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Diseases Human African Trypanosomiasis Current Treatments
Diseases Human African Trypanosomiasis Current Treatments
Current Treatments
Current Treatments
| Currently available treatments for HAT are few and are limited by toxicity issues, complexity of regimen and loss of efficacy in several regions. Treatment is stage-specific, with the more toxic and difficult-to-administer treatments for stage 2 of the disease. Taken together with complicated and invasive diagnostic methods, the reality of present-day HAT treatments makes it very challenging to integrate HAT control into current health systems, which are already burdened by a chronic lack of skilled staff and adequate tools, and have many other health emergencies to deal with. |
| HAT | Drug | Associated Key Problems |
| Stage 1 | Pentamidine (1940) | 7-10 daily intramuscular (i.m.) injections; only efficacious for stage 1 |
| Suramin (1920s) | Used primarily for stage 1 T.b. rhodesiense HAT | |
| Stage 2 | Melarsoprol (1949) | 10 painful daily intravenous injections; highly toxic, with ~5% treatment-related mortality Increasing number of treatment failures (up to 30% in some regions) |
| Eflornithine (1981) | Administration difficult – 4 intravenous infusions per day required for 14 days; primarily used as 2nd line for T.b. gambiense HAT | |
Nifurtimox (1970s) | Oral drug developed for Chagas disease, not registered for HAT; sometimes used compassionately after melarsoprol relapse – probably ~70% efficacy | |
| Nifurtimox-eflornithine (2009) | Simplified stage 2 treatment combining 7 days eflornithine (2 infusions/day) and 10 days oral nifurtimox. Included in WHO's List of Essential Medicines (EML) in May 2009 |
HAT
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