Chagas Disease: Comparison of Therapy with Nifurtimox and Benznidazole in Indigenous Communities in Colombia.

: For indigenous people in Colombia, high infection rates with Chagas disease (CD) are known. : In 2018 and 2020, nine villages were screened for CD. CD-positive patients could enter a drug observed treatment. While, in 2018, Benznidazole (BNZ) was provided as the first-line drug by the government, nifurtimox (NFX) was administered in 2020. : Of 121 individuals treated with BNZ, 79 (65%) suffered from at least one adverse event (AE). Of 115 treated with NFX, at least one AE occurred in 96 (84%) patients. In 69% of BNZ cases, the side effects did not last longer than one day; this applied to 31% of NFX cases. Excluding extreme outlier values, average duration of AEs differed highly significantly: BNZ ( = 0.7, = 1.4) and NFX ( = 1.7, = 1.5, < 0.001). Using an intensity scale, AEs were highly significantly more severe for NFX ( = 2.1, = 0.58) compared to BZN ( = 1.1, = 0.38), < 0.001. When analyzing the duration in relation to the intensity, the burden of AEs caused by NFX was significantly more pronounced. Dropouts ( = 2) due to AEs were in the NFX-group only. : Side effects caused by BNZ were significantly fewer, as well as milder, shorter in duration, and more easily treatable, compared to NFX.

PMID: 38731093