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Am. J. Trop. Med. Hyg., 71(5), 2004, pp. 594-597
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT: BENZNIDAZOLE EFFICACY AMONG TRYPANOSOMA CRUZI-INFECTED ADOLESCENTS AFTER A SIX-YEAR FOLLOW-UP

ANA LUCIA S. S. ANDRADE, CELINA M. T. MARTELLI, RENATO M. OLIVEIRA, SIMONNE A. SILVA, ANDRÉA I. S. AIRES, LEA M. T. SOUSSUMI, DIMAS T. COVAS, LUIZ S. SILVA, JOÃO G. ANDRADE, LUIZ R. TRAVASSOS, AND IGOR C. ALMEIDA
Institute of Tropical Pathology and Public Health, Department of Community Health, Federal University of Goias, Goiânia, Brazil; Fundação Hemocentro de Ribeirão Preto, Ribeirão Preto, Sao Paulo, Brazil; Discipline of Cell Biology, Federal University of Sao Paulo, Sao Paulo, Brazil; Department of Parasitology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil

 

ABSTRACT

Data from a six-year follow-up of Trypanosoma cruzi-infected adolescents enrolled in a randomized, double-blind, clinical trial of benznidazole showed successful chemotherapy in 64.7% (95% confidence interval [CI] = 50.2–78.7) and 84.7% (95% CI = 66.8–92.9), respectively, by intention-to treat and by per protocol analysis measured by seronegativity in a chemiluminescent enzyme-linked immunosorbent assay with a purified trypomastigote mucin antigen. No incident case of cardiomyopathy was detected by electrocardiogram assessment in this cohort of adolescents who had been infected in childhood. The persistent and consistently long-term negative serologic reactions suggest the absence of the parasite in the treated patients and reinforces the recommendation of early benznidazole chemotherapy for T. cruzi-infected infants as a public health policy in endemic areas.

Received March 27, 2004. Accepted for publication May 13, 2004.

Financial support: This study was supported by Fundação de Amparo a Pesquisa do Estado de São Paulo grant 98/10495-5 to Igor C. Almeida; United Nations/World Bank/World Health Organization-Tropical Disease Research grant 960295 and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Brazil grant 304909/2002-5 to Ana Lucia S. S. Andrade; and CNPq grant 300443/ 97-3 to Celina M. T. Martelli. Ana Lucia S. S. Andrade, Celina M. T. Martelli, Igor C. Almeida, and Luiz R. Travassos are research fellows of CNPq, Brazil.

Authors’ addresses: Ana Lucia S. S. Andrade, Celina M. T. Martelli, Renato M. Oliveira, Simonne A. Silva, Andréa I. S. Aires, and João G. Andrade, Institute of Tropical Pathology and Public Health, Department of Community Health, Federal University of Goias, Rua Delenda R Melo, S/N, Setor Universitário Goiânia, GO 74605-050, Brazil, E-mail: ana{at}iptsp.ufg.br. Lea M. T. Soussumi and Dimas T. Covas, Fundação Hemocentro de Ribeirão Preto, Ribeirão Preto, Sao Paulo 14051-140, Brazil. Luiz S. Silva and Luiz R. Travassos, Discipline of Cell Biology, Federal University of São Paulo, Sao Paulo 04023-062, Brazil. Igor C. Almeida, Department of Parasitology, Institute of Biomedical Sciences, University of Sao Paulo, Avenida Prof. Lineu Prestes, 1374 Sao Paulo, 05508-000, Brazil, Telephone: 55-11-3091-7271, Fax: 55-11-3091-7417, E-mail: ialmeida{at}icb.usp.br or almeidaic{at}yahoo.com.




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