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Many treatments are used every day in general medicine without any evidence of their efficacy. This last year, three randomised studies tried to prove the clinical utility of chondroitin/glucosamine in arthritis, cranberry in urinary infections, and acupuncture in migraine. Screening and management of prostate cancer are still controversial. Two recent studies help us advising our patients on this difficult topic. Muscle side effects from statins are well known and have been widely relayed by the press these last years, although myopathies are rare in clinical trials. A new study try to determine if negative expectations could favor such adverse events., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

People living with HIV (PLHIV) frequently travel, including to the tropics, with a variable risk of infection by one of the species of Plasmodium, the hemoprotozoan parasite responsible for malaria. The HIV-malaria co-infection increases the risk of severe malaria, in proportion to the degree of immunosuppression. Protective measures against mosquito bites and antimalarial drug prophylaxis are recommended for PLHIV travelling to malaria highly endemic areas. PLHIV, as compared to the general population, are less likely to attend a pre-travel consultation prior to departure. Among returning travelers with malaria, early diagnosis and artemisinin-based treatments are the main determinants of successful treatment outcome.

Background: Existing diagnostic and treatment tools for human African trypanosomiasis (HAT) are limited. The recent development of nifurtimox-eflornithine combination therapy (NECT) has brought new hopes for patients in the second stage. While NECT has been rolled out in most endemic countries, safety data are scarce and derive only from clinical trials. The World Health Organization (WHO) coordinates a pharmacovigilance program to collect additional data on NECT safety and efficacy. We report here the results of 18 months of experience of NECT use in treatment centers run by Médecins Sans Frontières in the Democratic Republic of the Congo (DRC)., Methods: This cohort study included 684 second-stage HAT patients (including 120 children) treated with NECT in Doruma and Dingila hospitals, northeastern DRC, between January 2010 and June 2011. All treatment-emergent adverse events (AEs) were recorded and graded according to the Common Terminology Criteria for Adverse Events version 3.0. Safety and efficacy data were retrieved from the WHO pharmacovigilance forms and from Epitryps, a program monitoring database., Results: Eighty-six percent of the patients experienced at least 1 AE during treatment. On average, children experienced fewer AEs than adults. Most AEs were mild (37.9%) or moderate (54.7%). Severe AEs included vomiting (n = 32), dizziness (n = 16), headache (n = 11), and convulsions (n = 11). The in-hospital case fatality rate was low (0.15%) and relapses were rare (n = 14)., Conclusions: In comparison with previous treatments, NECT was effective, safe, and well tolerated in nontrial settings in DRC, further supporting the roll-out of NECT as first-line treatment in second-stage Trypanosoma brucei gambiense HAT. Tolerance was particularly good in children.