Chagas disease treatment

The drugs used for T. cruzi include nifurtimox (Lampit) and benznidazole (Rochagan). Oral nifurtimox is available from the CDC, while benznidazole is only available in Brazil. The adult dose of nifurtimox is 8 to 10 mg/kg per day in divided doses for 120 days. Since children seem to tolerate the dose better than adults, the pediatric dose of nifurtimox in children 1 to 10 years old is 15 to 20 mg/kg per day, and the dose for children 11 to 16 years old is 12.5 to 15 mg/kg per day in divided doses. Symptomatic treatment for heart failure associated with Chagas disease should be initiated. The gastrointestinal complications may require surgical revisions and reconstruction. 

Treatment of the acute phase of the disease (i.e., fever, malaise, edema of the face, and hepatosplenomegaly) is nifurtimox. The congestive heart failure associated with cardiomyopathy of Chagas disease is treated the same way as cardiomyopathy from other causes. 

The drugs most frequently used in the treatment of Chagas disease are nifurtimox and benzni-dazole. But both of them have very low antiparasitic activity in the chronic stage of the disease and... 

Benznidazole is an orally administered nitroimidazole that appears to have efficacy similar to that of nifurtimox in the treatment of acute Chagas disease. Availability of the drug is currently limited. Important toxicities include peripheral neuropathy, rash, gastrointestinal symptoms, and myelosuppression. 

Viotti R et al. Long-term cardiac outcomes of treating chronic Chagas disease with benznidazole versus no treatment A nonrandomized trial. Ann Intern Med 2006 144 724. [PMID 16702588]... 

Olea-Azar et al. have also explored the use of 1,2,5-oxadiazole N-oxides in the treatment of Chagas disease. Spectra of radicals were obtained by both electrochemical and microsomal reduction. The calculated electron affinities of the compounds correlated well with the measured reduction potentials, which were... 

Chagas disease prevalent in South and Central America, affecting 16-18 million people in 21 countries. Causes 13,000 deaths per year. Infection is often asymptomatic for years but can eventually cause fatal heart damage. Two drugs are available for treatment, but can have serious and frequent side-effects. Dengue fever more than one-third of the world s population are under threat from this mosquito-borne disease. Responsible tor 21,000 deaths per year. No specific treatment exists. 

Trichomoniasis. Infection by protozoa usually affecting the genitourinary system. Trypanosomiasis. Infection of the blood of man or animals in tropical countries by protozoa transmitted by blood sucking insects. Examples are African sleeping sickness and Chagas disease. Trypanocide a drug for the treatment of trypanosomiasis. Vasomotor relaxation. Relaxation of the walls of blood vessels. 

According to the World Health Organization (WHO), it is estimated that about 10 million people are infected with Chagas in the Americas, 2 million of them in Brazil alone. More than 10,000 die each year as a result. Because Chagas disease affects mainly poor people in developing countries, diagnosis and treatment of this disease have not been well studied (WHO, 2009). 

Ferreira, C. S., Amato Neto, V., Gakiya, E., Bezerra, R. C., and Rodriguez Alarcon, R. S. (2003). Microwave treatment of human milk to prevent transmission of Chagas disease. Rev. Inst. Med. Trop. Sao Paulo 45(1), 41-42. 

Like metronidazole, benznidazole is mutagenic. In tests for chromosomal aberrations and induction of micronuclei in cultures of peripheral lymphocytes from children with Chagas disease, there were increases in micro-nucleated interphase lymphocytes and of chromosomal aberrations after treatment with benznidazole (4). 

Cancado JR. Long term evaluation of etiological treatment of Chagas disease with benznidazole. Rev Inst Med Trop Sao Paulo 2002 44(l) 29-37. 

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