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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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An Important Paper

Posted by Photini on 07 Dec 2007 at 16:29 GMT

Being the academic editor who handled this paper was a rewarding experience. Like many readers of this journal, I work on diseases that affect the world's poor. Nonetheless, I rarely have the feeling that my work is directly helping those in need. In a small, indirect way, being part of the team that moved this paper into print made me feel like I was part of an effort that is likely to save lives in the near future. Currently there are no safe, effective and easy to administer drugs for the treatment of African Trypanosomiasis, especially after the parasite has entered the central nervous system. In this current paper, which was a follow up to a randomized clinical trial published in PLoS Clinical Trials [1], the authors study the effect of combining two less-than-optimal drugs, eflornithine, an effective but difficult to administer drug that requires intravenous administration over a 14 day period, and nifurtimox, a safe oral drug with limited efficacy when used alone. The sample size is small but the results are impressive. Of the 31 patients in the study, all with stage 2 disease, (i.e. evidence for involvement of the central nervous system), there were no treatment-related deaths and all patients were cured and found to be free of disease on follow-up. Large scale studies investigating the use of eflornithine and nifurtimox are underway and there is no doubt that this combination is likely to save lives in Africa until new drugs come through the pipeline.

[1] Priotto G, Fogg C, Balasegaram M, Erphas O, Louga A, et al. (2006) Three Drug Combinations for Late-Stage Trypanosoma brucei gambiense Sleeping Sickness: A Randomized Clinical Trial in Uganda. PLoS Clin Trials 1: e39.