Author: Sergio Sosa-Estani
Position: Research associate
Institution: Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
E-mail: ssosa@msal.gov.ar
Additional Authors: Jose M. Belizan, Fernando Althabe, Adolfo Rubinstein
Submitted Date: September 13, 2005
Published Date: September 15, 2005
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

We have read about the efforts and initiatives related to the design of drugs for parasitic diseases (1) with interest and expectation. One of the pressing needs in this area is for a neonatal preparation for Chagas disease.

Satisfactory achievements have been made in Argentina in relation to the transmission of the disease by vectors and through blood transfusion. Vertical transmission is now the great challenge, in order to eradicate Chagas disease. Around 800 to 1,300 neonates infected with Trypanosmoma cruzi are born every year in our country (2). Almost 99% of all births occur in hospital, thus allowing the detection of infants born with parasites immediately after birth. The initiation of treatment of these neonates, before they and their mothers leave the hospital, is a good strategy to obtain high treatment coverage. Later attendance of mothers with their children to health care facilities is quite unpredictable and irregular. Also, it is difficult to link information about maternal and neonatal parasitic status obtained at birth with later attendance at other health care facilities.

It would, therefore, be of great value to have a neonatal preparation for the treatment of Chagas disease. There is currently no neonatal or infant preparation available. Instead, one or other of the two commercial adult available preparations (Nifurtimox or Benznidazol) is mashed and diluted at local level in order to be administered to newborns and infants. It is easy to understand the difficulties and uncertainties that these procedures involve.

We hope that, in the agenda of the several initiatives mentioned in this article (1), the development of a neonatal preparation for Chagas disease could be considered. It would benefit many infants every year.

References
1. McKerrow JH (2005) Designing Drugs for Parasitic Diseases of the Developing World. PLoS Med 2(8): e210.
2. Gurtler RE, Segura EL, Cohen JE. Congenital transmission of Trypanososma cruzi infection in Argentina. Emerg Infect Dis, 2003; 9:29-32.