references
DISEASES and TREATMENTS
Chagas disease*
• About 5.7 million people infected, mostly across 21 Latin American countries, but also Europe, North America, Japan, and Australia • Less than 1% receive treatment • Trypanosoma cruzi parasite transmitted through the bite of a triatomine vector known as the ‘kissing bug’, but also congenital transmission, blood transfusion, organ transplantation, or ingestion of contaminated food or beverage • Approx. 7,000 deaths per year • Chronic symptomatic disease develops in 10 to 30% of infected patients and most often causes cardiomyopathies and digestive tract pathologies
*American Trypanosomiasis
Human African Trypanosomiasis*
• Number of estimated cases: currently approx. 3,800 • 21 million people at risk • Trypanosoma brucei parasite transmitted through the bite of a tsetse fly • Affects 36 countries in subSaharan Africa, but seven countries report 97% of all cases, with the Democratic Republic of Congo accounting for 87% of them in 2014 • Disease occurs in two stages: stage 1 is often not diagnosed, and the disease passes undetected; stage 2, the neurological stage, is usually deadly without treatment
*HAT; Sleeping sickness
Visceral Leishmaniasis*
• An estimated 200,000 – 400,000 cases occur per year • Fatal without treatment (approx. 48,000 deaths in 2012) • Leishmania parasite transmitted through the bite of a sandfly • Present in over 80 countries across Asia, East Africa, South America, and the Mediterranean region • Children mostly at risk • VL in HIV co-infected patients is an increasing concern (35 countries)
*VL; Kala Azar
Cutaneous Leishmaniasis*
• An estimated 700,0001,300,000 cases per year • Characterized by disfiguring skin lesions; generally not life-threatening but causes disability and leaves permanent scars that can lead to social prejudice • Leishmania parasite transmitted through the bite of a sandfly • Wider geographic range than VL (on 5 continents); 90% of cases are found in Iran, Syria, Saudi Arabia, Afghanistan, Peru, and Brazil
*CL; L. tropica and L. braziliensis forms included in DNDi projects
Current: Only two treatments exist and have specific drawbacks, including tolerability issues Our work: An adapted paediatric dosage form of benznidazole (delivered 2011); clinical testing of new treatments and regimens Our aim: Increase access to benznidazole, and develop a new, effective, and safer oral treatment for both the chronic and acute forms of the disease
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Current: For stage 2, NECT has replaced the older, toxic melarsoprol and the complicated eflornithine monotherapy. For stage 1, two treatments, pentamidine and suramin, exist. All require multiple injections or infusions Our work: NECT, a combination therapy of nifurtimox and eflornithine, developed and implemented with a large network of partners (delivered 2009) - the first new treatment for HAT in over 25 years; clinical testing of two entirely new drugs Our aim: An oral, safe, effective, short-course treatment for both disease stages
Current: Several treatments exist, but most have undesirable side effects, are long and complicated to administer in field conditions, or face problems of drug resistance Our work: For Africa, SSG&PM, a combination therapy of sodium stibogluconate and paromomycin (delivered 2010); for Asia, a set of treatments modalities (2011): both developed and implemented with a large group of partners; early drug discovery and clinical testing of several treatment options Our aim: An oral, safe, effective, low-cost, and short-course (≤11 days) treatment for VL, ideally for PKDL (Post Kala Azar Dermal Leishmaniasis) as well; a new regimen for VL-HIV co-infected patients
Current: Few treatments exist specifically for CL. Many are VL treatments used for CL, and their effectiveness or safety have often not been tested in CL patients Our work: DNDi and partners are developing a topical (applied to skin) treatment Our aim: A new topical or oral, safe, effective, and shorter-course treatment for CL