references
IMPLEMENTATION
CHAGAS DISEASE VISCERAL LEISHMANIASIS PAEDIATRIC HIV
First paediatric drug (2011)
Despite recommendations to treat children with Chagas disease, benznidazole, the main drug of choice for treating Chagas, was only available in an adult tablet strength. Infants and kids were treated with fractioned or macerated tablets, which complicated administration and made dosing imprecise. DNDi’s partnership with Brazilian public laboratory Lafepe enabled the development of the first age-adapted, easy-to-use paediatric dosage form of benznidazole for the treatment of children with Chagas disease.
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Adoption of new treatments in South Asia (2011)
Existing treatment options for VL in South Asia caused severe side effects and were growing ineffective due to resistance. Research was needed to assess the safety and efficacy of and patient compliance to various new treatment options. DNDi convened a consortium of partners to identify the best combination therapies for South Asia. The results spurred the Indian, Bangladeshi, and Nepali Ministries of Health to select, adopt, and implement the best management strategies to support control and elimination of Kala Azar.
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More effective HIV treatment for children that also have TB (2016)
Among the many challenges of treating children co-infected with both tuberculosis (TB) and HIV is the fact that a key TB drug negates the effectiveness of ritonavir, one of the main antiretrovirals to treat HIV. A DNDisponsored study at five hospitals in South Africa demonstrated the safety and effectiveness of ‘super-boosting’ or adding extra ritonavir to a child’s treatment regimen. WHO has since strengthened recommendations to use super-boosting in TB/HIV co-infected children.
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Age-adapted, easy-to-use, and affordable treatment, with an easily dispersible tablet for children under 2 years of age Registered in Brazil Included on WHO Essential Medicines List
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Main partners: BRAZIL: LAFEPE; ARGENTINA: Fundación Mundo Sano and ELEA; Centro Nacional de Diagnóstico e Investigación de Endemo-epidemias, Administración Nacional de Laboratorios e Institutos de Salud; Centro de Chagas y Patologia Regional, Hospital Independencia, Santiago del Estero; Hospital de Niños de Jujuy; Hospital de Niños Dr. Ricardo Gutiérrez; Hospital Público Materno Infantil – Salta; Instituto Nacional de Parasitología Dr M Fatala Chabén; Ministry of Health; Ministério de Salud, Província de Jujuy
implementation and registration of paediatric benznidazole and aims to secure a second source with the Mundo Sano Foundation.
Ongoing activities: DNDi continues to support
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Large four-arm implementation study with health authorities at national, state, and local levels Helped shape the recommendations of the WHO Expert Committee on the Control of Leishmaniases Helped shape the Indian National Roadmap for Kala Azar Elimination recommendations
Supported by interim results from study, ‘super-boosting’ ritonavir was recommended by WHO in its antiretroviral guidelines in 2016
Ongoing activities: DNDi continues to conduct follow-up studies to accompany the implementation of new treatment options for VL in South Asia.
Ongoing activities: DNDi continues to support implementation of and access to stand-alone ritonavir, to be added to protease inhibitor regimens for the treatment of children co-infected with TB and HIV. Main partners: SOUTH AFRICA: Department of Health and
Department of Science and Technology; Stellenbosch University and Tygerberg Children’s Hospital; Perinatal HIV Research Unit, University of Witswatersrand; Shandukani Research Centre, Wits Reproductive Health and HIV Institute; Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital; Enhancing Care Foundation; Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
Main partners: INDIA: Indian Council of Medical Research;
