Posts filed under ‘Antiparasitarios’

The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro

 Antiviral Research April 3, 2020

Highlights

  • Ivermectin is an inhibitor of the COVID-19 causative virus (SARS-CoV-2) in vitro.
  • A single treatment able to effect ∼5000-fold reduction in virus at 48h in cell culture.
  • Ivermectin is FDA-approved for parasitic infections, and therefore has a potential for repurposing.
  • Ivermectin is widely available, due to its inclusion on the WHO model list of essential medicines.

Although several clinical trials are now underway to test possible therapies, the worldwide response to the COVID-19 outbreak has been largely limited to monitoring/containment. We report here that Ivermectin, an FDA-approved anti-parasitic previously shown to have broad-spectrum anti-viral activity in vitro, is an inhibitor of the causative virus (SARS-CoV-2), with a single addition to Vero-hSLAM cells 2 hours post infection with SARS-CoV-2 able to effect ∼5000-fold reduction in viral RNA at 48 h. Ivermectin therefore warrants further investigation for possible benefits in humans.

FULL TEXT

https://www.sciencedirect.com/science/article/pii/S0166354220302011

PDF (CLIC en DOWNLOAD PDF)

April 4, 2020 at 9:23 pm

NEWS – Covid-19 – US gives emergency approval to hidroxichloroquine despite lack of evidence

British Medical Journal April 1, 2020 V.369

La FDA (Administración de Alimentos y Medicamentos de EEUU) ha autorizado a los médicos a recetar cloroquina e hidroxicloroquina para pacientes ingresados en el hospital con covid-19, a pesar de las advertencias de los asesores científicos de que no se han realizado ensayos controlados aleatorios para respaldar la seguridad y eficacia de los medicamentos en esta población.

En la autorización de uso de emergencia emitida el 28/marzo/20, la agencia reconoció que la aprobación se basaba en “datos clínicos limitados in vitro y anecdóticos”.

La acción de la FDA siguió a las declaraciones del presidente Trump en una conferencia de prensa la semana pasada de que la hidroxicloroquina mostró “una gran promesa” para los pacientes con covid-19, y agregó: “Creo que va a ser genial”. …..

FULL TEXT

https://www.bmj.com/content/369/bmj.m1335.long

PDF

https://www.bmj.com/content/bmj/369/bmj.m1335.full.pdf

April 4, 2020 at 7:36 pm

Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region

PLOS Neglected Tropical Diseases December 19, 2019

Chagas disease, caused by the parasite Trypanosoma cruzi, is the neglected tropical disease with a highest burden in Latin America.

Its acute stage is mostly asymptomatic and goes unnoticed.

Symptoms appear at the chronic stage, which is when diagnosis is usually made. This is based on the agreement of two conventional serological tests such as Enzyme-Linked Immunosorbent Assays (ELISAs).

There are commercial kits with good sensitivity and specificity but their use is impractical in many highly endemic regions with poorly equipped laboratories.

Luckily, several rapid diagnostic tests (RDTs) are available for the detection of anti-T. cruzi immunoglobulins.

They are easy to operate, require no cold storage, provide fast turnaround of results, and some can work with a tiny volume of whole blood as sample.

With the aim to field validate their use we compared an alternative algorithm based on a combination of RDTs with the standard based on ELISAs.

In both cases a third test was available in case of discordance. RDTs were implemented by mobile teams in field campaigns to detect chronic T. cruzi-infections in the Chaco region of Bolivia.

ELISAs were made in the reference laboratories located in the main hospitals of Yacuiba and Villa Montes, two major cities of the region.

We enrolled 685 subjects who voluntarily participated in the study and had not been treated against the disease before.

The agreement between the two main RDTs was 93.1% (638/685) (kappa index = 0.86; CI 95% 0.83–0.90). In comparison to the ELISAs algorithm, the combined use of the RDTs provided a sensitivity of 97.7% and a specificity of 96.1%.

These results support the use of RDTs for the diagnosis of chronic Chagas disease in the studied region, and encourage their evaluation in other regions of Bolivia and other endemic countries.

FULL TEXT

https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007877#abstract0

PDF

https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0007877&type=printable

January 3, 2020 at 4:05 pm

2018 European Guideline on the organization of a consultation for Sexually Transmitted Infections.

J Eur Acad Dermatol Venereol. August 2019 V.33 N.8 P.1452-1458.

Gamoudi D, Flew S, Cusini M, Benardon S, Poder A, Radcliffe K.

This is an update of the 2012 IUSTI guideline. In this new version, we have expanded the sections on sexual history taking to include PEP and PrEP use, intimate partner and gender‐based violence, chemsex, swinging and psychosexual problems. We highlight the potential for the use of technology in the context of sexual health to facilitate sexual history taking and partner notification. We have explained the principle of safeguarding young and other vulnerable people who may present to services.

This guideline is primarily aimed at services provided in mainstream clinic/office environments, but increasingly many countries are seeing an era of rapid transition of sexual health services in which satellite clinics and online service provision are centre stage. Services are moving away from the main hospitals/clinics into smaller peripheral sites and various non‐traditional or outreach type settings such as saunas, brothels, bars, clubs, educational facilities, prisons and gay pride events. The advantage of such services is that it might allow hard‐to‐reach groups to be engaged with clinical services.1 We need a cohesive, multiagency approach to addressing the challenges associated with this style of service provision, if we are to harness the potential for decentralization of sexual health services while safeguarding the most vulnerable and remaining true to the founding principles of sexual health care.

FULL TEXT

https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.15577

PDF

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jdv.15577

August 14, 2019 at 3:49 pm

Building an innovative Chagas disease program for primary care units, in an urban non- endemic city

BMC Public Healthvolume 19, Article number: 904 (2019

Background

On an absolute basis, Argentina is the country with the largest affected population with Chagas Disease (ChD). This constitutes a significant public health issue. As a consequence of Argentina’s migratory patterns, there has been a significant increase of affected population in urban centers. An innovative project for early diagnosis and timely treatment of ChD was designed for Municipal Primary Care Facilities of La Plata City, a non- endemic area, in line with a proposal from the Pan-American Health Organization. The project was a public –private intervention. The objectives of this study were to demonstrate the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD; to design and implement a tailor made program and to innovate in a public-private association.

Methods

The healthcare barriers for early diagnosis and timely treatment for the population with ChD of La Plata were analyzed. The four dimensions described by Peters et al. (Ann N Y Acad Sci 1136:161–71, 2008) were used. The baseline was measured during a previous pilot project and the same items were evaluated at the end of 2017. The model from Damschroder et al. (Implement Sci 4:50, 2009) was used during the implementation process.

Results

With all the information gathered during this investigation, a “patient-centered” model was designed. During the program, 17,894 people were serologically tested for ChD, 1,394 were positive and 1,035 were treated. Additionally, 3,750 children from 46 public schools were evaluated for risk factors of ChD.

Conclusions

This project showed the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD. Tailor made programs and public-private associations should be considered for vulnerable populations in emerging economies in order to enhance efforts and obtain better results. This program may be replicated in other countries of Latin America were Chagas is a main public health issue and, with the corresponding adaptations, for other neglected diseases as well.

FULL TEXT

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7248-5

PDF

https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-7248-5

July 24, 2019 at 8:15 am

Cryptosporidiosis Outbreaks — United States, 2009–2017

MMWR  June 28, 2019  V.68 N.25 P.568–572

Radhika Gharpure, DVM1,2; Ariana Perez, MPH1,3; Allison D. Miller, MPH1,4; Mary E. Wikswo, MPH5; Rachel Silver, MPH1,3; Michele C. Hlavsa, MPH1

Summary

What is already known about this topic?

Cryptosporidium is the leading cause of outbreaks of diarrhea linked to water and the third leading cause of diarrhea associated with animal contact in the United States.

What is added by this report?

During 2009–2017, 444 cryptosporidiosis outbreaks, resulting in 7,465 cases were reported by 40 states and Puerto Rico. The number of reported outbreaks has increased an average of approximately 13% per year. Leading causes include swallowing contaminated water in pools or water playgrounds, contact with infected cattle, and contact with infected persons in child care settings.

What are the implications for public health practice?

To prevent cryptosporidiosis outbreaks, CDC recommends not swimming or attending child care if ill with diarrhea and recommends hand washing after contact with animals….

FULL TEXT

https://www.cdc.gov/mmwr/volumes/68/wr/mm6825a3.htm#contribAff

PDF

https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6825a3-H.pdf

 

July 1, 2019 at 11:03 am

American trypanosomiasis and Chagas disease – Sexual transmission

International Journal of Infectious Diseases April 2019 V.81 N.4 P.81-84

Clever Gomes, Adriana B. Almeida, Ana C. Rosa, Perla F. Araujo, Antonio R.L. Teixeira

Highlights

  • Trypanosoma cruzi infection can be transmitted sexually from males and females to naïve mates.
  • T. cruzi parasites were detected in semen ejaculates from individuals with Chagas disease by nucleic acid techniques.
  • Semen aliquots from humans with Chagas disease instilled into the vagina of naïve female mice resulted in T. cruzi infections.
  • Breeding T. cruzi-infected male and female mice vertically transmitted the infection to progeny mice.

Objective

To contribute to the discussion on the research findings indicating the sexual transmission of American trypanosomiasis and Chagas disease in humans.

Methods

A review of the literature was performed to investigate the routes of transmission of Trypanosoma cruzi parasites and to evaluate the distribution of Chagas disease, which is now found across five continents.

Results

The epidemiological profile of American trypanosomiasis, which is still considered a neglected disease of the poor people of Latin America, has changed over time. A family-based study demonstrated that the blood protozoan T. cruzi can be transmitted sexually from infected males and females to naïve mates.

Conclusions

Evidence that Chagas disease can be transmitted sexually, coupled with the migration of individuals with Chagas disease to previously non-endemic countries and increased travel to endemic countries, has implications for public health. Improved screening of blood supplies and prenatal care are required to prevent congenital spread.

FULL TEXT

https://www.ijidonline.com/article/S1201-9712(19)30032-3/fulltext

PDF

https://www.ijidonline.com/article/S1201-9712(19)30032-3/pdf

June 30, 2019 at 12:18 pm

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