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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge
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s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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Intensificar o reforço das abordagens de monitorização do tratamento através dos testes da carga viral, assim como o diagnóstico pediátrico precoce, será fundamental para garantir cuidados e tratamentos de boa qualidade e o êxito dos programas. Considerar uma boa rede de diagnósticos, tipos
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de amostras, intervenções e estratégias em cada um dos países e em todas as partes interessadas nacionais, regionais e parceiros contribuirá para apoiar este esforço, melhorar a colaboração e maximizar o investimento nos diagnósticos para um impacto clínico visível.
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L’expansion de la mise en œuvre des approches de suivi du traitement par la réalisation de tests de mesure de la charge virale et de tests de diagnostic chez le nourrisson sera indispensable pour garantir la qualité des soins et des traitements ainsi que le succès des programmes. Le fait de ch
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oisir le réseau de diagnostic, les types d’échantillons ainsi que les interventions et les stratégies les plus appropriés dans chaque pays et pour chaque partenaire au niveau national et régional permettra de soutenir cet effort, de renforcer la collaboration et d’optimiser les investissements réalisés dans la mise en œuvre des tests en vue d’obtenir des effets manifestes.
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Stop TB`s GDF provides a wide range of diagnostic equipment and laboratory supplies in its Diagnostics Catalog
Burmese Language
Guidelines for the Diagnose and Management of Community Pneumonia in Indonesia
Clinical Guidelines for the Diagnose and Management of Nosocomial Pneumonia in Indonesia
Guidelines of Mediastinum Tumor non Lymphoma
Guidelines for the Diagnose and Management of Chronic Obstructive Lung Disease in Indonesia
The portable diagnostic imaging technology covered by this document will serve not only the pressing demands for tuberculosis screening and triage but also other diseases. Therefore, the requirements, accessories, hardware and software packages listed in the following specifications are described in
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detail in order to serve also other pathologies and conditions, like trauma and pneumonia.
Through the definition of "minimum technical requirements", this document is recommended to support decision-making regarding the selection, incorporation, allocation and use of portable X-ray systems and is intended for health care providers, managers of imaging departments, procurement and regulatory agencies, policymakers and planning officers in ministries of health, as well as biomedical engineering professionals, medical physicists, the private health sector, medical device industry and intergovernmental and international agencies.
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Localized cutaneous leishmaniasis and its evolving forms (diffuse cutaneous leishmaniasis, mucosal leishmaniasis and cutaneous leishmaniasis recidivans), together with the sequela of visceral leishmaniasis (post-kala-azar dermal leishmaniasis), account for about one million cases of dermal leishmani
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ases per year worldwide. Although not lethal, the dermal leishmaniases cause chronic, disfiguring skin lesions which are an important cause of morbidity and stigma.
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Case Management; Guide for Tutors
