New drugs for Human African Trypanosomiasis: a twenty first century success story

Dickie, E. A., Giordani, F. , Gould, M. K., Mäser, P., Burri, C., Mottram, J. C. , Rao, S. P.S. and Barrett, M. P. (2020) New drugs for Human African Trypanosomiasis: a twenty first century success story. Tropical Medicine and Infectious Disease, 5(1), 29. (doi: 10.3390/tropicalmed5010029)

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Abstract

The twentieth century ended with human African trypanosomiasis (HAT) epidemics raging across many parts of Africa. Resistance to existing drugs was emerging, and many programs aiming to contain the disease had ground to a halt, given previous success against HAT and the competing priorities associated with other medical crises ravaging the continent. A series of dedicated interventions and the introduction of innovative routes to develop drugs, involving Product Development Partnerships, has led to a dramatic turnaround in the fight against HAT caused by Trypanosoma brucei gambiense. The World Health Organization have been able to optimize the use of existing tools to monitor and intervene in the disease. A promising new oral medication for stage 1 HAT, pafuramidine maleate, ultimately failed due to unforeseen toxicity issues. However, the clinical trials for this compound demonstrated the possibility of conducting such trials in the resource-poor settings of rural Africa. The Drugs for Neglected Disease initiative (DNDi), founded in 2003, has developed the first all oral therapy for both stage 1 and stage 2 HAT in fexinidazole. DNDi has also brought forward another oral therapy, acoziborole, potentially capable of curing both stage 1 and stage 2 disease in a single dosing. In this review article, we describe the remarkable successes in combating HAT through the twenty first century, bringing the prospect of the elimination of this disease into sight.

Item Type:Articles
Keywords:human African trypanosomiasis, sleeping sickness, elimination, chemotherapy, fexinidazole, pafuramidine, acoziborole.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Giordani, Dr Federica and Barrett, Professor Michael and Mottram, Professor Jeremy and Dickie, Dr Emily and Gould, Matthew
Authors: Dickie, E. A., Giordani, F., Gould, M. K., Mäser, P., Burri, C., Mottram, J. C., Rao, S. P.S., and Barrett, M. P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Tropical Medicine and Infectious Disease
Publisher:MDPI
ISSN:2414-6366
ISSN (Online):2414-6366
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Tropical Medicine and Infectious Disease 5(1):29
Publisher Policy:Reproduced under a Creative Commons License

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