-CP) en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | | | - Joseph Timothy
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
13
|
Pain Abdomen in Children in Tropics. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02709-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
14
|
Schioppa L, Fall F, Ortiz S, Poupaert JH, Quetin-Leclercq J. A Validated HPLC-PDA-HRMS Method to Investigate the Biological Stability and Metabolism of Antiparasitic Triterpenic Esters. Molecules 2021; 26:molecules26237154. [PMID: 34885738 PMCID: PMC8659078 DOI: 10.3390/molecules26237154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Pentacyclic triterpenes (PTs) are commonly found in medicinal plants with well-known antiparasitic effects. Previous research on C-3 and C-27 triterpenic esters showed effective and selective in vitro antiparasitic activities and in vivo effectiveness by parenteral routes. The aim of this study was to determine triterpenic esters' stability in different biological-like media and the main microsomal degradation products. An HPLC-PDA method was developed and validated to simultaneously analyze and quantify bioactive triterpenic esters in methanol (LOQ: 2.5 and 1.25-100 µg/mL) and plasma (LOQ: 5-125 µg/mL). Overall, both triterpenic esters showed a stable profile in aqueous and buffered solutions as well as in entire plasma, suggesting gaining access to the ester function is difficult for plasma enzymes. Conversely, after 1 h, 30% esters degradation in acidic media was observed with potential different hydrolysis mechanisms. C-3 (15 and 150 µM) and C-27 esters (150 µM) showed a relatively low hepatic microsomal metabolism (<23%) after 1 h, which was significantly higher in the lowest concentration of C-27 esters (15 µM) (>40% degradation). Metabolic HPLC-PDA-HRMS studies suggested hydrolysis, hydroxylation, dehydration, O-methylation, hydroxylation and/or the reduction of hydrolyzed derivatives, depending on the concentration and the position of the ester link. Further permeability and absorption studies are required to better define triterpenic esters pharmacokinetic and specific formulations designed to increase their oral bioavailability.
Collapse
Affiliation(s)
- Laura Schioppa
- Pharmacognosy Laboratory, Louvain Drug Research Institute (LDRI), Université Catholique de Louvain (UCLouvain), Avenue E. Mounier, B1 72.03, B-1200 Brussels, Belgium; (F.F.); (S.O.); (J.Q.-L.)
- Correspondence:
| | - Fanta Fall
- Pharmacognosy Laboratory, Louvain Drug Research Institute (LDRI), Université Catholique de Louvain (UCLouvain), Avenue E. Mounier, B1 72.03, B-1200 Brussels, Belgium; (F.F.); (S.O.); (J.Q.-L.)
| | - Sergio Ortiz
- Pharmacognosy Laboratory, Louvain Drug Research Institute (LDRI), Université Catholique de Louvain (UCLouvain), Avenue E. Mounier, B1 72.03, B-1200 Brussels, Belgium; (F.F.); (S.O.); (J.Q.-L.)
| | - Jacques H. Poupaert
- Medicinal Chemistry Research Group (CMFA), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain (UCLouvain), Avenue E. Mounier, B1 72.04, B-1200 Brussels, Belgium;
| | - Joelle Quetin-Leclercq
- Pharmacognosy Laboratory, Louvain Drug Research Institute (LDRI), Université Catholique de Louvain (UCLouvain), Avenue E. Mounier, B1 72.03, B-1200 Brussels, Belgium; (F.F.); (S.O.); (J.Q.-L.)
| |
Collapse
|
15
|
Conserva GA, Costa-Silva TA, Quirós-Guerrero LM, Marcourt L, Wolfender JL, Queiroz EF, Tempone AG, Lago JHG. Kaempferol-3-O-α-(3,4-di-E-p-coumaroyl)-rhamnopyranoside from Nectandra oppositifolia releases Ca 2+ from intracellular pools of Trypanosoma cruzi affecting the bioenergetics system. Chem Biol Interact 2021; 349:109661. [PMID: 34537181 DOI: 10.1016/j.cbi.2021.109661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 08/12/2021] [Accepted: 09/15/2021] [Indexed: 12/22/2022]
Abstract
Phytochemical analysis of EtOH extract from leaves of Nectandra oppositifolia afforded three flavonoids: kaempferol (1), kaempferol-3-O-α-rhamnopyranoside (2) and kaempferol-3-O-α-(3,4-di-E-p-coumaroyl)-rhamnopyranoside (3), which were characterized by NMR and ESI-HRMS. When tested against the protozoan parasite Trypanosoma cruzi, the etiologic agent of Chagas disease, flavonoids 1 and 3 were effective to kill the trypomastigotes with IC50 values of 32.0 and 6.7 μM, respectively, while flavonoid 2 was inactive. Isolated flavonoids 1-3 were also tested in mammalian fibroblasts and showed CC50 values of 24.8, 48.7 and 153.1 μM, respectively. Chemically, these results suggested that the free aglycone plays an important role in the bioactivity while the presence of p-coumaroyl unities linked in the rhamnoside unity is important to enhance the antitrypanosomal activity and reduce the mammalian cytotoxicity. The mechanism of cellular death was investigated for the most potent flavonoid 3 in the trypomastigotes using fluorescent and luminescent-based assays. It indicated that this compound induced neither permeabilization of the plasma membrane nor depolarization of the membrane electric potential. However, early time incubation (20 min) with flavonoid 3 resulted in a constant elevation of the Ca2+ levels inside the parasite. This effect was followed by a mitochondrial imbalance, leading to a hyperpolarization and depolarization of the mitochondrial membrane potential, with reduction of the ATP levels. During this time, the levels of reactive oxygen species levels (ROS) were unaltered. The leakage of Ca2+ from the intracellular pools can affect the bioenergetics system of T. cruzi, leading to the parasite death. Therefore, flavonoid 3 can be a useful tool for future studies against T. cruzi parasites.
Collapse
Affiliation(s)
- Geanne A Conserva
- Center of Natural Sciences and Humanities, Federal University of ABC, Santo Andre, SP, 09210-180, Brazil.
| | - Thais A Costa-Silva
- Center of Natural Sciences and Humanities, Federal University of ABC, Santo Andre, SP, 09210-180, Brazil.
| | - Luis M Quirós-Guerrero
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSW), University of Geneva, Geneva, Switzerland.
| | - Laurence Marcourt
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSW), University of Geneva, Geneva, Switzerland.
| | - Jean-Luc Wolfender
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSW), University of Geneva, Geneva, Switzerland.
| | - Emerson F Queiroz
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSW), University of Geneva, Geneva, Switzerland.
| | - Andre G Tempone
- Centre for Parasitology and Mycology, Instituto Adolfo Lutz, São Paulo, SP, 01246-000, Brazil.
| | - João Henrique G Lago
- Center of Natural Sciences and Humanities, Federal University of ABC, Santo Andre, SP, 09210-180, Brazil.
| |
Collapse
|
16
|
Agboraw E, Sosu F, Dean L, Siakeh A, Thomson R, Kollie K, Worrall E. Factors influencing mass drug administration adherence and community drug distributor opportunity costs in Liberia: a mixed-methods approach. Parasit Vectors 2021; 14:557. [PMID: 34711278 PMCID: PMC8555123 DOI: 10.1186/s13071-021-05058-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 10/07/2021] [Indexed: 11/23/2022] Open
Abstract
Background Preventive chemotherapy delivered via mass drug administration (MDA) is essential for the control of neglected tropical diseases (NTDs), including lymphatic filariasis (LF), schistosomiasis and onchocerciasis. Successful MDA relies heavily on community drug distributor (CDD) volunteers as the interface between households and the health system. This study sought to document and analyse demand-side (households) and supply-side (health system) factors that affect MDA delivery in Liberia. Methods Working in two purposively selected counties, we conducted a household MDA access and adherence survey; a CDD survey to obtain information on direct and opportunity costs associated with MDA work; an observational survey of CDDs; and key informant surveys (KIS) with community-level health workers. Data from the CDD survey and Liberian minimum wage rates were used to calculate the opportunity cost of CDD participation per MDA round. The observational data were used to calculate the time spent on individual household-level tasks and CDD time costs per house visited. KIS data on the organisation and management of the MDA in the communities, and researcher reflections of open-ended survey responses were thematically analysed to identify key demand- and supply-side challenges. Results More respondents were aware of MDA than NTD in both counties. In Bong, 39% (103/261) of respondents reported taking the MDA tablet in the last round, with “not being informed” as the most important reason for non-adherence. In Maryland, 56% (147/263) reported taking MDA with “being absent” at the time of distribution being important for non-adherence. The mean cost per CDD of participating in the MDA round was −$11.90 (median $5.04, range −$169.62 to $30.00), and the mean time per household visited was 17.14 min which equates to a mean opportunity cost of $0.03 to $0.05 per household visited. Thematic analysis identified challenges, including shortages of and delays in medicine availability; CDD frustration over costs; reporting challenges; and household concerns about drug side effects. Conclusions Improved adherence to MDA and subsequent elimination of NTDs in Liberia would be supported by an improved medicine supply chain, financial compensation for CDDs, improved training, healthcare workforce strengthening, greater community involvement, capacity building, and community awareness. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-05058-w.
Collapse
Affiliation(s)
- Efundem Agboraw
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Street, Liverpool, L3 5 QA, UK.
| | - Fred Sosu
- University of Liberia, Pacific Institute for Research and Evaluation (UL-PIRE), Capitol Hill, Monrovia, Liberia
| | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Street, Liverpool, L3 5 QA, UK
| | - Alice Siakeh
- University of Liberia, Pacific Institute for Research and Evaluation (UL-PIRE), Capitol Hill, Monrovia, Liberia
| | - Rachael Thomson
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Street, Liverpool, L3 5 QA, UK
| | - Karsor Kollie
- Ministry of Health, SKD Boulevard, Monrovia, Liberia
| | - Eve Worrall
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Street, Liverpool, L3 5 QA, UK
| |
Collapse
|
17
|
Towards global control of parasitic diseases in the Covid-19 era: One Health and the future of multisectoral global health governance. ADVANCES IN PARASITOLOGY 2021; 114:1-26. [PMID: 34696842 PMCID: PMC8503781 DOI: 10.1016/bs.apar.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human parasitic infections—including malaria, and many neglected tropical diseases (NTDs)—have long represented a Gordian knot in global public health: ancient, persistent, and exceedingly difficult to control. With the coronavirus disease (Covid-19) pandemic substantially interrupting control programmes worldwide, there are now mounting fears that decades of progress in controlling global parasitic infections will be undone. With Covid-19 moreover exposing deep vulnerabilities in the global health system, the current moment presents a watershed opportunity to plan future efforts to reduce the global morbidity and mortality associated with human parasitic infections. In this chapter, we first provide a brief epidemiologic overview of the progress that has been made towards the control of parasitic diseases between 1990 and 2019, contrasting these fragile gains with the anticipated losses as a result of Covid-19. We then argue that the complementary aspirations of the United Nations Sustainable Development Goals (SDGs) and the World Health Organization (WHO)’s 2030 targets for parasitic disease control may be achieved by aligning programme objectives within the One Health paradigm, recognizing the interdependence between humans, animals, and the environment. In so doing, we note that while the WHO remains the preeminent international institution to address some of these transdisciplinary concerns, its underlying challenges with funding, authority, and capacity are likely to reverberate if left unaddressed. To this end, we conclude by reimagining how models of multisectoral global health governance—combining the WHO's normative and technical leadership with greater support in allied policy-making areas—can help sustain future malaria and NTD elimination efforts.
Collapse
|
18
|
In silico and in vitro study of epiisopiloturine/ hydroxypropyl-β-cyclodextrin inclusion complexes obtained by different methods. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
19
|
Habib M, Adegnika AA, Honkpehedji J, Klug SJ, Lobmaier S, Vogg K, Bustinduy AL, Ullrich A, Reinhard-Rupp J, Esen M, Prazeres da Costa C. The challenges for women's health in sub-Saharan Africa: Lessons learned from an integrative multistakeholder workshop in Gabon. J Glob Health 2021; 11:02002. [PMID: 34552713 PMCID: PMC8442509 DOI: 10.7189/jogh.11.02002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marrium Habib
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich (TUM), Munich, Germany.,Center for Global Health, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Ayola Akim Adegnika
- Institute for Tropical Medicine (ITM), University Clinic Tübingen, (UKT), Tübingen, Germany.,Centre de Réchèrches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Josiane Honkpehedji
- Centre de Réchèrches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,German Center for Infection Research (DZIF), Tübingen, Germany
| | - Stefanie J Klug
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich (TUM), Munich, Germany
| | - Silvia Lobmaier
- Clinic and Polyclinic for Gynecology, University Hospital, Klinikum Rechts der Isar (MRI), Technical University Munich (TUM), Munich, Germany
| | - Kathrin Vogg
- Clinic and Polyclinic for Gynecology, University Hospital, Klinikum Rechts der Isar (MRI), Technical University Munich (TUM), Munich, Germany
| | - Amaya L Bustinduy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | | | | | - Meral Esen
- Institute for Tropical Medicine (ITM), University Clinic Tübingen, (UKT), Tübingen, Germany.,Centre de Réchèrches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,German Center for Infection Research (DZIF), Tübingen, Germany
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich (TUM), Munich, Germany.,Center for Global Health, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany.,German Center for Infection Research (DZIF), Tübingen, Germany
| |
Collapse
|
20
|
Apt W, Llancaqueo M, Zulantay I, Canals M, Kara S, Arribada A, Muñoz G, Martínez G. Clinical, electrocardiographic and echocardiographic evolution of chronic Chagas disease treated with nifurtimox on prolonged follow-up in Chile: observational study. J Glob Antimicrob Resist 2021; 27:160-166. [PMID: 34496323 DOI: 10.1016/j.jgar.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 07/07/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study aimed to describe the electrocardiographic and echocardiographic status of chronic Chagas disease (cChD) patients treated with nifurtimox. METHODS An observational study was performed in 146 cChD patients followed over a mean of 7.9 years. RESULTS Of the 146 patients, 41 (28.1%) with normal electrocardiogram (ECG) at baseline maintained this condition, 34 (23.3%) with altered ECG at baseline normalised the alterations, and 46 (31.5%) with ECG abnormalities at baseline maintained this condition [23 (15.8%) with small alterations]. Finally, 25 cases (17.1%) in indeterminate phase altered the ECG. Differences before and after follow-up (P < 0.001) were found. The percentage of beneficial treatment was different than expected by chance (Z = 4.8; P < 0.001) and the annual percentage of cases that developed ECG alterations was lower than that of a historical cohort of untreated patients (P < 0.001). An echocardiogram was performed in 68 patients with baseline ECG alterations. The ejection fraction (EF) was normal in 57 (83.8%) and abnormal in 11 (16.2%). In 38 patients with ECG abnormalities that did not progress after treatment, EF and segmental motility (SM) were normal in 31 (81.6%) and 26 (68.4%), respectively. In 17 patients with ECG abnormalities, EF and SM were normal in 15 (88.2%) and 14 (82.4%) cases, respectively. CONCLUSION Less progression to cardiomyopathy compared with a historical untreated cohort as well as the EF/SM results in patients with abnormal ECG that did not progress and in indeterminate cChD that altered the ECG suggests a beneficial effect of nifurtimox.
Collapse
Affiliation(s)
- Werner Apt
- Laboratory of Basic-Clinical Parasitology, Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Marcelo Llancaqueo
- Department of Cardiology, Clinic Hospital University of Chile, Santiago, Chile
| | - Inés Zulantay
- Laboratory of Basic-Clinical Parasitology, Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Mauricio Canals
- School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Sergio Kara
- Service of Cardiology, San José Hospital, Santiago, Chile
| | | | - Gabriela Muñoz
- Laboratory of Basic-Clinical Parasitology, Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Gabriela Martínez
- Laboratory of Basic-Clinical Parasitology, Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| |
Collapse
|
21
|
Maldonado E, Morales-Pison S, Urbina F, Solari A. Molecular and Functional Characteristics of DNA Polymerase Beta-Like Enzymes From Trypanosomatids. Front Cell Infect Microbiol 2021; 11:670564. [PMID: 34422676 PMCID: PMC8375306 DOI: 10.3389/fcimb.2021.670564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
Trypanosomatids are a group of primitive unicellular eukaryotes that can cause diseases in plants, insects, animals, and humans. Kinetoplast genome integrity is key to trypanosomatid cell survival and viability. Kinetoplast DNA (kDNA) is usually under attack by reactive oxygen and nitric species (ROS and RNS), damaging the DNA, and the cells must remove and repair those oxidatively generated lesions in order to survive and proliferate. Base excision repair (BER) is a well-conserved pathway for DNA repair after base damage, single-base loss, and single-strand breaks, which can arise from ROS, RSN, environmental genotoxic agents, and UV irradiation. A powerful BER system has been described in the T. cruzi kinetoplast and it is mainly carried out by DNA polymerase β (pol β) and DNA polymerase β-PAK (pol β-PAK), which are kinetoplast-located in T. cruzi as well as in other trypanosomatids. Both pol β and pol β-PAK belong to the X-family of DNA polymerases (pol X family), perform BER in trypanosomatids, and display intrinsic 5-deoxyribose phosphate (dRP) lyase and DNA polymerase activities. However, only Pol β-PAK is able to carry out trans-lesion synthesis (TLS) across 8oxoG lesions. T. cruzi cells overexpressing pol β are more resistant to ROS and are also more efficient to repair 8oxoG compared to control cells. Pol β seems to play a role in kDNA replication, since it associates with kinetoplast antipodal sites in those development stages in trypanosomatids which are competent for cell replication. ROS treatment of cells induces the overexpression of pol β, indicating that plays a role in kDNA repair. In this review, we will summarize the main features of trypanosomatid minicircle kDNA replication and the biochemical characteristics of pol β-like enzymes and their involvement in BER and kDNA replication. We also summarize key structural features of trypanosomatid pol β compared to their mammalian (human) counterpart.
Collapse
Affiliation(s)
- Edio Maldonado
- Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Sebastian Morales-Pison
- Laboratorio de Genética Molecular Humana, Programa de Genética Humana, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Fabiola Urbina
- Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Aldo Solari
- Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|
22
|
Turner HC, Stolk WA, Solomon AW, King JD, Montresor A, Molyneux DH, Toor J. Are current preventive chemotherapy strategies for controlling and eliminating neglected tropical diseases cost-effective? BMJ Glob Health 2021; 6:bmjgh-2021-005456. [PMID: 34385158 PMCID: PMC8362715 DOI: 10.1136/bmjgh-2021-005456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Neglected tropical diseases (NTDs) remain a significant cause of morbidity and mortality in many low-income and middle-income countries. Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts.
Collapse
Affiliation(s)
- Hugo C Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK .,Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Wilma A Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Jonathan D King
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - David H Molyneux
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jaspreet Toor
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK,Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| |
Collapse
|
23
|
|
24
|
Rinaldi G, Porter K. Mass drug administration for endemic scabies: a systematic review. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2021; 7:21. [PMID: 34193305 PMCID: PMC8247067 DOI: 10.1186/s40794-021-00143-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022]
Abstract
Background Scabies is an extremely fastidious infestation caused by the Sarcoptes scabiei mite. It causes a persistent itch that can disrupt a person’s mental health, sleep, and overall quality of life. In endemic areas, treatment by targeting symptomatic individuals and their contacts is often unsuccessful due to an asymptomatic period and high rates of re-infection. To overcome this, Mass Drug Administration (MDA) is often used to treat the whole community, irrespective of whether individuals presently have scabies. This review summarises the evidence for the effectiveness of MDA in treating scabies. Methods An exhaustive literature review was conducted on MEDLINE, EMBASE, Web of Science and Scopus. All peer-reviewed articles published in English January 1990 to March 2020 were eligible and only if the studies were primary and interventional. Furthermore, the intervention had to be a pharmacological MDA method involving human subjects. Results TWELVE articles that qualified for inclusion were identified. MDA for scabies significantly reduced its prevalence in communities at follow up. Some of the drivers of success were communities with low levels of migration, an uptake of MDA of > 85%, the use of oral Ivermectin therapy, the treatment of children and pregnant women within the treated population, and repeated treatment for participants diagnosed with scabies at baseline. Conclusions The average absolute reduction in prevalence of scabies was 22.0% and the relative reduction average was 73.4%. These results suggest MDA is effective in treating scabies in the endemic community. Further evidence is needed surrounding MDA use in urban areas with increased levels of migration. Importantly, MDA should not substitute the tackling of socioeconomic factors which contribute to endemic disease such as good sanitation and hygiene. Supplementary Information The online version contains supplementary material available at 10.1186/s40794-021-00143-5.
Collapse
Affiliation(s)
- Giulia Rinaldi
- Institute for Global Health, University College London, London, UK.
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| |
Collapse
|
25
|
Molyneux DH, Asamoa-Bah A, Fenwick A, Savioli L, Hotez P. The history of the neglected tropical disease movement. Trans R Soc Trop Med Hyg 2021; 115:169-175. [PMID: 33508096 PMCID: PMC7842098 DOI: 10.1093/trstmh/trab015] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 01/05/2023] Open
Abstract
The history of the neglected tropical disease movement is seen through the lens of authors who worked during the last 4 decades in different roles and in different settings, from Western-based laboratories to clinical roles in endemic countries and in critical policy roles in the World Health Organization (WHO). The authors seek to identify key players from the introduction of the word 'neglected' by the late Kenneth Warren in his Rockefeller Foundation-supported Great Neglected Diseases of Mankind movement through to the more recent developments after the London Declaration of 2012. The role of the various actors-endemic countries, major pharmaceutical companies, the WHO, non-government development organizations, bilateral donors and academia-are discussed. The critical events and decisions are highlighted that were essential enabling factors in creating a viable and successful movement and with a resultant massive global public health and antipoverty impact. The importance of advocacy is emphasized in creating the momentum to establish a globally recognized public health 'brand' as a target in the United Nations Sustainable Development Goals.
Collapse
Affiliation(s)
- David H Molyneux
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | | | - Alan Fenwick
- School of Public Health Imperial College Norfolk Place W2 1PG, UK
| | - Lorenzo Savioli
- P.O. Box 267, Chake Chake, Pemba Island, Zanzibar, United Republic of Tanzania
| | - Peter Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| |
Collapse
|
26
|
Lascano F, Altcheh J. An evaluation of nifurtimox for Chagas disease in children. Expert Opin Orphan Drugs 2021. [DOI: 10.1080/21678707.2021.1933431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Fernanda Lascano
- Servicio de Parasitologia-Chagas, Hospital de Niños Ricardo Gutierrez, Instituto Multidisciplinario de Investigacion en Patologias Pediatricas (IMIPP) CONICET-GCBA, Buenos Aires, Argentina
| | - Jaime Altcheh
- Servicio de Parasitologia-Chagas, Hospital de Niños Ricardo Gutierrez, Instituto Multidisciplinario de Investigacion en Patologias Pediatricas (IMIPP) CONICET-GCBA, Buenos Aires, Argentina
| |
Collapse
|
27
|
da Gama ANS, Soeiro MNC. Quinoline-based Compounds as Key Candidates to Tackle Drug Discovery Programs of Microbicidal Agents. Curr Pharm Des 2021; 27:1757-1762. [PMID: 33023440 DOI: 10.2174/1381612826666201006125644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 11/22/2022]
Abstract
Quinolines are heterocyclic nitrogen compounds, ubiquitous in nature and largely used as a structural component of dyes, solvent for resins, terpenes as well as during the production of several other chemical stuffs, including pesticides. Quinolines, such as quinine and chloroquine, exhibit various pharmacological properties, acting as antimalarial drugs, antiparasitic, antibacterial, antiviral, antifungal, and anticancer agents, besides being in clinical use for autoimmune diseases. A brief review has been presented regarding the biological effect and clinical use of quinolines and derivatives upon three trypanosomatids agents of important neglected tropical diseases; Trypanosoma cruzi, Trypanosoma brucei spp and Leishmania spp, which trigger Chagas disease, sleeping sickness and leishmaniasis, respectively, also extending to a glance update of their potential application towards other microbes relevant for emerging illness caused by fungi, bacteria and virus, including the pandemic Covid-19.
Collapse
Affiliation(s)
- Aline N Silva da Gama
- Laboratorio de Biologia Celular, Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Maria N C Soeiro
- Laboratorio de Biologia Celular, Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| |
Collapse
|
28
|
Wu LL, Hu HH, Zhang X, Zhou XN, Jia TW, Wang C, Hong Z, Xu J. Cost-effectiveness analysis of the integrated control strategy for schistosomiasis japonica in a lake region of China: a case study. Infect Dis Poverty 2021; 10:79. [PMID: 34049589 PMCID: PMC8161988 DOI: 10.1186/s40249-021-00863-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Schistosomiasis japonica remains an important public health concern due to its potential to cause severe outcomes and long-term sequelae. An integrated control strategy implemented in the Peoples' Republic of China has been shown to be effective to control or interrupt the transmission of schistosomiasis. The objective of this study is to estimate the disease burden of schistosomiasis and assess the cost-effectiveness of the integrated control strategy focused on different major interventions at three stages for schistosomiasis control in a lake setting, to provide reference for policy making or planning. METHODS Annual cost data of schistosomiasis control during 2009-2019 were obtained from the control program implementers in Jiangling County, Hubei Province, China. Economic costs are provided in constant 2009 Chinese Yuan (CNY). Epidemiological data of schistosomiasis were collected from the Jiangling county station for schistosomiasis control. Disease burden of schistosomiasis was assessed by calculating years of life lost (YLLs) owing to premature death, years lived with disability (YLDs) and disability-adjusted life years (DALYs). DALYs were calculated as the sum of YLLs and YLDs. We then conducted a rudimentary cost-effectiveness analysis by determining the ratio by dividing the difference between the average cost of integrated control strategy at transmission control (2013-2016) or transmission interruption (2017-2019) and the average cost at stage of infection control (2009-2012) with the difference between the DALYs of schistosomiasis at different control stages. Descriptive statistics on the costs and DALYs were used in the analysis. RESULTS The total economic costs for schistosomiasis control in Jiangling County from 2009 to 2019 were approximately CNY 606.88 million. The average annual economic costs for schistosomiasis prevention and control at stages of infection control (2009-2012), transmission control (2013-2016), and transmission interruption (2017-2019) were approximately CNY 41.98 million, CNY 90.19 million and CNY 26.06 million respectively. The overall disease burden caused by schistosomiasis presented a downward trend. Meanwhile, the disease burden of advanced cases showed an upward trend with the DALY increased from 943.72 to 1031.59 person-years. Most disease burden occurred in the age group over 45 years old (especially the elderly over 60 years old). Taking the infection control stage as the control, the incremental cost-effectiveness ratio of integrated control strategy was CNY 8505.5 per case averted, CNY 60 131.6 per DALY decreased at transmission control stage and CNY -2217.6 per case averted, CNY -18 116.0 per DALY decreased at transmission interruption stage. CONCLUSIONS The disease burden of schistosomiasis decreased significantly with the implementation of the integrated prevention and control strategy. Surveillance and management on elder population should be strengthened to decrease diseases burden. There remains a need for well-conducted studies that examine the long-term cost-effectiveness of the integrated control strategy for schistosomiasis. GRAPHIC ABSTARCT.
Collapse
Affiliation(s)
- Ling-Ling Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - He-Hua Hu
- Jiangling Station of Schistosomiasis Control, Hubei Province, Jiangling, 434100, China
| | - Xia Zhang
- Jiangling Station of Schistosomiasis Control, Hubei Province, Jiangling, 434100, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Tie-Wu Jia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Can Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Zhong Hong
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China.
| |
Collapse
|
29
|
Salm A, Krishnan SR, Collu M, Danton O, Hamburger M, Leonti M, Almanza G, Gertsch J. Phylobioactive hotspots in plant resources used to treat Chagas disease. iScience 2021; 24:102310. [PMID: 33870129 PMCID: PMC8040286 DOI: 10.1016/j.isci.2021.102310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/23/2021] [Accepted: 03/11/2021] [Indexed: 12/22/2022] Open
Abstract
Globally, more than six million people are infected with Trypanosoma cruzi, the causative protozoan parasite of the vector-borne Chagas disease (CD). We conducted a cross-sectional ethnopharmacological field study in Bolivia among different ethnic groups where CD is hyperendemic. A total of 775 extracts of botanical drugs used in Bolivia in the context of CD and botanical drugs from unrelated indications from the Mediterranean De Materia Medica compiled by Dioscorides two thousand years ago were profiled in a multidimensional assay uncovering different antichagasic natural product classes. Intriguingly, the phylobioactive anthraquinone hotspot matched the antichagasic activity of Senna chloroclada, the taxon with the strongest ethnomedical consensus for treating CD among the Izoceño-Guaraní. Testing common 9,10-anthracenedione derivatives in T. cruzi cellular infection assays demarcates hydroxyanthraquinone as a potential antichagasic lead scaffold. Our study systematically uncovers in vitro antichagasic phylogenetic hotspots in the plant kingdom as a potential resource for drug discovery based on ethnopharmacological hypotheses.
Collapse
Affiliation(s)
- Andrea Salm
- Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Sandhya R. Krishnan
- Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Marta Collu
- Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Ombeline Danton
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Matthias Hamburger
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Marco Leonti
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giovanna Almanza
- Instituto de Investigaciones Químicas, Universidad Mayor de San Andres, La Paz, Bolivia
| | - Jürg Gertsch
- Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
30
|
Abstract
Chagas disease is an inflammatory, infectious disease caused by the parasite Trypanosoma cruzi found in the feces of the triatomine bug, which can cause a sudden, brief acute illness, or it may become a long-lasting chronic condition. Chagas disease is common in South America and Central America, however, the constantly expanding global community has brought Chagas disease to the forefront of non-endemic areas, particularly the United States and Europe. The authors present a case of a 47-year-old healthy farmer diagnosed with a right orbital cellulitis refractory to systemic antibiotics. Based on clinical symptoms, the patient's medical/demographical history and a proper differential diagnosis, an acute phase of Chagas disease was diagnosed. After antiparasitic treatment, the patient had a proper recovery and continued with a regular follow-up to monitor the possible development of a chronic phase.
Collapse
|
31
|
Wainwright E, Evans D, Rotondo L, Pou B, Yevstigneyeva V, Zoerhoff KL, Ottesen EA, Reithinger R. The Elimination of Neglected Tropical Diseases: A Case Study Exemplifying How Foreign Assistance Funding Can Be Catalytic in Reducing the Burden of Major Global Health Conditions. Clin Infect Dis 2021; 70:958-964. [PMID: 31402376 DOI: 10.1093/cid/ciz742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/01/2019] [Indexed: 11/13/2022] Open
Abstract
In 2006, following direct advocacy and published rationale, the US Agency for International Development (USAID) established a neglected tropical diseases (NTDs) program to support the scale-up of integrated platforms to target the elimination and control of 5 NTDs-lymphatic filariasis, trachoma, onchocerciasis, schistosomiasis, and soil-transmitted helminthiasis. By 2017, more than 2.3 billion NTD treatments had been delivered to at-risk populations in 25 countries, leveraging $19 billion in donated drugs-approximately $26 dollars in donated medicine per $1 spent by USAID. As a result, most of the supported countries are on track to achieve their elimination goals (for lymphatic filariasis and trachoma) by 2020 or 2021 and their control goals soon thereafter. Though "small" when compared to other global health initiatives, this investment proved to be catalytic, and indeed highlights how foreign assistance funding can be transformative, in reducing the burden of major global health conditions such as NTDs.
Collapse
Affiliation(s)
| | - Darin Evans
- US Agency for International Development, Washington, DC, USA
| | | | | | | | | | - Eric A Ottesen
- RTI International, Washington, DC, USA.,Task Force for Global Health, Decatur, Georgia, USA
| | | |
Collapse
|
32
|
Pacheco AB, Melo RDJL, Rochitte CE. Cardiac Magnetic Resonance in the Assessment of Chagas Disease and its Complications. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20200250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
33
|
Hamill LC, Haslam D, Abrahamsson S, Hill B, Dixon R, Burgess H, Jensen K, D'Souza S, Schmidt E, Downs P. People are neglected, not diseases: the relationship between disability and neglected tropical diseases. Trans R Soc Trop Med Hyg 2020; 113:829-834. [PMID: 31111941 PMCID: PMC6903785 DOI: 10.1093/trstmh/trz036] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/04/2019] [Accepted: 05/02/2019] [Indexed: 01/24/2023] Open
Abstract
People with disabilities and the neglected tropical diseases (NTDs) are separately receiving increased focus. In light of this positive development, and the similarities and intersections between the negative impacts experienced by both people with disabilities and people with NTDs, we believe now is the right time to focus attention on the overlap between the two. Both people with NTDs and people with disabilities experience a myriad of overlapping negative health, financial and socio-cultural consequences. Despite this, we believe that disability is not yet properly prioritised on the development agenda, and that there are multiple opportunities to make NTD programming more inclusive, to the benefit of those at this neglected intersection and beyond. There are both opportunities and need to scale up, integrate, and invest in inclusive, health system-focused NTD programming. Realisation of the Sustainable Development Goals, Universal Health Coverage, and the control and elimination of NTDs all rely on ensuring people with disabilities are not left behind.
Collapse
Affiliation(s)
| | - Dominic Haslam
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | | | - Becks Hill
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | - Ruth Dixon
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | - Heather Burgess
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | - Kimberly Jensen
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | - Susan D'Souza
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | - Elena Schmidt
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | - Philip Downs
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| |
Collapse
|
34
|
Assunção ELF, Carvalho DB, das Neves AR, Kawasoko Shiguemotto CY, Portapilla GB, de Albuquerque S, Baroni ACM. Synthesis and Antitrypanosomal Activity of 1,4-Disubstituted Triazole Compounds Based on a 2-Nitroimidazole Scaffold: a Structure-Activity Relationship Study. ChemMedChem 2020; 15:2019-2028. [PMID: 32729242 DOI: 10.1002/cmdc.202000460] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Indexed: 12/14/2022]
Abstract
Chagas disease affects 6-8 million people worldwide, remaining a public health concern. Toxicity, several adverse effects and inefficiency in the chronic stage of the disease are the major challenges regarding the available treatment protocols. This work involved the synthesis of twenty-two 1,4-disubstituted-1,2,3-triazole analogues of benznidazole (BZN), by using a click chemistry strategy. Analogues were obtained in moderate to good yields (40-97 %). Antitrypanosomal activity was evaluated against the amastigote forms of Trypanosoma cruzi. Compound 8 a (4-(2-nitro-1H-imidazol-1-yl)methyl)-1-phenyl-1H-1,2,3-triazole) without substituents on phenyl ring showed similar biological activity to BZN (IC50 =3.0 μM, SI>65.3), with an IC50 =3.1 μM and SI>64.5. Compound 8 o (3,4-di-OCH3 -Ph) with IC50 = 0.65 μM was five-fold more active than BZN, and showed an excellent selectivity index (SI>307.7). Compound 8 v (3-NO2 , 4-CH3 -Ph) with IC50 =1.2 μM and relevant SI>166.7, also exhibited higher activity than BZN. SAR analysis exhibited a pattern regarding antitrypanosomal activity relative to BZN, in compounds with electron-withdrawing groups (Hammett σ+) at position 3, and electron-donating groups (Hammett σ-) at position 4, as observed in 8 o and 8 v. Further research might explore in vivo antitrypanosomal activity of promising analogues 8 a, 8 o, and 8 v. Overall, this study indicates that approaches such as the bioisosteric replacement of amide group by 1,2,3-triazole ring, the use of click chemistry as a synthesis strategy, and design tools like Craig-plot and Topliss tree are promising alternatives to drug discovery.
Collapse
Affiliation(s)
- Elvis L F Assunção
- Laboratório de Síntese e Química Medicinal (LASQUIM), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal do Mato Grosso do Sul - UFMS, Campo Grande, Mato Grosso do Sul CEP, 79051-470, Brazil
| | - Diego B Carvalho
- Laboratório de Síntese e Química Medicinal (LASQUIM), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal do Mato Grosso do Sul - UFMS, Campo Grande, Mato Grosso do Sul CEP, 79051-470, Brazil
| | - Amarith R das Neves
- Laboratório de Síntese e Química Medicinal (LASQUIM), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal do Mato Grosso do Sul - UFMS, Campo Grande, Mato Grosso do Sul CEP, 79051-470, Brazil
| | - Cristiane Y Kawasoko Shiguemotto
- Laboratório de Síntese e Química Medicinal (LASQUIM), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal do Mato Grosso do Sul - UFMS, Campo Grande, Mato Grosso do Sul CEP, 79051-470, Brazil
| | - Gisele B Portapilla
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo,CEP, 14040-900, Brazil
| | - Sergio de Albuquerque
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo,CEP, 14040-900, Brazil
| | - Adriano C M Baroni
- Laboratório de Síntese e Química Medicinal (LASQUIM), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal do Mato Grosso do Sul - UFMS, Campo Grande, Mato Grosso do Sul CEP, 79051-470, Brazil
| |
Collapse
|
35
|
Aya Pastrana N, Beran D, Somerville C, Heller O, Correia JC, Suggs LS. The process of building the priority of neglected tropical diseases: A global policy analysis. PLoS Negl Trop Dis 2020; 14:e0008498. [PMID: 32785262 PMCID: PMC7423089 DOI: 10.1371/journal.pntd.0008498] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/18/2020] [Indexed: 11/18/2022] Open
Abstract
The global burden attributed to Neglected Tropical Diseases (NTDs) is 47.9 million Disability-Adjusted Life Years (DALYs). These diseases predominantly affect disadvantaged populations. Priority for NTDs has grown in recent years, which is observed by their inclusion in the sustainable development goals (SDGs). This study analyzed the process that allowed these diseases to be included on the global health policy agenda. This global policy analysis used the Shiffman and Smith framework to understand the determinants of global health political priority for NTDs. The framework comprises four categories: actor power, ideas, political contexts, and issue characteristics. Global documents and World Health Assembly (WHA) resolutions were examined, key-informant interviews were conducted, and academic publications were reviewed to understand the four categories that comprise the framework. A total of 37 global policy documents, 15 WHA resolutions, and 38 academic publications were examined. Twelve semi-structured interviews were conducted with individuals representing different sectors within the NTD community who have been involved in raising the priority of these diseases. This study found that several factors helped better position NTDs in the global health agenda. These include the leadership of actors that mobilized the global health community, the creation of a label combining these diseases as a group to represent a larger disease burden, the presence of mechanisms aligning the NTD community, and the agreement on ways to present the NTD burden and potential solutions. The process of building the priority of NTDs in the global health agenda shows that several determinants led to positive outcomes, but these diseases continue to have low priority at the global level which requires the implementation of actions to increase their global priority. These include sustaining the commitment of current actors and engaging new ones; increasing the attention given to diseases formerly categorized as "tool-deficient", including zoonotic NTDs; continue leveraging on policy windows and creating favorable policy moments to sustain commitment, as well as setting realistic targets. Findings from this study can help develop strategies to build the momentum and drive actions to implement the goals of the new Roadmap for NTDs in the pathway to universal health coverage (UHC) and sustainable development.
Collapse
Affiliation(s)
- Nathaly Aya Pastrana
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
- * E-mail: ,
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
| | - Claire Somerville
- Gender Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Olivia Heller
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Jorge C. Correia
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - L. Suzanne Suggs
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
| |
Collapse
|
36
|
Turner HC, French MD, Montresor A, King CH, Rollinson D, Toor J. Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs. Wellcome Open Res 2020; 5:45. [PMID: 32587899 PMCID: PMC7308887 DOI: 10.12688/wellcomeopenres.15754.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Schistosomiasis is one of the most prevalent neglected tropical diseases (NTDs) with an estimated 229 million people requiring preventive treatment worldwide. Recommendations for preventive chemotherapy strategies have been made by the World Health Organization (WHO) whereby the frequency of treatment is determined by the settings prevalence. Despite recent progress, many countries still need to scale up treatment and important questions remain regarding optimal control strategies. This paper presents a systematic review of the economic evaluations of human schistosomiasis interventions. Methods: A systematic review of the literature was conducted on 22nd August 2019 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. The focus was economic evaluations of schistosomiasis interventions, such as cost-effectiveness and cost-benefit analyses. No date or language stipulations were applied to the searches. Results: We identified 53 relevant health economic analyses of schistosomiasis interventions. Most studies related to Schistosoma japonicum followed by S. haematobium. Several studies also included other NTDs. In Africa, most studies evaluated preventive chemotherapy, whereas in China they mostly evaluated programmes using a combination of interventions (such as chemotherapy, snail control and health education). There was wide variation in the methodology and epidemiological settings investigated. A range of effectiveness metrics were used by the different studies. Conclusions: Due to the variation across the identified studies, it was not possible to make definitive policy recommendations. Although, in general, the current WHO recommended preventive chemotherapy approach to control schistosomiasis was found to be cost-effective. This finding has important implications for policymakers, advocacy groups and potential funders. However, there are several important inconsistencies and research gaps (such as how the health benefits of interventions are quantified) that need to be addressed to identify the resources required to achieve schistosomiasis control and elimination.
Collapse
Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, W2 1PG, UK
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Antonio Montresor
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA
| | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London, UK
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| |
Collapse
|
37
|
Abe EM, Tambo E, Xue J, Xu J, Ekpo UF, Rollinson D, Yang K, Li SZ, Zhou XN. Approaches in scaling up schistosomiasis intervention towards transmission elimination in Africa: Leveraging from the Chinese experience and lessons. Acta Trop 2020; 208:105379. [PMID: 32006521 DOI: 10.1016/j.actatropica.2020.105379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 12/20/2022]
Abstract
Schistosoma japonicum, differs from the African species including S. mansoni and S. haematobium, is a zoonotic parasite as it infects both human and animals including domestic ruminant animals such as cattle and animals from the wild. Considering China's success story in the elimination of schistosomiasis, the China-Africa collaboration on schistosomaisis elimination in Africa is an important cooperative health development initiative. This review examines the importance of China-Africa collaboration on schistosomiasis elimination using effective surveillance-response intervention strategy as the platform to effectively drive the elimination of schistosomiasis in Africa. Three conclusions were made after reviewing the similarity and differences in schistososmiasis control programmes between China and African continent as follows: (i) Politically, China's lessons is that leveraging on the integrated control strategies and the recognition that schistosomiasis is a public health problem which prompted the interest of government in China. It is necessary for African leaders and governments to recognize schistosomiasis as a public health challenge that must be given serious attention in terms of funding and setting up frameworks to complement control efforts. (ii) Technically, efficient monitoring and surveillance system mechanism will facilitate contextual and effective management of schistosomiasis elimination across different environment, and African programme managers should embrace the use of appropriate diagnostic tools to guide treatment strategies at different thresholds of schistosomiasis control. (iii) Strategically, effective control of snail intermediate hosts and precision mapping of snail distribution should be prioritized for successful schistosomiasis elimination in Africa.
Collapse
Affiliation(s)
- Eniola M Abe
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - E Tambo
- Département de Biochimie et Science Pharmaceutiques, Université des Montagnes, Bagangté, République du Cameroon.
| | - Jingbo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Uwem F Ekpo
- Department of Pure and Applied Zoology, Federal University of Agriculture, Alabata Road, Abeokuta, 110001, Nigeria.
| | - David Rollinson
- The Natural History Museum, Cromwell Road, London SW7 5BD, United Kingdom.
| | - Kun Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi, China.
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| |
Collapse
|
38
|
Senapati A, Panday P, Samanta S, Chattopadhyay J. Disease control through removal of population using Z-control approach. PHYSICA A 2020; 548:123846. [PMID: 32292237 PMCID: PMC7127574 DOI: 10.1016/j.physa.2019.123846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/22/2019] [Indexed: 06/02/2023]
Abstract
Present study considers the situation where the removal of population is adopted as a prevention measure for isolating the susceptible population from an infected region to reduce the disease prevalence. To investigate the scenario, a dynamic error based method, Z-type control is applied in an SI type disease model with the aim of achieving a predetermined disease prevalence. The controlled system is designed by introducing a new compartment (the population in an infection-free region) in the uncontrolled system to capture the removal of susceptible population from the infected region to an infection free region. By performing numerical simulations, our study shows that using Z-control mechanism, the removal of susceptible to an infection free region can effectively achieve a predetermined disease prevalence. The removal rates required for achieving a specific reduction in infected population for different levels of disease endemicity are quantified. Furthermore, the global sensitivity analysis (PRCC) is also performed to have a more clear insights on the correlations of the control parameter with the model parameters.
Collapse
Affiliation(s)
- Abhishek Senapati
- Agricultural and Ecological Research Unit, Indian Statistical Institute, 203, B. T. Road, Kolkata 700108, India
| | - Pijush Panday
- Agricultural and Ecological Research Unit, Indian Statistical Institute, 203, B. T. Road, Kolkata 700108, India
| | - Sudip Samanta
- Department of Mathematics, Bankura University, Bankura, West Bengal, India
| | - Joydev Chattopadhyay
- Agricultural and Ecological Research Unit, Indian Statistical Institute, 203, B. T. Road, Kolkata 700108, India
| |
Collapse
|
39
|
Ravaynia PS, Lombardo FC, Biendl S, Dupuch MA, Keiser J, Hierlemann A, Modena MM. Parallelized Impedance-Based Platform for Continuous Dose-Response Characterization of Antischistosomal Drugs. ACTA ACUST UNITED AC 2020; 4:e1900304. [PMID: 32510834 DOI: 10.1002/adbi.201900304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/19/2020] [Indexed: 11/11/2022]
Abstract
Schistosomiasis is an acute and chronic disease caused by tropical parasitic worms of the genus Schistosoma, which parasitizes annually over 200 million people worldwide. Screening of antischistosomal compounds is hampered by the low throughput and potential subjectivity of the visual evaluation of the parasite phenotypes, which affects the current drug assays. Here, an impedance-based platform, capable of assessing the viability of Schistosoma mansoni schistosomula exposed to drugs, is presented. This automated and parallelized platform enables unbiased and continuous measurements of dose-response relationships for more than 48 h. The platform performance is established by exposure of schistosomula to three test compounds, praziquantel, oxethazaine, and mefloquine, which are known to affect the larvae phenotypes. The system is thereafter used to investigate the response of schistosomula to methiothepine, an antipsychotic compound, which causes complex drug-induced effects. Continuous monitoring of the parasites reveals transient behavioral phenotypes and allows for extracting temporal characteristics of dose-response curves, which are essential for selecting drugs that feature high activity and fast kinetics of action. These measurements demonstrate that impedance-based detection provides a wealth of information for the in vitro characterization of candidate antischistosomals and, represents a promising tool for the identification of new lead compounds.
Collapse
Affiliation(s)
- Paolo S Ravaynia
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, Basel, 4058, Switzerland
| | - Flavio C Lombardo
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, Basel, 4051, Switzerland
| | - Stefan Biendl
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, Basel, 4051, Switzerland
| | - Matthias A Dupuch
- Micro and Nanosystems, Department of Mechanical and Process Engineering, ETH Zürich, Tannenstrasse 3, Zurich, 8092, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, Basel, 4051, Switzerland
| | - Andreas Hierlemann
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, Basel, 4058, Switzerland
| | - Mario M Modena
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, Basel, 4058, Switzerland
| |
Collapse
|
40
|
Acosta IC, Pérez-Tanoira R, Prieto-Pérez L, Úbeda AC, Álvarez Álvarez B, Antoranz PA, Fernández Guerrero M, Fernández Roblas R, Orejas M, Tomás M, Cariñanos I, Górgolas M. Chagas' heart disease: Descriptive analysis of 141 patients in a hospital of Madrid, Spain. Travel Med Infect Dis 2020; 37:101690. [PMID: 32334089 DOI: 10.1016/j.tmaid.2020.101690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 02/24/2020] [Accepted: 04/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Spain is the European country with the highest number of Trypanosoma cruzi infected patients. Due to the cardiac complications that these patients can develop, it is of paramount importance to evaluate the value of the different heart diagnostic tools. METHOD In this observational study, we describe the main characteristics and data from electrocardiogram, chest X-ray, echocardiogram and cardiac magnetic resonance imaging (MRI) of 141 patients with Chagas' disease attended in a tertiary university hospital in Madrid from 2009 to 2018. RESULTS A total of 50 patients (35.4%) had at least one abnormal cardiac test: 34.2% altered electrocardiogram (40/117), 24.5% altered echocardiogram (27/110) and 9.2% abnormal cardiac MRI (13/41). Of those 13 with a pathological MRI, 53.8% had normal results for any other test. The most frequent alterations observed were hypokinesia with decreased LVEF (left ventricular ejection fraction), dilatation of cavities and cardiac fibrosis. Two thirds of patients with abnormal cardiac test were asymptomatic. Altered echocardiogram was found in 43.8% of patients ≥50 years compared to 16.6% under 50 years (p = 0.003). CONCLUSIONS A transthoracic echocardiogram and a MRI of the heart added a 23.8% increment in diagnosing cardiac pathological findings.
Collapse
Affiliation(s)
- Irene Carrillo Acosta
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Ramón Pérez-Tanoira
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
| | - Laura Prieto-Pérez
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Alfonso Cabello Úbeda
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | | | | | - Manuel Fernández Guerrero
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Ricardo Fernández Roblas
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
| | - Miguel Orejas
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
| | - Marta Tomás
- Department of Radiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
| | - Irune Cariñanos
- Department of Digestive, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Miguel Górgolas
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| |
Collapse
|
41
|
Zulhussnain M, Zahoor MK, Rizvi H, Zahoor MA, Rasul A, Ahmad A, Majeed HN, Rasul A, Ranian K, Jabeen F. Insecticidal and Genotoxic effects of some indigenous plant extracts in Culex quinquefasciatus Say Mosquitoes. Sci Rep 2020; 10:6826. [PMID: 32321960 PMCID: PMC7176662 DOI: 10.1038/s41598-020-63815-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/13/2020] [Indexed: 01/25/2023] Open
Abstract
Five different weed plants viz. Convulvulus arvensis, Chenopodium murale, Tribulus terrestris, Trianthema portulacastrum, and Achyranthes aspera were investigated for their entomocidal and genotoxic effects against Culex quinquefasciatus mosquitoes. High mortality was observed at 72 hours in a dose dependent manner. Among all the tested plants, A. aspera was found highly significant which showed 100% mortality at 250 ppm after 72 hours with LC50 of 87.46, 39.08 and 9.22 ppm at 24, 48, respectively. In combination with Bacillus thuringiensis israelensis (Bti); A. aspera also caused 100% mortality at 250 ppm concentration after 72 hours (LC50 8.29 ppm). Phytochemical analysis of all the tested weed plants showed the presence of flavonoids, saponins, tannins, steroids, cardiac glycosides, alkaloids, anthrequinones and terpenoids. Random Amplification of Polymorphic DNA-Polymerase chain reaction (RAPD-PCR) and comet assay were performed to assess the genotoxic effect of A. aspera but no change in DNA profile was observed. Furthermore, FTIR showed the presence of phenolic compounds in A. aspera extract. It is suggested that certain phenolic compounds such as flavonoids modulate the enzymatic activity and, hence, cause the death of larvae of Cx. quinquefasciatus. Altogether, current study would serve as an initial step towards replacement of synthetic insecticides to plant-microbe based biopesticide against Culex mosquitoes in future.
Collapse
Affiliation(s)
- Muhammad Zulhussnain
- Department of Zoology, Government College University Faisalabad, Faisalabad, Pakistan
| | | | - Hina Rizvi
- Department of Environmental Sciences & Engineering, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Asif Zahoor
- Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Azhar Rasul
- Department of Zoology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Aftab Ahmad
- Department of Biochemistry/US-Pakistan Center for Advance Studies in Agriculture and Food Security (USPCAS-AFS), University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Humara Naz Majeed
- Department of Biochemistry, Government College Women University, Faisalabad, Pakistan
| | - Amer Rasul
- Department of Entomology, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Kanwal Ranian
- Department of Zoology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Farhat Jabeen
- Department of Zoology, Government College University Faisalabad, Faisalabad, Pakistan
| |
Collapse
|
42
|
Turner HC, French MD, Montresor A, King CH, Rollinson D, Toor J. Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs. Wellcome Open Res 2020; 5:45. [PMID: 32587899 PMCID: PMC7308887 DOI: 10.12688/wellcomeopenres.15754.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2020] [Indexed: 11/05/2023] Open
Abstract
Background: Schistosomiasis is one of the most prevalent neglected tropical diseases (NTDs) with an estimated 229 million people requiring preventive treatment worldwide. Recommendations for preventive chemotherapy strategies have been made by the World Health Organization (WHO) whereby the frequency of treatment is determined by the settings prevalence. Despite recent progress, many countries still need to scale up treatment and important questions remain regarding optimal control strategies. This paper presents a systematic review of the economic evaluations of human schistosomiasis interventions. Methods: A systematic review of the literature was conducted on 22nd August 2019 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. The focus was economic evaluations of schistosomiasis interventions, such as cost-effectiveness and cost-benefit analyses. No date or language stipulations were applied to the searches. Results: We identified 53 relevant health economic analyses of schistosomiasis interventions. Most studies related to Schistosoma japonicum followed by S. haematobium. Several studies also included other NTDs. In Africa, most studies evaluated preventive chemotherapy, whereas in China they mostly evaluated programmes using a combination of interventions (such as chemotherapy, snail control and health education). There was wide variation in the methodology and epidemiological settings investigated. A range of effectiveness metrics were used by the different studies. Conclusions: Due to the variation across the identified studies, it was not possible to make definitive policy recommendations. Although, in general, the current WHO recommended preventive chemotherapy approach to control schistosomiasis was found to be cost-effective. This finding has important implications for policymakers, advocacy groups and potential funders. However, there are several important inconsistencies and research gaps (such as how the health benefits of interventions are quantified) that need to be addressed to identify the resources required to achieve schistosomiasis control and elimination.
Collapse
Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, W2 1PG, UK
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Antonio Montresor
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA
| | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London, UK
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| |
Collapse
|
43
|
Molyneux DH. The London Declaration on Neglected Tropical Diseases: 5 years on. Trans R Soc Trop Med Hyg 2020; 110:623-625. [PMID: 28115685 DOI: 10.1093/trstmh/trw082] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 12/23/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- David H Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| |
Collapse
|
44
|
Añez N, Crisante G, Rojas A, Segnini S, Espinoza-Álvarez O, Teixeira MM. Update on Chagas disease in Venezuela during the period 2003-2018. A review. Acta Trop 2020; 203:105310. [PMID: 31862464 DOI: 10.1016/j.actatropica.2019.105310] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/04/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
The present article reviews the status of Chagas disease in Venezuela during the period 2003-2018, based on the detection of Trypanosoma cruzi-infection in 3,343 blood samples of individuals from rural localities and 182 patients referred from health centers to confirm presumptive clinical diagnostic. The study involved samples from 81 rural localities of 17 states located at different regions and ecological life zones of the country. Analysis by parasitological (fresh microscopic observation, hemoculture and Giemsa stained blood smears), serological (DAT, IFAT-polyvalent, IgM, IgG tests) and molecular (PCR) tests, revealed 10.7% seroprevalence and 42.8% T. cruzi-infection, in individuals from rural localities and referred patients, respectively. In both groups T. cruzi-infection was detected at any age, revealing active transmission in children under 10-years-old. Clinical profile detected in referred patients, showed significantly major number of symptoms in orally infected patients than in infected by vectorial route (P<0.01). Genetic characterization of T. cruzi isolates obtained from orally and vectorial transmitted acute Chagas disease in western Venezuela, revealed the circulation of DTUI and DTUIII in the former, and DTUI, DTUII and DTUIII in patients infected by vectorial route. DTUI predominated in both cases, and haplotype Ib was the most frequently found in this genotype. Statistical analysis of clinical profile - T. cruzi DTUs - transmission route relationships did not show association among these variables and, consequently, chagasic patient's clinical condition did not depend of T. cruzi genotype or its route of transmission. In addition, differences in clinical severity may be associated with host susceptibility and/or parasite load received by the human receptor in spite of the T. cruzi genotype itself. The epidemiological implications of the present findings are discussed, and the need for developing efficient tools as well as implementation of urgent and radical changes in the public health policy to control Chagas disease transmission in the Venezuelan territory are suggested.
Collapse
|
45
|
Bivona AE, Alberti AS, Cerny N, Trinitario SN, Malchiodi EL. Chagas disease vaccine design: the search for an efficient Trypanosoma cruzi immune-mediated control. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165658. [PMID: 31904415 DOI: 10.1016/j.bbadis.2019.165658] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/20/2019] [Indexed: 12/21/2022]
Abstract
Chagas disease is currently endemic to 21 Latin-American countries and has also become a global concern because of globalization and mass migration of chronically infected individuals. Prophylactic and therapeutic vaccination might contribute to control the infection and the pathology, as complement of other strategies such as vector control and chemotherapy. Ideal prophylactic vaccine would produce sterilizing immunity; however, a reduction of the parasite burden would prevent progression from Trypanosoma cruzi infection to Chagas disease. A therapeutic vaccine for Chagas disease may improve or even replace the treatment with current drugs which have several side effects and require long term treatment that frequently leads to therapeutic withdrawal. Here, we will review some aspects about sub-unit vaccines, the rationale behind the selection of the immunogen, the role of adjuvants, the advantages and limitations of DNA-based vaccines and the idea of therapeutic vaccines. One of the main limitations to advance vaccine development against Chagas disease is the high number of variables that must be considered and the lack of uniform criteria among research laboratories. To make possible comparisons, much of this review will be focused on experiments that kept many variables constant including antigen mass/doses, type of eukaryotic plasmid, DNA-delivery system, mice strain and sex, lethal and sublethal model of infection, and similar immunogenicity and efficacy assessments.
Collapse
Affiliation(s)
- Augusto E Bivona
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Inmunología and Instituto de Estudios de la Inmunidad Humoral Prof. Dr. Ricardo A. Margni (IDEHU), UBA-CONICET, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología and Instituto de Microbiología y Parasitología Médica (IMPaM), UBA-CONICET, Buenos Aires, Argentina
| | - Andrés Sánchez Alberti
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Inmunología and Instituto de Estudios de la Inmunidad Humoral Prof. Dr. Ricardo A. Margni (IDEHU), UBA-CONICET, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología and Instituto de Microbiología y Parasitología Médica (IMPaM), UBA-CONICET, Buenos Aires, Argentina
| | - Natacha Cerny
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Inmunología and Instituto de Estudios de la Inmunidad Humoral Prof. Dr. Ricardo A. Margni (IDEHU), UBA-CONICET, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología and Instituto de Microbiología y Parasitología Médica (IMPaM), UBA-CONICET, Buenos Aires, Argentina
| | - Sebastián N Trinitario
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Inmunología and Instituto de Estudios de la Inmunidad Humoral Prof. Dr. Ricardo A. Margni (IDEHU), UBA-CONICET, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología and Instituto de Microbiología y Parasitología Médica (IMPaM), UBA-CONICET, Buenos Aires, Argentina
| | - Emilio L Malchiodi
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Inmunología and Instituto de Estudios de la Inmunidad Humoral Prof. Dr. Ricardo A. Margni (IDEHU), UBA-CONICET, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología and Instituto de Microbiología y Parasitología Médica (IMPaM), UBA-CONICET, Buenos Aires, Argentina.
| |
Collapse
|
46
|
Kamara W, Zoerhoff KL, Toubali EH, Hodges MH, Bisanzio D, Chowdhury D, Sonnie M, Magbity E, Samai M, Conteh A, Macarthy F, Baker M, Koroma JB. Are census data accurate for estimating coverage of a lymphatic filariasis MDA campaign? Results of a survey in Sierra Leone. PLoS One 2019; 14:e0224422. [PMID: 31856176 PMCID: PMC6922463 DOI: 10.1371/journal.pone.0224422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 10/14/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Preventive chemotherapy was administered to 3.2 million Sierra Leoneans in 13 health districts for lymphatic filariasis, onchocerciasis, and soil transmitted helminthes from October 2008 to February 2009. This paper aims to report the findings of a coverage survey conducted in 2009, compare the coverage survey findings with two reported rates for lymphatic filariasis coverage obtained using pre-mass drug administration (MDA) registration and national census projections, and use the comparison to understand the best source of population estimates in calculating coverage for NTD programming in Sierra Leone. METHODOLOGY/PRINCIPAL FINDINGS Community drug distributors (CDDs) conducted a pre- MDA registration of the population. Two coverage rates for MDA for lymphatic filariasis were subsequently calculated using the reported number treated divided by the total population from: 1) the pre-MDA register and 2) national census projections. A survey was conducted to validate reported coverage data. 11,602 persons participated (response rate of 76.8%). Overall, reported coverage data aggregated to the national level were not significantly different from surveyed coverage (z-test >0.05). However, estimates based on pre-MDA registration have higher agreement with surveyed coverage (mean Kendall's W = 0.68) than coverage calculated with census data (mean Kendall's = 0.59), especially in districts with known large-scale migration, except in a highly urban district where it was more challenging to conduct a pre-MDA registration appropriately. There was no significant difference between coverage among males versus females when the analyses were performed excluding those women who were pregnant at the time of MDA. The surveyed coverage estimate was near or below the minimum 65% epidemiological coverage target for lymphatic filariasis MDA in all districts. CONCLUSION/SIGNIFICANCE These results from Sierra Leone illustrate the importance of choosing the right denominator for calculating treatment coverage for NTD programs. While routinely reported coverage results using national census data are often good enough for programmatic decision making, census projections can quickly become outdated where there is substantial migration, e.g. due to the impact of civil war, with changing economic opportunities, in urban settings, and where there are large migratory populations. In districts where this is known to be the case, well implemented pre-MDA registration can provide better population estimates. Pre-MDA registration should, however, be implemented correctly to reduce the risk of missing pockets of the population, especially in urban settings.
Collapse
Affiliation(s)
- Wogba Kamara
- Statistics Sierra Leone, Circular Road, Tower Hill, Freetown, Sierra Leone
| | | | - Emily H. Toubali
- Helen Keller International, New York, NY, United States of America
| | | | - Donal Bisanzio
- RTI International, Washington, DC, United States of America
| | | | | | - Edward Magbity
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Abdulai Conteh
- Neglected Tropical Disease Control Program, New England, Freetown, Sierra Leone
| | - Florence Macarthy
- Neglected Tropical Disease Control Program, New England, Freetown, Sierra Leone
| | - Margaret Baker
- RTI International, Washington, DC, United States of America
| | | |
Collapse
|
47
|
Shelar A, Sangshetti J, Chakraborti S, Singh AV, Patil R, Gosavi S. Helminthicidal and Larvicidal Potentials of Biogenic Silver Nanoparticles Synthesized from Medicinal Plant Momordica charantia. Med Chem 2019; 15:781-789. [PMID: 31208313 DOI: 10.2174/1573406415666190430142637] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/07/2019] [Accepted: 04/15/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The drug formulations used to control mosquito vectors and helminth infections have resulted in the development of resistance, and negative impact on non-target organisms and environment. OBJECTIVE Plant-mediated synthesis of silver nanoparticles (P-AgNPs) using aqueous fruit peel extract of M. charantia, applications of P-AgNPs for helminthicidal activity against Indian earthworms (P. posthuma) and larvicidal activity against larvae of mosquito A. albopictus and A. aegypti. METHODS Aqueous fruit peel extract of Momordica charantia was used to reduce silver ions to silver nanoparticles (P-AgNPs). UV-Visible (UV-Vis) Spectroscopy, X-ray diffraction, Fourier Transform Infrared Spectroscopy and Transmission Electron Microscopy characterize synthesized P-AgNPs. The motility and survival rate of the worms were recorded for the helminthicidal activity. Percent mortality of larvae of A. albopictus and A. aegypti was recorded for larvicidal activity. RESULTS The UV-Vis absorption spectrum of P-AgNPs showed a strong surface plasmon absorption band in the visible region with a maximum absorption at 445 nm indicating the synthesis of silver nanoparticles by the addition of aqueous fruit peel extract. The XRD spectrum of P-AgNPs showed Bragg's reflection peaks 2θ value characteristics for the Face-Centered Cubic (FCC) structure of silver. The sharp absorption peak in FTIR at 1659 cm-1 assigned to C=O stretching vibration in carbonyl compounds represents terpenoids, flavonoids and polyphenols in the corona of PAgNPs; a 2 mg/mL of P-AgNPs. The concentration aqueous extract and P-AgNPs showed complete death of worms (the morphological alteration/coiling of body). A 20 ppm concentration of PAgNPs showed 85% mortality in larvae of Ae. albopictus and Ae. aegypti. P-AgNPs were nontoxic at low concentrations. CONCLUSION The aqueous extracts played a dual role as reducing and capping agent during the biosynthesis of AgNPs as per FTIR and XRD results. The surface reactivity facilitated by biomolecule corona attached to silver nanoparticles can further help to functionalize AgNPs in various pharmaceuticals, biomedicals, and environmental applications.
Collapse
Affiliation(s)
- Amruta Shelar
- Department of Biotechnology, Savitribai Phule Pune University, Pune 411007, India
| | | | | | - Ajay Vikram Singh
- Department of Physical Intelligence, Max Planck Institute for Intelligent Systems, Heisenbergstr 3, 70569 Stuttgart, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Rajendra Patil
- Department of Biotechnology, Savitribai Phule Pune University, Pune 411007, India
| | - Suresh Gosavi
- Department of Physics, Savitribai Phule Pune University, Pune 411007, India
| |
Collapse
|
48
|
Fleau C, Padilla A, Miguel-Siles J, Quesada-Campos MT, Saiz-Nicolas I, Cotillo I, Cantizani Perez J, Tarleton RL, Marco M, Courtemanche G. Chagas Disease Drug Discovery: Multiparametric Lead Optimization against Trypanosoma cruzi in Acylaminobenzothiazole Series. J Med Chem 2019; 62:10362-10375. [PMID: 31657555 DOI: 10.1021/acs.jmedchem.9b01429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Acylaminobenzothiazole hits were identified as potential inhibitors of Trypanosoma cruzi replication, a parasite responsible for Chagas disease. We selected compound 1 for lead optimization, aiming to improve in parallel its anti-T. cruzi activity (IC50 = 0.63 μM) and its human metabolic stability (human clearance = 9.57 mL/min/g). A total of 39 analogues of 1 were synthesized and tested in vitro. We established a multiparametric structure-activity relationship, allowing optimization of antiparasite activity, physicochemical parameters, and ADME properties. We identified compound 50 as an advanced lead with an improved anti-T. cruzi activity in vitro (IC50 = 0.079 μM) and an enhanced metabolic stability (human clearance = 0.41 mL/min/g) and opportunity for the oral route of administration. After tolerability assessment, 50 demonstrated a promising in vivo efficacy.
Collapse
Affiliation(s)
- Charlotte Fleau
- BIOASTER, Microbiology Technology Institute , 28 rue du Docteur Roux , 75015 Paris , Ile-de-France , France
| | - Angel Padilla
- Center for Tropical and Emerging Global Infectious Diseases and Department of Cellular Biology , University of Georgia , 30602 Athens , Georgia , United States
| | - Juan Miguel-Siles
- Global Health R&D, GlaxoSmithKline , Calle Severo Ochoa 2 , 28760 Tres Cantos , Madrid , Spain
| | - Maria T Quesada-Campos
- Global Health R&D, GlaxoSmithKline , Calle Severo Ochoa 2 , 28760 Tres Cantos , Madrid , Spain
| | - Isabel Saiz-Nicolas
- Global Health R&D, GlaxoSmithKline , Calle Severo Ochoa 2 , 28760 Tres Cantos , Madrid , Spain
| | - Ignacio Cotillo
- Global Health R&D, GlaxoSmithKline , Calle Severo Ochoa 2 , 28760 Tres Cantos , Madrid , Spain
| | - Juan Cantizani Perez
- Global Health R&D, GlaxoSmithKline , Calle Severo Ochoa 2 , 28760 Tres Cantos , Madrid , Spain
| | - Rick L Tarleton
- Center for Tropical and Emerging Global Infectious Diseases and Department of Cellular Biology , University of Georgia , 30602 Athens , Georgia , United States
| | - Maria Marco
- Global Health R&D, GlaxoSmithKline , Calle Severo Ochoa 2 , 28760 Tres Cantos , Madrid , Spain
| | - Gilles Courtemanche
- BIOASTER, Microbiology Technology Institute , 28 rue du Docteur Roux , 75015 Paris , Ile-de-France , France
| |
Collapse
|
49
|
Reed SL, McKerrow JH. Why Funding for Neglected Tropical Diseases Should Be a Global Priority. Clin Infect Dis 2019; 67:323-326. [PMID: 29688342 DOI: 10.1093/cid/ciy349] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/19/2018] [Indexed: 01/01/2023] Open
Abstract
Neglected tropical diseases affect >1 billion of the world's poorest persons. Control programs range from near-elimination (dracunculiasis) to increasing prevalence (dengue and cutaneous leishmaniasis). These are some of the most cost-effective public health interventions and should be a global priority.
Collapse
Affiliation(s)
- Sharon L Reed
- Departments of Pathology and Medicine, UC San Diego Health
| | - James H McKerrow
- Skaggs School of Pharmacy and Pharmaceutical Science, University of California, San Diego
| |
Collapse
|
50
|
Villalta F, Rachakonda G. Advances in preclinical approaches to Chagas disease drug discovery. Expert Opin Drug Discov 2019; 14:1161-1174. [PMID: 31411084 PMCID: PMC6779130 DOI: 10.1080/17460441.2019.1652593] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/02/2019] [Indexed: 12/21/2022]
Abstract
Introduction: Chagas disease affects 8-10 million people worldwide, mainly in Latin America. The current therapy for Chagas disease is limited to nifurtimox and benznidazole, which are effective in treating only the acute phase of the disease but with severe side effects. Therefore, there is an unmet need for new drugs and for the exploration of innovative approaches which may lead to the discovery of new effective and safe drugs for its treatment. Areas covered: The authors report and discuss recent approaches including structure-based design that have led to the discovery of new promising small molecule candidates for Chagas disease which affect prime targets that intervene in the sterol pathway of T. cruzi. Other trypanosome targets, phenotypic screening, the use of artificial intelligence and the challenges with Chagas disease drug discovery are also discussed. Expert opinion: The application of recent scientific innovations to the field of Chagas disease have led to the discovery of new promising drug candidates for Chagas disease. Phenotypic screening brought new hits and opportunities for drug discovery. Artificial intelligence also has the potential to accelerate drug discovery in Chagas disease and further research into this is warranted.
Collapse
Affiliation(s)
- Fernando Villalta
- Department of Microbiology, Immunology and Physiology, School of Medicine, Meharry Medical College , Nashville , TN , USA
| | - Girish Rachakonda
- Department of Microbiology, Immunology and Physiology, School of Medicine, Meharry Medical College , Nashville , TN , USA
| |
Collapse
|