Browsing by Autor "Jimy Pinto"

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2128. Lack of Congenital Transmission in Infants Born of Female Patients with Chagas Disease who Became Pregnant During a Nifurtimox Study (CHICO and CHICO SECURE Study)
(Oxford University Press, 2022) A L T C H E H Jaime; Teresa González Ramírez; Víctor Parra Sierra; Guillermo Moscatelli; Juan Carlos Dib; Jimy Pinto; Lourdes Ortiz; Andrea Falaschi
Abstract Background There is some concern about the safety of nifurtimox (NF) for the offspring of treated women. Potential genotoxicity of NF was reported in in vitro models. However, the evidence to support the risks in fetal development is lacking for humans. In addition, a preventative effect over transplacental transmission was reported in girls and women with T.cruzi infection treated before pregnancy (mainly with benznidazole). Methods A multicenter, randomized, double-blind phase 3 clinical trial (NCT02625974) was set up to evaluate safety and efficacy of NF. A total of 330 patients, younger 18 years old, were enrolled, 67 were females of child-bearing age. The enrolled females of childbearing age agreed to use an effective method of contraception until 3 months after the last administration of NF. Pregnancy tests were performed at screening, during treatment and 30 days after end of treatment. Results No pregnancies were reported during treatment period. There were 5 pregnancies reported during the 1st year of post-treatment follow-up and another 21 pregnancies during the additional 3-year follow-up period. Two mothers did not consent to have their babies tested for T cruzi infection, and in one case an abortion was reported. Two women gave birth twice. There was information about transplacental transmission available in 18 babies. All mothers were T.cruzi RT-PCR negative at the end of the treatment period and remained negative during follow up. All newborns were live, healthy full-term and of weight appropriate for their gestational age, and had no perinatal complications except one baby who was healthy but small for gestational age. T.cruzi infection was ruled out by a negative direct parasitological test during the first days of life in 12 infants , and /or by ELISA T.cruzi serology at 8 -12 months of age in 14 infants, which was negative in all cases. Conclusion Our results showed that treatment of females on childbearing age with nifurtimox may prevent transplacental transmission of CD as was reported previously for benznidazole. Disclosures Jaime ALTCHEH, Sr., MD,PhD, Bayer: Advisor/Consultant.
A Phase 2, Randomized, Multicenter, Placebo-Controlled, Proof-of-Concept Trial of Oral Fexinidazole in Adults With Chronic Indeterminate Chagas Disease
(Oxford University Press, 2022) Faustino Torrico; Joaquím Gascón; Lourdes Ortiz; Jimy Pinto; Gimena Rojas; Alejandro Palacios; Fabiana Barreira; Bethania Blum; Alejandro G. Schijman; Michel Vaillant
NCT02498782.
A strategy for scaling up access to comprehensive care in adults with Chagas disease in endemic countries: The Bolivian Chagas Platform
(Public Library of Science, 2017) María‐Jesús Pinazo; Jimy Pinto; Lourdes Ortiz; Jareth Sánchez; Wilson García; Ruth Saravia; Mirko Rojas Cortez; Silvia Moriana; Enric Grau; Daniel Lozano
This strategy provides a solution to unmet demands in the care of patients with CD, improving access to diagnosis and treatment. Further scaling up of diagnosis and treatment will be based on the expansion of the model of care to the NHS structures. Its sustainability will be ensured as it will build on existing local resources in Bolivia. Still human trained resources are scarce and the high staff turnover in Bolivia is a limitation of the model. Nevertheless, in a preliminary two-years-experience of scaling up this model, this limitations have been locally solved together with the health local authorities.
Clinical use of molecular methods for Trypanosoma cruzi infection in endemic and non-endemic countries: Benefits, limitations and challenges
(Frontiers Media, 2023) María‐Jesús Pinazo; Colin Forsyth; Constanza Lopez-Albízu; Margarita Bisio; Adriana González Martínez; Laura C. Bohórquez; Jimy Pinto; Israel Molina; Andrea Marchiol; Rafael Herazo
Trypanosoma cruzi infection is diagnosed by parasitological, molecular, and serological tests. Molecular methods based on DNA amplification provide a more sensitive alternative to classical parasitological techniques for detecting evidence of T. cruzi parasitemia, and are the preferred tests for congenital and oral transmission cases and parasite reactivation in chronically infected immunosuppressed individuals. In newborns at risk of vertical transmission, simplified diagnostic algorithms that provide timely results can reduce the high follow-up losses observed with current algorithms. Molecular methods have also proved useful for monitoring T. cruzi infection in solid organ transplantation recipients, regardless of host immune status, allowing parasite detection even before symptom manifestation. Furthermore, in the absence of other biomarkers and a practical test of cure, and given the limitations of serological methods, recent clinical guidelines have included polymerase chain reaction (PCR) to detect therapeutic failure after antiparasitic treatment in chronically infected adults. Increasing evidence supports the use of molecular tests in a clinical context, given the improved sensitivity and specificity of current assays - characteristics which largely depend on epidemiological factors and genetic and antigenic variability among T. cruzi strains. Further development and registration of commercial PCR kits will improve the use of molecular tests. We discuss the attributes of PCR and other molecular tests for clinical management in people with T. cruzi infection.
Community-based entomological surveillance in three Chagas disease-endemic regions in sub-Andean Bolivia
(Oxford University Press, 2021) Mirko Rojas Cortez; María‐Jesús Pinazo; Joaquím Gascón; Enzo Gamarra; Rosse Mary Grágeda; R Telmo Fernández; Eduardo Arana‐Rueda; Jimy Pinto; Helmut Magne Anzoleaga; Yurly Escobar Caballero
The report of triatomines foci by inhabitants represents an effective surveillance system coordinated by a network of specialized and multidisciplinary health centers. These strategies, which should be included in the health policies of endemic countries, enable extending and deepening the dialogue among technicians, communities and their local authorities.
Entomological surveillance with community engagement at Chagas Platform Centers for comprehensive care in the mesothermal valleys of three regions of the endemic area of Triatoma infestans in Bolivia
(Research Square (United States), 2019) Mirko Rojas Cortez; María‐Jesús Pinazo; Jimy Pinto; Helmut Magne Anzoleaga; Yurly Escobar Caballero; Gloria Sandy Urioste; Jareth Sánchez; Mario Castellon; Wilson Garcia; Lourdes Ortiz Daza
Abstract Background The detection of residual foci inside the houses, or the reinfestation of triatomines is one of the main entomological surveillance challenges. Actions aimed at increasing the probability of vector detection and to detect re-infestation when the density of vector populations is low, is a priority objective for Chagas control programs. MethodsFamilies belonging to local communities were responsible of triatomine specimens capture, following a strategic methodology based on entomological surveillance with community participation developed by the National Chagas Programme of the Ministry of Health of Bolivia. The main objective of the study is to evaluate the entomological surveillance strategy with community engagement implemented in Chagas Platform Centers for comprehensive care (CPs). The degree of intradomicillary residual vector infestation, the main seasonal period of triatomines capture, and natural infection by trypanosomatids rates were evaluated. Results In rural and peri-urban Punata, in the Department of Cochabamba, the houses infestation rate by triatomines exceeds the national average and is above the recommendations of PAHO / WHO. The observations during the seasons of the year showed that Spring season (September to December) was the period where there was a higher average of T. infestans positive houses detected by the families participating in the study in the three departments of Bolivia. The presence of infected triatomines with Trypanosomatideos in positive houses was 6% in the study area, still finding active domestic cycles in rural and peri-urban areas and not in urban areas where triatomines with parasites were not reported during the seven years of monitoring. Conclusions Reporting infestation foci by the inhabitants is the simplest and most direct way of participation of the community in entomological surveillance. These strategies should be included in the health policies of the countries, as well as extending and deepening the dialogue between technicians, communities and their local authorities.
Five-year serological and clinical evolution of chronic Chagas disease patients in Cochabamba, Bolivia
(Public Library of Science, 2023) Jimy Pinto; Malia Skjefte; Julio Alonso-Padilla; Daniel Franz Lozano Beltrán; Lilian Pinto; Aina Casellas; Mery Elena Arteaga Terrazas; Karen Galindo; Roxana Challapa Quechover; María Escobar Caballero
The study confirms that follow-up of benznidazole-treated T. cruzi-infected patients should be longer than five years to determine, with current tools, if they are cured. In terms of serological evolution, the single use of a total antigen ELISA might be a more reliable measure and suffice to address infection status, at least in the region of Bolivia where the study was done. Additional work is needed to develop a test-of-cure for an early assessment of drugs´ efficacy with the aim of improving case management protocols.
New chemotherapy regimens and biomarkers for Chagas disease: the rationale and design of the TESEO study, an open-label, randomised, prospective, phase-2 clinical trial in the Plurinational State of Bolivia
(BMJ, 2021) Cristina Alonso‐Vega; Julio A. Urbina; Sergi Sanz; María‐Jesús Pinazo; Jimy Pinto; Virginia Gonzalez; Gimena Rojas; Lourdes Ortiz; Wilson García; Daniel Lozano
NCT03981523.
Results and evaluation of the expansion of a model of comprehensive care for Chagas disease within the National Health System: The Bolivian Chagas network
(Public Library of Science, 2022) María‐Jesús Pinazo; Mirko Rojas Cortez; Ruth Saravia; Wilson Garcia-Ruiloba; Carlos Alberto do Nascimento Ramos; Jimy Pinto; Lourdes Ortiz; Mario Castellon; Nilce Mendoza-Claure; Daniel Lozano
After being recognized by the Chagas National Programme as a healthcare model aligned with national laws and priorities, the Bolivian platform of Chagas as an innovation, includes attributes that they have made it possible to expand the strategy at the national level and could also be adapted in other countries.