Sleeping sickness: towards its elimination by 2030? – Science and the future

Sleeping sickness, this parasitosis carried by the tsetse fly, will it be eradicated before 2030, as originally planned by the World Health Organization? Certainly, in line with the excellent results of a recent study published in The Lancet in Infectious Diseases. This indeed suggests that a single oral dose of acosiborol is as effective as conventional treatments, i.e. a combination of drugs (one of which lasts for two months) and the other must be administered intravenously and requires specialized personnel.

100% of patients with early or intermediate disease are no longer found to have the parasite

Therefore, such a significant simplification of treatment is especially welcome in the face of deadly parasitosis, which continues to rage in some regions of Africa (Congo, Guinea), where about a thousand cases per year are still recorded, but the numbers of which, however, are not known. a common measure with the epidemiology of the 90s, i.e. nearly 300,000 cases. Here, the researchers conducted their work with 208 patients in 10 hospitals in the Democratic Republic of the Congo and Guinea. Of these, 167 suffered from an advanced form of pathology and 41 from an early or intermediate form, and all received the same dose: 960 mg of acosiborol at once.

They were then followed up for 18 months, and the result at the end of this follow-up is impressive: 100% of patients with an early or intermediate form no longer have the parasite, as do 95% of patients with advanced pathology. The results are completely similar to those who received conventional treatment with a combination of two molecules, intravenous eflornithine and nifurtimox taken orally three times a day for two months.

“Extraordinary Progress”

In a commentary related to the study, infectious disease specialist Jacques Pepin (of the University of Sherbrooke in Canada), who was not involved in the study, elaborates that “acosiborol represents an outstanding advance in the treatment of this neglected disease and may be the key to stopping the transmission of sleeping sickness. . The next step, which is already underway, is testing acosiborol in 900 serological patients, i.e. those who have positive serology but negative parasitological tests.”

And the specialist notes the fact that thanks to this work, which received comprehensive funding (the Bill and Melinda Gates Foundation, UK Aid, the Swiss Federal Ministry of Research and Education, the Swiss Agency for Development and Cooperation, Médecins Sans Frontières, etc.), the disease may become the first , which will not be destroyed by a vaccine, but by a medicine. “You can always dream,” the infectious disease specialist concludes, not without humor.

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