1. Effectiveness of a 10-Day Melarsoprol Schedule for the Treatment of Late-Stage Human African Trypanosomiasis: Confirmation from a Multinational Study (IMPAMEL II).
- Author
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Schmid, Caecilia, Richer, Michaleen, Bilenqe, Constantin Miaka Mia, Josenando, Théophile, Chappuis, Francois, Manthelot, Claude R., Nanqouma, Auquste, Doua, Félix, Asumu, Pedro N., Simarro, Pere P., and Burn, Christian
- Subjects
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AFRICAN trypanosomiasis , *TRYPANOSOMIASIS , *TRYPANOSOMA brucei , *HOSPITAL care , *PATIENTS , *DISEASES - Abstract
Background. Treatment of late-stage human African trypanosomiasis (HAT) with melarsoprol can be improved by shortening the regimen. A previous trial demonstrated the safety and efficacy of a 10-day treatment schedule. We demonstrate the effectiveness of this schedule in a noncontrolled, multinational drug-utilization study. Methods. A total of 2020 patients with late-stage HAT were treated with the 10-day melarsoprol schedule in 16 centers in 7 African countries. We assessed outcome on the basis of major adverse events and the cure rate after treatment and during 2 years of follow-up. Results. The cure rate 24 h after treatment was 93.9%; 2 years later, it was 86.2%. However, 49.3% of patients were lost to follow-up. The overall fatality rate was 5.9%. Of treated patients, 8.7% had an encephalopathic syndrome that was fatal 45.5% of the time. The rate of severe bullous and maculopapular eruptions was 0.8% and 6.8%, respectively. Conclusions. The 10-day treatment schedule was well implemented in the field and was effective. It reduces treatment duration, drug amount, and hospitalization costs per patient, and it increases treatment-center capacity. The shorter protocol has been recommended by the International Scientific Council for Trypanosomiasis Research and Control for the treatment of late-stage HAT caused by Trypanosoma brucei gambiense. [ABSTRACT FROM AUTHOR]
- Published
- 2005