title: Treatment and seroconversion in a cohort of children suffering from recent chronic Chagas infection in Yoro, Honduras.
abstract: Between 1999-2002, Médécins Sans Frontières-Spain implemented a project seeking to determine the efficacy and safety of benznidazole in the treatment of recent chronic Chagas disease in a cohort of seropositive children in the Yoro Department, Honduras. A total of 24,471 children were screened for Trypanosoma cruzi IgG antibodies through conventional enzyme-linked immunosorbent assays (ELISA) on filter paper. Recombinant ELISA (0.93% seroprevalence) showed 256 initially reactive cases, including 232 confirmed positive cases. Of these, 231 individuals were treated with benznidazole (7.5 mg/kg/day) for 60 days and were followed with a strict weekly medical control and follow-up protocol. At the end of the project, 229 patients were examined by the Honduras Secretariat of Health for post-treatment serological assessments; 88.2% seroconverted after 18 months and 93.9% seroconverted after three years. No differences were found in the seroconversion rates according to age or sex. Most of the side effects of the treatment were minor. These results support the argument that in areas where T. cruzi I is predominant and in areas affected by T. cruzi II, when vector transmission has been interrupted, Chagas disease diagnosis and treatment are feasible, necessary and ethically indisputable.
authors.affiliation: Médécins Sans Frontières-Spain, Barcelona, Spain. 22766jej@comb.cat
authors.forename: Josep M
authors.initials: JM
authors.lastname: Escribà
authors.forename: Elisa
authors.initials: E
authors.lastname: Ponce
authors.forename: Alberto de Dios
authors.initials: Ade D
authors.lastname: Romero
authors.forename: Pedro Albajar
authors.initials: PA
authors.lastname: Viñas
authors.forename: Andrea
authors.initials: A
authors.lastname: Marchiol
authors.forename: Glòria
authors.initials: G
authors.lastname: Bassets
authors.forename: Pedro Pablo
authors.initials: PP
authors.lastname: Palma
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Lima
authors.forename: Concepción
authors.initials: C
authors.lastname: Zúniga
authors.forename: Carlos
authors.initials: C
authors.lastname: Ponce
mesh_terms: D017677:Age Distribution; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D014355:Chagas Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004812:Epidemiologic Methods; D005260:Female; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D007300:Insect Control; D008297:Male; D009593:Nitroimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014344:Trypanocidal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014349:Trypanosoma cruzi / Q000276:immunology
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G; D009593:Nitroimidazoles; D014344:Trypanocidal Agents; C009999:benzonidazole