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Update on field use of the available drugs for the chemotherapy of human African trypanosomiasis

机译：关于可用于非洲人锥虫病化学疗法的药物的现场使用的最新信息

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Despite the fact that eflornithine was considered as the safer drug to treat human African trypanosomiasis (HAT) and has been freely available since 2001, the difficulties in logistics and cost burden associated with this drug meant that the toxic melarsoprol remained the drug of choice. The World Health Organization responded to the situation by designing a medical kit containing all the materials needed to use eflornithine, and by implementing a training and drugs distribution programme which has allowed a transition to this much safer treatment. The introduction of the combination of nifurtimox and eflornithine (NECT) has accelerated the shift from melarsoprol to the best treatment available, due to reduced dosage and treatment time for eflornithine that has significantly lessened the cost and improved the burden of logistics encountered during treatment and distribution. The decrease in the use of more dangerous but cheaper melarsoprol has meant a rise in the per patient cost of treating HAT. Although NECT is cheaper than eflornithine monotherapy, an unexpected consequence has been a continuing rise in the per patient cost of treating HAT. The ethical decision of shifting to the best available treatment imposes a financial burden on HAT control programmes that might render long-term application unsustainable. These factors call for continuing research to provide new safer and more effective drugs that are simple to administer and cheaper when compared to current drugs.
机译：尽管事实上，氟氯鸟碱被认为是治疗人类非洲锥虫病（HAT）的更安全的药物，并且自2001年以来就可以免费获得，但与该药物相关的物流和成本负担的困难意味着有毒的美拉莫索仍然是首选药物。为了应对这种情况，世界卫生组织设计了一套医疗工具包，其中包含使用氟氯鸟氨酸所需的所有材料，并实施了培训和药物分配计划，该计划已使这种治疗更为安全。硝呋替莫和依氟鸟氨酸（NECT）的组合的引入加速了从美拉索尔到可用的最佳治疗的转变，因为依氟鸟氨酸的剂量和治疗时间减少了，从而大大降低了成本并改善了治疗和分配过程中遇到的物流负担。减少使用更危险但更便宜的美拉索洛意味着减少每位患者治疗HAT的费用。尽管NECT比氟氯鸟嘌呤单一疗法便宜，但出乎意料的结果是每位患者治疗HAT的费用持续增加。转向最佳治疗方法的道德决定对HAT控制程序造成了财务负担，这可能会使长期应用变得不可持续。这些因素要求继续进行研究，以提供与现有药物相比更易于管理且更便宜的新型安全，有效药物。

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