Benznidazole and Chagas disease: can an old drug be the answer to an old problem?

BACKGROUND

Chagas disease is a significant public health problem in the Americas, despite efforts to decrease the number of new cases since 1990. Etiologic treatment of the disease's chronic phase is still controversial.

OBJECTIVE

We reviewed the strongest studies to evaluate the drugs used in the acute and chronic disease phases, with emphasis on benznidazole.

METHODS

A Medline search using the keywords 'Chagas disease' and 'treatment,' with no date limitations, was performed.

RESULTS

Study methods in completed trials varied greatly, with none being a randomized, double-blind, placebo-controlled study. The only trial using these methods is still ongoing. The treatment in acute phase is the major indication, but during chronic phase doubts still remain.

CONCLUSION

Only patients in the acute phase of Chagas disease (whatever their age; including children and adolescents) who are treated have good outcomes, although the criteria defining 'cure' remain controversial.