The phenomenon of treatment failures in Human African Trypanosomiasis

  title={The phenomenon of treatment failures in Human African Trypanosomiasis},
  author={Reto Brun and Reto Schumacher and C{\'e}cile Schmid and Christina Kunz and Christian Burri},
  journal={Tropical Medicine \& International Health},
Treatment of Human African Trypanosomiasis (HAT or sleeping sickness) relies on a few drugs which are old, toxic and expensive. The most important drug for the treatment of second stage infection is melarsoprol. During the last 50 years treatment failures with melarsoprol were not a major problem in Trypanosoma brucei gambiense patients. Commonly a relapse rate of 5–8% was reported, but in recent years it has increased dramatically in some important foci of T. b. gambiense sleeping sickness… 

Drug resistance in human African trypanosomiasis.

The possibility that parasites resistant to melarsoprol on the one hand, and eflornithine on the other, are present in the field indicates that genes capable of conferring drug resistance to both drugs are in circulation.

Isolation, propagation and characterization of "Trypanosoma brucei gambiense" from human African trypanosomosis patients in south Sudan

The objective of this PhD study was to isolate and characterize (phenotypically and genotypically) T. gambiense from HAT patients and find that, the cryopreservation of T. gamblingense in this medium led to a better survival of the trypanosomes than in the standard 10% glycerol.

Population genetics of Trypanosoma brucei gambiense in sleeping sickness patients with treatment failures in the focus of Mbuji-Mayi, Democratic Republic of the Congo.

  • P. PyanaM. Séré V. Jamonneau
  • Biology, Medicine
    Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases
  • 2015

Isolation of Trypanosoma brucei gambiense from Cured and Relapsed Sleeping Sickness Patients and Adaptation to Laboratory Mice

A unique collection of T.b. gambiense from cured and relapsed patients, isolated in the same disease focus and within a limited period is established to investigate the mechanism behind abnormally high treatment failure rates in Mbuji-Mayi, D.R. Congo.

Recent developments in human African trypanosomiasis

This molecular tool has shown that the Rhodesian form of the disease is being carried in cattle northwards in Uganda towards areas endemic for the Gambian form, which will present problems for both control and treatment.

Drug Resistance in African Trypanosomiasis

The current drugs against African trypanosomes are reviewed, the mechanisms of drug resistance are discussed, and key issues for the control oftrypanosomiasis in face of the limited options for chemotherapy are addressed.

Human African trypanosomiasis

Investment in clinical and pathophysiological research and a broad international commitment to fight trypanosomiasis in Africa are urgently needed.

Novel Treatment of African Trypanosomiasis

Different series of lead compounds that can be used for the development of drugs to treat HAT are described, which indicate that preferential testis tropism must be considered during drug development, since parasites might be protected from many drugs by the blood-testis barrier.

Human African Trypanosomiasis: a Reemerging Public Health Threat

Human African trypanosomiasis has dramatically reemerged as a serious public health problem in the central African region and huge challenges occur in implementing previously successful strategies to regain control of the disease, in view of the weak or absent health systems in some of the most affected areas.

Human African Trypanosomiasis

The distribution of sleeping sickness nowadays parallels that of wars that have recently devastated parts of Africa, with the highest incidences occurring in the Democratic Republic of Congo, Angola, and Sudan, and the highest incidence is seen in DRC, where 20–25,000 cases are reported annually.



Drug resistance in pathogenic African trypanosomes: what hopes for the future?

Risk factors for treatment failure after melarsoprol for Trypanosoma brucei gambiense trypanosomiasis in Uganda.

Susceptibility of Ugandan Trypanosoma brucei rhodesiense isolated from man and animal reservoirs to diminazene, isometamidium and melarsoprol

Control of sleeping sickness by treatment of the animal reservoir could, therefore, face serious problems since drug‐resistant stocks as reported here would most likely not be eliminated by recommended doses of diminazene and isometamidium.

Susceptibility of severe combined immuno‐deficient (SCID) mice to Trypanosoma brucei gambiense and T. b. rhodesiense

The results demonstrate that the SCID mice, in which functional B‐ and T‐cell‐mediated immunities are congenitally lacking, are highly susceptible for ‘low‐virulence’, which makesSCID mice useful tools for the isolation of parasites from T. b.

Drug resistance in Sudanese Trypanosoma evansi.

Innate lack of susceptibility of Ugandan Trypanosoma brucei rhodesiense to DL-alpha-difluoromethylornithine (DFMO).

  • M. ItenE. MatovuR. BrunR. Kaminsky
  • Biology
    Tropical medicine and parasitology : official organ of Deutsche Tropenmedizinische Gesellschaft and of Deutsche Gesellschaft fur Technische Zusammenarbeit
  • 1995
DFMO is not an appropriate alternative or backup drug for treatment of Rhodesian sleeping sickness in Uganda because T. b.

Trypanosoma brucei brucei: expression of drug resistance in vitro.

In vitro assays to determine drug sensitivities of African trypanosomes: a review.