New WHO guidelines for treatment of gambiense human African trypanosomiasis including fexinidazole: substantial changes for clinical practice
Lancet infect. dis
; 20(2): [E38-E46], Feb. 01, 2020.
Artigo
em Inglês
| BIGG - guias GRADE
| ID: biblio-1117170
Biblioteca responsável:
BR1.1
ABSTRACT
Human African trypanosomiasis caused by Trypanosoma brucei gambiense is a parasitic infection that usually progresses to coma and death unless treated. WHO has updated its guidelines for the treatment of this infection on the basis of independent literature reviews and using the Grading of Recommendations Assessment, Development and Evaluation methodology. The first-line treatment options, pentamidine and nifurtimoxeflornithine combination therapy, have been expanded to include fexinidazole, an oral monotherapy given a positive opinion from the European Medicines Agency. Fexinidazole is recommended for individuals who are aged 6 years and older with a bodyweight of 20 kg or more, who have first-stage or second-stage gambiense human African trypanosomiasis and a cerebrospinal fluid leucocyte count less than 100 per µL. Nifurtimoxeflornithine combination therapy remains recommended for patients with 100 leucocytes per µL or more. Without clinical suspicion of severe second-stage disease, lumbar puncture can be avoided and fexinidazole can be given. Fexinidazole should only be administered under supervision of trained health staff. Because these recommendations are expected to change clinical practice considerably, health professionals should consult the detailed WHO guidelines. These guidelines will be updated as evidence accrues.
Texto completo:
Disponível
Coleções:
Bases de dados temática
Contexto em Saúde:
Doenças Negligenciadas
Problema de saúde:
Doenças Negligenciadas
/
Tripanossomíase
/
Zoonoses
Base de dados:
BIGG - guias GRADE
Assunto principal:
Pentamidina
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Tripanossomicidas
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Trypanosoma brucei gambiense
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Tripanossomíase Africana
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Eflornitina
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Nifurtimox
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Nitroimidazóis
Tipo de estudo:
Guia de prática clínica
Idioma:
Inglês
Revista:
Lancet infect. dis
Ano de publicação:
2020
Tipo de documento:
Artigo
Instituição/País de afiliação:
American University of Beirut/LB
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Cochrane Response/GB
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Humboldt-Universität zu Berlin/DE
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Hôpitaux Universitaires de Genève/SZ
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Institut de Recherche pour le Développement/FR
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Ministry of Health/UG
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Ministry of Health, Kinshasa/CG
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NOVA University/PT
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Neglected Tropical Diseases Department, World Health Organization/SZ
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University of Glasgow/GB