Bioanalysis Zone

A DBS method for quantitation of the new oral trypanocidal drug fexinidazole and its active metabolites

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Sleeping sickness is the common name for human African trypanosomiasis (HAT), which is caused by bites of the tsetse fly, whereby kinetoplastid parasites – the trypanosomes – are injected. Two fly subspecies cause markedly different syndromes in sub-Saharan Africa: in western and central Africa, Trypanosoma brucei (T.b.) gambiense causes a chronic form of sleeping sickness, whereas in eastern and southern Africa, T.b. rhodesiense causes an acute form of the disease, which can lead to death within weeks or months [1,2]. Both forms of HAT evolve in two stages: early stage or stage 1 (hemolymphatic) shows nonspecific symptoms characterized by malaise, headache, fever and peripheral edema, whereas late stage 2 (meningoencephalic) brings neurological symptoms including behavior changes, sleeping rhythm alteration and convulsions, which, if left untreated, often lead to coma and death [3,4]. The number of new HAT cases reported to the WHO dropped to 3000 in 2015 – the lowest level since systematic global data began to be collected 75 years ago [5].

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