Feasibility, Drug Safety, and Effectiveness of Etiological Treatment Programs for Chagas Disease in Honduras, Guatemala, and Bolivia 10-Year Experience of Médecins Sans Frontières 英文参考文献.docVIP

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Feasibility, Drug Safety, and Effectiveness of Etiological Treatment Programs for Chagas Disease in Honduras, Guatemala, and Bolivia 10-Year Experience of Médecins Sans Frontières 英文参考文献.doc

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Feasibility, Drug Safety, and Effectiveness of Etiological Treatment Programs for Chagas Disease in Honduras, Guatemala, and Bolivia 10-Year Experience of Médecins Sans Frontières 英文参考文献

Feasibility,DrugSafety,andEffectivenessofEtiological TreatmentProgramsforChagasDiseaseinHonduras, Guatemala,andBolivia:10-YearExperienceofMe′decins SansFrontie`res OliverYun1,M.AngelesLima2*,TomEllman3,WilmaChambi3,SandraCastillo3,LaurenceFlevaud2 ,Paul Roddy2,FernandoParren?o2,PedroAlbajarVin?as4,PedroPabloPalma2 1Me′decins SansFrontie`res/DoctorsWithoutBorders,NewYork,NewYork,UnitedStatesofAmerica,2Me′decins SansFrontie`res,OperationalCenterBarcelona-Athens (OCBA),Barcelona,Spain,3Me′decinsSansFrontie`res/Me′dicosSinFronteras,LaPaz,Bolivia,4LaboratoryofParasitologicalDiseases,OswaldoCruzInstitute,FIOCRUZ,Rio deJaneiro,Brazil Abstract Background:Chagasdisease(Americantrypanosomiasis)isazoonoticoranthropozoonoticdiseasecausedbytheparasite Trypanosoma cruzi. Predominantly affecting populations in poor areas of Latin America, medical care for this neglected diseaseisoftenlacking.Me′decins SansFrontie`res/DoctorsWithoutBorders(MSF)hasprovideddiagnosticandtreatment servicesforChagasdiseasesince1999.Thisreportdescribes10yearsoffieldexperienceinfourMSFprogramsinHonduras, Guatemala,andBolivia,focusingonfeasibilityprotocols,safetyofdrugtherapy,andtreatmenteffectiveness. Methodology:From1999to2008,MSFprovidedfreediagnosis,etiologicaltreatment,andfollow-upcareforpatients,18 years of age seropositive for T. cruzi in Yoro, Honduras (1999–2002); Olopa, Guatemala (2003–2006); Entre R?′os, Bolivia (2002–2006); and Sucre, Bolivia (2005–2008). Essential program components guaranteeing feasibility of implementation were information, education, and communication (IEC) at the community and family level; vector control; health staff training; screening and diagnosis; treatment and compliance, including family-based strategies for early detection of adverse events; and logistics. Chagas disease diagnosis was confirmed by testing blood samples using two different diagnostic tests. T. cruzi-positive patients were treated with benznidazole as first-line treatment, with appropriate