Abstract
Chagas disease, or American trypanosomiasis, is the result of infection by the parasite Trypanosoma cruzi. It is endemic in Latin America, and spreading around the globe due to human migration. Although it was first identified more than a century ago, only two old drugs are available for treatment and a lot of questions related to the disease progression, its pathologies, and not to mention the assessment of treatment efficacy, are subject to debate and remain to be answered. Indeed, the current status of evidence and data available does not allow any absolute statement related to treatment needs and outcome for Chagas patients to be made. Although there has been some new impetus in Research and Development for Chagas disease following recent new clinical trials, there is a scientific requirement to review and challenge the current status of evidence and define basic and clinical research priorities and next steps in the field. This should ensure that the best drugs for Chagas disease are developed, but will require a focused and collaborative effort of the entire Chagas disease research community.
Highlights
Chagas disease (CD), known as American trypanosomiasis [1,2] is an important public health problem in Latin America where it is endemic in 21 countries but it is increasingly spreading in other areas such as Europe, North America, Japan and Australia, mainly due to migration [3,4]
A recent Cochrane systematic review focusing on trypanocidal drugs for chronic asymptomatic T. cruzi infection concluded that despite the evidence that trypanocidal treatment reduced parasite related outcome, the low quality and inconsistency of the data for patient outcomes should be treated with caution [40]
Not enough clinical research is feeding back into drug discovery and the lack of markers of cure or treatment efficacy is a major limitation to current Research and Development (R&D) efforts
Summary
Chagas disease (CD), known as American trypanosomiasis [1,2] is an important public health problem in Latin America where it is endemic in 21 countries but it is increasingly spreading in other areas such as Europe, North America, Japan and Australia, mainly due to migration [3,4]. While there is increasing evidence of their efficacy in the chronic indeterminate stage of the disease, the use of these drugs is limited due to their poor availability and side-effects such as allergic dermatitis, pruritus and gastrointestinal manifestations among others [17,18,19]. These facts highlight an urgent need for improved access to currently available treatments in the short term and a clear need for efficacious and safer drugs for the future
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