What's new for 'Trypanosomatids' in PubMed

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Sent on Friday, 2011 May 13
Search kinetoplastids OR kinetoplastid OR Kinetoplastida OR "trypanosoma brucei" OR leishmania OR brucei OR leishmaniasis OR "African trypanosomiasis"
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1.	Lancet. 2011 May 9. [Epub ahead of print] Successes and failures in the control of infectious diseases in Brazil: social and environmental context, policies, interventions, and research needs. Barreto ML, Teixeira MG, Bastos FI, Ximenes RA, Barata RB, Rodrigues LC. Source Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil. Abstract Despite pronounced reductions in the number of deaths due to infectious diseases over the past six decades, infectious diseases are still a public health problem in Brazil. In this report, we discuss the major successes and failures in the control of infectious diseases in Brazil, and identify research needs and policies to further improve control or interrupt transmission. Control of diseases such as cholera, Chagas disease, and those preventable by vaccination has been successful through efficient public policies and concerted efforts from different levels of government and civil society. For these diseases, policies dealt with key determinants (eg, the quality of water and basic sanitation, vector control), provided access to preventive resources (such as vaccines), and successfully integrated health policies with broader social policies. Diseases for which control has failed (such as dengue fever and visceral leishmaniasis) are vector-borne diseases with changing epidemiological profiles and major difficulties in treatment (in the case of dengue fever, no treatment is available). Diseases for which control has been partly successful have complex transmission patterns related to adverse environmental, social, economic, or unknown determinants; are sometimes transmitted by insect vectors that are difficult to control; and are mostly chronic diseases with long infectious periods that require lengthy periods of treatment. Copyright © 2011 Elsevier Ltd. All rights reserved.
	PMID: 21561657 [PubMed - as supplied by publisher]
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2.	Br J Dermatol. 2011 May 11. doi: 10.1111/j.1365-2133.2011.10402.x. [Epub ahead of print] Title: Miltefosine as an effective choice in the treatment of Post-kala-azar Dermal Leishmaniasis. Ramesh V, Katara GK, Verma S, Salotra P. Source Department of Dermatology, Safdarjung Hospital Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi-110029, India. Abstract BACKGROUND: Post kala-azar dermal leishmaniasis (PKDL) constitutes a parasite reservoir important in transmission of visceral leishmaniasis (VL). Unacceptable treatment regimens and increasing drug resistance blight control programs. The success of oral miltefosine in VL prompted a clinical, histopathological and parasitological study of this drug in PKDL. METHODS: Twenty-six patients confirmed by slit-skin smear, histopathology and molecular tests were inducted in the study. They were advised miltefosine capsules 50 mg thrice daily after food. Treatment was for 60 days with a provision to increase by 30 days if a responder had not attained cure. Cure was ascertained by clinical and histopathological examination, and measuring parasite burden using real time PCR. RESULTS: Twenty-four patients having a wide range of parasite burden completed the study. Twenty three achieved cure giving an initial cure rate of 95.8% (efficacy as 79 to 99 at 95% confidence interval). Sixteen patients were cured with 50 mg thrice daily, 13 in 60 days and 3 within 90 days. In 7 cases, miltefosine had to be reduced to 50 mg twice daily due to gastrointestinal intolerance to a total of 180 capsules. Lesional parasites were undetectable at one month post-treatment. Treatment was safe with no relapses at 1 year of follow up. CONCLUSION: Oral miltefosine, 50 mg thrice daily for 60 days or twice daily for 90 days could be an effective treatment for PKDL. Copyright © 2011 British Association of Dermatologists.
	PMID: 21561437 [PubMed - as supplied by publisher]
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3.	J Infect Dev Ctries. 2010 Nov 24;4(11):682-8. History, current issues and future of the brazilian network for attending and studying Trypanosoma cruzi/HIV coinfection. Ramos Júnior AN, Correia D, Almeida EA, Shikanai-Yasuda MA. Source Department of Community Health, Faculty of Medicine, Federal University of Ceará, Ceará, Brazil. novaes@ufc.br Abstract INTRODUCTION: In countries with endemic Chagas disease, coinfection involving Trypanosoma cruzi and HIV is expected to become more frequent. There is a clear need to structure a comprehensive care network aimed at dealing with this situation, with mobilization going from primary care to care at the highest level of technological complexity. The objective of this study was to describe the Brazilian response to the challenges of Chagas disease: the history, current issues, and future of the Brazilian Network for attending and studying T. cruzi/HIV coinfection. METHODOLOGY: This descriptive study reviewed technical documents relating to the basis and structuring process of the Brazilian network for attending and studying T. cruzi/HIV coinfection. RESULTS: The process of setting up the network was marked by technical and political debates in technical-scientific meetings going back to the 1990s. This process made it possible to expand and focus on different aspects of comprehensive care for Chagas disease in Brazil, regardless of the associated immunosuppressive conditions. These meetings produced a structure of national technical guidelines and standards, health care and research protocols and research priorities, along with mobilization and awareness-raising among HIV/AIDS reference centers regarding occurrences of coinfection. CONCLUSIONS: The creation of the Brazilian network was a milestone for the country in terms of integration of control programs, with the reference point of quality of care and comprehensiveness. The possibility of extending this network to form a Latin American network is seen as a strategy for dealing more effectively with this condition. Free Article
	PMID: 21252444 [PubMed - indexed for MEDLINE]
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