Shortage of benznidazole

The first-line treatment for Chagas disease is benznidazole. Originally thought to be effective only in the early stage of disease, it is now thought to be useful during the chronic asymptomatic phase, given medical supervision. Médecins Sans Frontières details the failure of the Brazilian Ministry of Health that is responsible for this shortage, and gives an update.

As per my earlier post, Chagas Disease and Typhus in Texas, the insect vectors for Chagas now extend north of the border. The cross-border legacy of poverty and neglected tropical diseases is presented in this PLoS article. along with these recommendations for Chagas disease.

Among the recommendations recently suggested for the control of Chagas disease in Texas is the need to make Chagas disease reportable (as it has been in Arizona and Massachusetts [30]), to carry out serological studies of human and canine populations, to monitor the extent of T. cruzi infection in rodents and other wild zoonotic reservoirs, and to undertake widespread testing of blood donors and other at-risk populations [30]. Similar programs of surveillance and transmission dynamics are also required for CL, dengue, and helminth infections [20]. Given the risks of Chagas disease (including congenital Chagas disease) in Mexico and the US, there is an urgent need to educate cardiologists, obstetricians, and other health care providers about the likelihood of this and other neglected infections of poverty [31].

The Instituto Carlos Slim de la Salud in Mexico City is at work on a vaccine, and Schering-Plough is presently recruiting for a phase II clinical trial of posaconazole for the asymptomatic chronic phase of the disease.