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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Safety and Efficacy of the 10-Day Melarsoprol Schedule for the Treatment of Second Stage Rhodesiense Sleeping Sickness
PLoS Neglected Tropical Diseases, Volume 6, No. 8, Article e1695, Year 2012
Notification
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Description
Objective: Assessment of the safety and efficacy of a 10-day melarsoprol schedule in second stage T.b. rhodesiense patients and the effect of suramin-pretreatment on the incidence of encephalopathic syndrome (ES) during melarsoprol therapy. Design: Sequential conduct of a proof-of-concept trial (n = 60) and a utilization study (n = 78) using historic controls as comparator. Setting: Two trial centres in the T.b. rhodesiense endemic regions of Tanzania and Uganda. Participants: Consenting patients with confirmed second stage disease and a minimum age of 6 years were eligible for participation. Unconscious and pregnant patients were excluded. Main Outcome Measures: The primary outcome measures were safety and efficacy at end of treatment. The secondary outcome measure was efficacy during follow-up after 3, 6 and 12 months. Results: The incidence of ES in the trial population was 11.2% (CI 5-17%) and 13% (CI 9-17%) in the historic data. The respective case fatality rates were 8.4% (CI 3-13.8%) and 9.3% (CI 6-12.6%). All patients discharged alive were free of parasites at end of treatment. Twelve months after discharge, 96% of patients were clinically cured. The mean hospitalization time was reduced from 29 to 13 days (p<0.0001) per patient. Conclusions: The 10-day melarsoprol schedule does not expose patients to a higher risk of ES or death than does treatment according to national schedules in current use. The efficacy of the 10-day melarsoprol schedule was highly satisfactory. No benefit could be attributed to the suramin pre-treatment. Trial Registration: Current Controlled Trials ISRCTN40537886. © 2012 Kuepfer et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3435133/bin/pntd.0001695.s001.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3435133/bin/pntd.0001695.s002.pdf
Authors & Co-Authors
Kuepfer, Irene
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Schmid, Caecilia
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Allan, Mpairwe
Uganda
Lwala Hospital
Edielu, Andrew
Uganda
Lwala Hospital
Haary, Emma P.
Tanzania
Kaliua Health Centre
Kakembo, A.
Uganda, Kampala
Uganda Ministry of Health
Kibona, Stafford N.
Tanzania, Tanga
National Institute for Medical Research Tanga
Blum, Johannes A.
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Burri, Christian
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Statistics
Citations: 54
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pntd.0001695
ISSN:
19352727
e-ISSN:
19352735
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Tanzania
Uganda