The Potential Economic Value of a Chagas Disease Vaccine in Latin America

Author Summary [PLoS - NTDS] The substantial burden of Chagas disease, especially in Latin America, and the limitations of currently available treatment and control strategies have motivated the development of a Trypanosoma cruzi (T. cruzi) vaccine. Evaluating a vaccine's potential economic value early in its development can answer important questions while the vaccine's key characteristics (e.g., vaccine efficacy targets, price points, and target population) can still be altered. This can assist vaccine scientists, manufacturers, policy makers, and other decision makers in the development and implementation of the vaccine. We developed a computational economic model to determine the cost-effectiveness of introducing a T. cruzivaccine in Latin America. Our results showed vaccination to be very cost-effective, in many cases providing both cost savings and health benefits, even at low infection risk and vaccine efficacy. Moreover, our study suggests that a vaccine may actually “pay for itself”, as even a relatively higher priced vaccine will generate net cost savings for a purchaser (e.g., a country's ministry of health). These findings support continued investments in and efforts toward the development of a human T. cruzivaccine.

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Lee BY, Bacon KM, Connor DL, Willig AM, Bailey RR (2010) The Potential Economic Value of aTrypanosoma cruzi (Chagas Disease) Vaccine in Latin America. PLoS Negl Trop Dis 4(12): e916. doi:10.1371/journal.pntd.0000916

Chagas Disease among the Latin American Adult Population Attending in a Primary Care Center in Barcelona, Spain

Introduction [PLoS NTDS] Trypanosoma cruzi (T. cruzi) is a flagellate protozoan that causes Chagas disease (CD). It is traditionally linked to rural areas of continental Latin America, where it is transmitted by a variety of bug vectors. In recent decades, the epidemiological pattern of this disease has undergone considerable changes. In the endemic countries of Latin America, the regional Chagas programs are working to interrupt vector-borne and transfusional transmission, to control congenital Chagas disease and to support initiatives aimed at improving diagnosis, management and surveillance of the disease. In non-endemic countries that receive immigrants from Latin America or send tourists to endemic areas, CD is an emerging disease and has become a public health problem because it can be transmitted by non-vectorial mechanisms.

Spain is a major European host country for people from Latin America. According to the Spanish National Institute of Statistics, in 2009 more than 1.8 million immigrants from Latin America were registered, accounting for 3.85% of the total population. In recent years several studies of CD in non-endemic countries have focused in particular on non-vectorial transmission mechanisms such as pregnancy and childbirth, blood transfusion and organ transplantation. However, when reviewing the literature we found little information on imported CD in non-endemic countries at the primary care level, which is ideal for screening the general population.

The clinical manifestations of chronic T. cruzi infection include the latent form (the indeterminate chronic form), which occurs in 60% of cases, the cardiac form, the digestive or cardiodigestive form, and sudden death. Therefore, many diagnoses of CD are based on epidemiological suspicion rather than clinical signs and symptoms.

The objectives of the present study were to assess the prevalence of Trypanosoma cruzi infection in the adult Latin American population treated at a health center in Barcelona, Spain; to analyze the clinical phase of the disease; and to determine whether screening for imported CD in primary care should be recommended.

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Roca C, Pinazo MJ, López-Chejade P, Bayó J, Posada E, et al. (2011) Chagas Disease among the Latin American Adult Population Attending in a Primary Care Center in Barcelona, Spain. PLoS Negl Trop Dis 5(4): e1135. doi:10.1371/journal.pntd.0001135

Brasil: Enfermedad de Chagas ya casi no afecta niños

[SciDev.net RIO DE JANEIRO] Exámenes de sangre realizados a niños de áreas rurales en los estados de Sao Paulo, Minas Gerais, Goiás y Distrito Federal entre 2001 y 2008 trajeron una buena noticia para la salud pública brasileña. Los resultados de la investigación, publicados en la última edición de la Revista de la Sociedad Brasileña de Medicina Tropical, apuntan a la virtual inexistencia de transmisión de la enfermedad de Chagas por vectores en Brasil en los últimos años.

Las muestras tomadas a 104.954 niños menores de cinco años se analizaron con dos técnicas distintas para detección de la infección.

Las que resultaron positivas se sometieron luego a exámenes más exhaustivos en un laboratorio de referencia de enfermedad de Chagas, incluyendo contramuestras y exámenes a madres y familiares de los niños.

En la evaluación final, se confirmó la enfermedad en 32 niños (0,03 por ciento de la muestra). En 20 de estos casos también resultaron positivas sus madres, lo que sugiere transmisión congénita.

Once pruebas (0,01 por ciento del total) confirmaron la enfermedad sólo en los niños, indicando una probable transmisión vectorial. Estos niños se concentraban en el noreste de Brasil (Piauí, Ceará, Rio Grande do Norte, Paraíba y Alagoas), con más de un caso en el Amazonas y uno en Paraná.

“El principal hallazgo del estudio fue la escasa presencia de infección chagásica en niños de hasta cinco años de edad en toda el área rural brasileña”, dicen los autores.

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Generation of New Drugs for Neglected Tropical Diseases

Sanofi and DNDi - Drugs for Neglected Diseases initiative - Sign an Innovative Agreement to Generate New Drugs for Neglected Tropical Diseases. Sanofi and Drugs for Neglected Diseases initiative announced a three-year research collaboration agreement for the research of new treatments for nine neglected tropical diseases (NTDs), listed by the World Health Organization (WHO) for which new, adapted, and efficient tools are urgently needed to treat patients in endemic countries. This agreement is built upon a history of successful collaboration between Sanofi and DNDi.

In the framework of this agreement, Sanofi will initially bring molecules from its libraries into the partnership, while DNDi and Sanofi collaborate in research activities on innovative molecular scaffolds. The core of the agreement lies in the innovative management of intellectual property generated through the collaboration. The rights to results produced by this partnership will be co- owned by Sanofi and DNDi. The partners will facilitate publication of the results to ensure access to the wider community of researchers focusing on NTDs. The public sector will benefit from the drugs developed through this agreement under the best possible conditions to ease access for patients in all endemic countries, irrespective of their level of economic development.

Neglected Tropical Diseases covered by the agreement

This agreement covers nine neglected tropical diseases (NTDs): kinetoplastid diseases (leishmaniases, Chagas disease, and human African trypanosomiasis), helminth infections (lymphatic filariasis, onchocerciasis, and soil-transmitted helminthiasis), and dracunculiasis, fascioliasis, and schistosomiasis.

[Press Release]

Vacuna contra Chagas seria Altamente rentable

[SciDev.net] Una vacuna contra la enfermedad de Chagas reportaría un sustancial beneficio económico, incluso en escenarios de bajo riesgo de infección y de poca eficacia de la vacuna, al reducir la carga económica que implica tratar la enfermedad. Así lo sugiere un modelo computarizado que ideó un equipo multidisciplinario de la Universidad de Pittsburgh, Estados Unidos, para evaluar desde una perspectiva social el impacto económico de una potencial vacuna contra el Trypanosoma cruzi, parásito causante de la enfermedad.

El modelo, que fue programado para analizar diversos escenarios, arrojó que la vacuna podría “pagarse sola”, ya que incluso si se vende a muy alto precio (US$50), generaría ahorro para el comprador en comparación con el costo promedio del tratamiento.

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