Some of the most wrenching treatment decisions facing clinicians in developing nations involve patients with such neglected tropical diseases as human African trypanosomiasis, often called sleeping sickness. Diagnosis and treatment may include painful lumbar puncture and injections of toxic melarsoprol, an arsenic derivative that causes intense burning sensations and, in about 5% who take it, fatal encephalopathy.
“Doctors and nurses in the field are forced to care for patients with treatments that are largely archaic, toxic, ineffective; some are unaffordable and some are nonexistent,” said Sophie Delaunay, executive director of the US section of the humanitarian medical group Médecins Sans Frontières (MSF; Doctors Without Borders), as she described the challenges of neglected tropical diseases.
Voelker R. Attention Sought for Neglected Diseases. JAMA. 2009;301(17):1755–1756. doi:10.1001/jama.2009.563
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