{ "schema_version": 1, "kind": "condition", "id": "chagas-disease", "name": "Chagas Disease (American Trypanosomiasis)", "category": "chronic", "sources": "Chagas Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK459272/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AD24.01 - condition scope only, no dose · Egyptian drug register - availability only, no dose", "review_status": "reviewed", "verified_against": "Chagas Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK459272/, Treatment / Management (benznidazole 5-10 mg/kg/day divided q12h for 30-60 days; nifurtimox 8-10 mg/kg/day in 3 doses for 60-120 days) · Egyptian drug register (neither benznidazole nor nifurtimox is marketed)", "verified_date": "2026-09", "treatments": [ { "id": 406, "generic": "Benznidazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "5 to 10 mg/kg/day divided every 12 hours for 30 to 60 days. NOT MARKETED IN EGYPT - obtained through a tropical medicine centre", "adult_duration": "30-60 days", "dose_source": "Chagas Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK459272/, Treatment / Management - verbatim: \"Benznidazole was approved by the Food and Drug Administration (FDA) in 2017 with a recommended dosage of 5 to 10 mg/kg/day divided every 12 hours for 30 to 60 days.\" Availability from the Egyptian drug register", "rationale": "Antitrypanosomal. There are only two drugs for this infection and neither is clearly better: the article, citing the Pan American Health Organization guideline, records that \"evidence to suggest which medication should be used as the first-line option is lacking; however, in the United States, benznidazole is used more often due to availability.\" Benznidazole leads here for the same reason - it is the one that is FDA-approved and can be obtained, whereas nifurtimox cannot.", "cautions": [ "NOT MARKETED IN EGYPT. Neither benznidazole nor nifurtimox has any entry in the national drug register, so treatment cannot be started from a Cairo prescription. A suspected case is referred to a tropical medicine centre, which is also where the drug is sourced. The dose is printed here so the referring physician knows what is being arranged.", "RED FLAG - Two adverse effects are a reason to stop the drug at once, not to reduce it. The article: \"A common adverse effect is dermatitis; more serious adverse effects include myelosuppression and peripheral neuropathy\" and \"The presence of myelosuppression or neuropathy is an indication to discontinue treatment immediately.\" That means a blood count and a neurological enquiry at every review during a course this long.", "The course is long and completion matters. Thirty to sixty days of twice-daily treatment with a drug that commonly causes a rash is hard to finish; the rash is the usual reason people stop. Warn about it in advance and review early.", "Not a Cairo diagnosis without a travel history. The triatomine ('kissing') bug that transmits it lives only in the Americas, so this is relevant to someone who lived in or travelled extensively through Latin America. Consider the travel history before anything else." ], "peds_mgkg_low": 5.0, "peds_mgkg_high": 10.0, "peds_max_mg": null, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Divided every 12 hours, for 30 to 60 days. The article gives one weight-based regimen and says only that \"Pediatric dosing also includes a 60-day weight-based regimen\" without stating separate figures, so the same mg/kg/day range is shown here and no different paediatric number is invented. Treatment is most effective in children and in acute infection, which is why a child is the patient most likely to be treated.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 50, "high_mg": 100, "capped": false }, { "weight_kg": 20, "low_mg": 100, "high_mg": 200, "capped": false }, { "weight_kg": 30, "low_mg": 150, "high_mg": 300, "capped": false }, { "weight_kg": 40, "low_mg": 200, "high_mg": 400, "capped": false } ], "brands": [], "condition_id": "chagas-disease" }, { "id": 407, "generic": "Recognition, travel history and referral (Referral & Advice)", "line": 2, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Chronic protozoal infection spread by triatomine ('kissing') bugs found only in the Americas. Not a Cairo diagnosis except in someone who lived in or travelled extensively through Latin America; the specific drugs (benznidazole, nifurtimox) are not marketed in Egypt, so any suspected case needs referral to a tropical medicine centre.", "adult_duration": "Refer", "dose_source": "No dose - the recognition and referral pathway, from Chagas Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK459272/, Treatment / Management", "rationale": "Chronic protozoal infection spread by triatomine ('kissing') bugs found only in the Americas. Not a Cairo diagnosis except in someone who lived in or travelled extensively through Latin America; the specific drugs (benznidazole, nifurtimox) are not marketed in Egypt, so any suspected case needs referral to a tropical medicine centre.", "cautions": [ "Not endemic in Egypt. Relevant to a returning traveller or an imported case; consider the travel history before anything else. The drug row above carries the dose that the receiving centre will use.", "RED FLAG - An acute febrile illness with periorbital swelling (Romana's sign) after a relevant exposure, or unexplained cardiomyopathy, megacolon or megaoesophagus in someone from an endemic area. The chronic complications are what usually bring the patient in, years later.", "Treatment is decided by a tropical medicine service, not started here - but the diagnosis is missed in primary care, which is where it matters. Both drugs work best in acute infection and in children, so recognising it early changes the outcome." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "chagas-disease" } ] }