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Research Article

Nifurtimox plus Eflornithine for Late-Stage Sleeping Sickness in Uganda: A Case Series

  • Francesco Checchi,

    Affiliations: Epicentre, Paris, France, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

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  • Patrice Piola,

    Affiliation: Epicentre, Paris, France

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  • Harriet Ayikoru,

    Affiliation: Médecins Sans Frontières, French section, Paris, France

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  • Florence Thomas,

    Affiliation: Epicentre, Paris, France

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  • Dominique Legros,

    Affiliations: Epicentre, Paris, France, Alert and Response Operations, Epidemic and Pandemic Alert and Response, World Health Organization, Geneva, Switzerland

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  • Gerardo Priotto mail

    gerardo.priotto@epicentre.msf.org

    Affiliation: Epicentre, Paris, France

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  • Published: November 07, 2007
  • DOI: 10.1371/journal.pntd.0000064

Reader Comments (2)

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Sleeping sickness status and its trend

Posted by simarro on 10 Jan 2008 at 13:47 GMT

To the Editor

The article published by Francesco Checci et al.: Nifurtimox and Eflornithine for Late-Stage Sleeping Sickness in Uganda: A Case Series, is essential in providing new information on safety and efficacy of the combination of eflornithine and nifurtimox for the treatment of T.b.gambiense second stage patients. The results of this study conducted in Uganda will complement those of the Nifurtimox Eflornithine Clinical Trial (NECT) expected later this year.
However, we do not agree with the statement “As the prospects of HAT elimination from Africa look unrealistic, such research (new molecules for HAT treatment) is greatly needed, and must receive greater attention from researchers, funding agencies, and governments of both rich and HAT-endemic countries.”
The concept or definition of HAT elimination needs clarifications. Currently in 28 out of 36 countries where the disease is endemic, available epidemiological information is compatible with the elimination of the disease as a public health problem. Of course, there is a need to continue surveillance and control activities as the disease is not eradicated. We believe that elimination is not unrealistic. We appreciate the need to advocate for further research on new molecules for HAT treatment in view of the need to integrate the HAT treatment within the national health structures, especially when vertical programmes run by NGOs are withdrawing.

We differ with the authors on their analysis of the current HAT status and its trend. We encourage your readers to refer to the paper we will publish on the next February issue of PloS Medicine