Sleeping sickness, therapy

Both male and female tsetse live solely on vertebrate blood, and the various species that carry sleeping sickness typically feed not only on humans but also on both domestic and wild animals. Infected flies pass on trypanosomes whenever they take a blood meal, so that the parasites not only move between flies and humans, but also infect a number of other hosts. Infected domestic animals develop nagana, but wild animals may show no sign of illness. They serve instead as healthy animal reservoirs of trypanosomes, permitting tsetse flies to pick up the parasites at any time without necessarily feeding on infected humans or domestic animals. For this reason and also because available drug therapies have proved no more practical here than for leishmaniasis, control of trypanosomiasis has long emphasized eradication of tsetse flies. 

Bisser S et al Equivalence trial of melarsoprol and nifurtimox monotherapy and combination therapy for the treatment of second-stage Trypanosoma brucei gambiense sleeping sickness. J Infect Dis 2007 195 322. [PMID 17205469]... 

Priotto G et al Nifurtimox-eflornithine combination therapy for second-stage Trypanosoma brucei gambiense sleeping sickness A randomized clinical trial in Congo. Clin Infect Dis 2007 45 1435. [PMID 17990225]... 

First introduced as a therapy for trypanosomiasis in 1937, pentamidine is now used in a variety of protozoal and fungal infections and, as such, finds use in the treatment of trypanosomiasis, leishmaniasis, and pneumocystis (PCP). The drug is primarily used for treatment of PCP. When used for trypanosomiasis, pentamidine is only effective against Trypanosoma brucei rhodesiense (east African sleeping sickness) and, even then, only during the early stage of the disease, because the drug does not readily cross the blood-brain barrier. 

Heby O, Persson L, Rentala M (2007) Targeting the polyamine biosynthetic enzymes a promising approach to therapy of African sleeping sickness, Chagas disease, and leishmaniasis. Amino Acids 33(2) 359-366... 

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