named D0870 to be effective against both short- and long-term Chagas’ disease. It is an inhibitor of sterol biosynthesis and as such was identified first as an anti-fungal agent. Inhibitors of sterol biosynthesis also affect T. cruzi, which has similar steroid metabolism to fungi. Earlier in vitro studies showed that D0870 causes the parasite’s natural sterols to be replaced by 14 a-methyl sterols. The new compound is able to cure a large percentage of both acute and chronic T. cruzi infections in miceblocking parasite growth and reproduction and penetrating cells infected by parasites in chronic infections. D0870 has been found to be effective against six different strains of T. cruzi in mice as well as T. brucei (responsible for African trypanosomiasis) in vitro. These results provide a sound basis for further pre-clinical development of D0870 as an anti-T. cruzi compound (toxicology and pharmacokinetics studies). After that, clinical studies using this compound for treating Chagas’ disease may be initiated. But the compound is in its early phases and it will be years before Zeneca Pharmaceutical makes it available for human treatment (TDRnews 1996:4-4).
APPENDIX 14
Baseline Studies in Chuquisaca
Baseline studies were completed in four communities of the Chuquisaca region where Proyecto Britanico Cardenal Maurer was working. Project members surveyed seropositivity to Chagas’ disease, infestation rates and percentage of infected vinchucas, and types of housing. Meeting some resistance, doctors and nurses extracted blood samples from thirty-seven people in the community of Choromomo. Andeans frequently fear that blood lost will not be restored, based on beliefs that they have only a limited supply of blood. Blood and bugs were shipped by air to a laboratory in Cochabamba, where they were analyzed for T. cruzi. Results indicated that 61 percent (403) of the bugs (660) and 32 percent (12) of the blood samples (37) were positive for Chagas’ disease. Significantly, 27 percent (9) were from people between the ages of eight and twenty-six years (CRS-PROCOSI 1990:16).
Additional baseline studies in 1990 gave project workers some idea of infestation rates and conditions of housing for four characteristic communities (see Table 5).
Table 5 BASE STUDY OF TRIATOMINE INFESTATION IN CHUQUISACA (CRS-PROCOSI 1990:8) | Community | Houses Examined | Triatoma Infected Houses | Triatomas Captured | Triatomas with T. cruzi |
| No. | No. | % | No. | No. | % |
| Puente Sucre | 21 | 18 | 86 | 73 | 32 | 44 |
| Choromomo | 32 | 32 | 100 | 120 | 104 | 87 |
| La Mendoza | 66 | 59 | 89 | 215 | 134 | 62 |
| T. Ackachila | 60 | 52 | 87 | 252 | 133 | 53 |
| TOTAL | 179 | 161 | 90 | 660 | 403 | 61 |
Ninety percent of houses in the four communities were infested with vinchucas, of which 61 percent were transmitting the chagasic parasite. Comparing the four communities, when infestation rates increase 10 percent, going from an average of 90 to 100 percent, the percentage of infected triatomines increases at a greater percentage, going from an average of 61 percent to 87 percent, as illustrated in Choromomo.
