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Updated: May 10, 2026
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Purification of Extracellular Trypanosomes, Including African, from Blood by Anion-Exchangers (Diethylaminoethyl-cellulose Columns)
Published on: April 6, 2019
Chemotherapy for second-stage human African trypanosomiasis.
Vittoria Lutje1, Jorge Seixas, Adrian Kennedy
1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. vlutje@liverpool.ac.uk.
The Cochrane Database of Systematic Reviews
|June 29, 2013
Summary
Eflornithine and nifurtimox combination therapy (NECT) offers a well-tolerated and effective treatment for second-stage Human African Trypanosomiasis (sleeping sickness), potentially replacing melarsoprol.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Parasitology
Background:
- Human African Trypanosomiasis (HAT), or sleeping sickness, is a fatal neglected tropical disease prevalent in impoverished African regions.
- Current treatments for second-stage HAT exhibit significant adverse effects and variable efficacy.
Purpose of the Study:
- To systematically evaluate the effectiveness and safety of available drugs for treating second-stage Human African Trypanosomiasis (HAT).
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to January 2013.
- Included randomized and quasi-randomized controlled trials involving adults and children with second-stage HAT treated with anti-trypanosomal drugs.
- Data extraction and quality assessment were performed by two independent reviewers, with a third acting as an arbitrator.
Main Results:
- Nine trials with 2577 participants (all with Trypansoma brucei gambiense HAT) were analyzed.
- Melarsoprol showed fewer relapses than pentamidine or nifurtimox but had more adverse events.
- Nifurtimox-eflornithine combination therapy (NECT) demonstrated low relapse rates and good tolerability, with practical advantages for administration.
Conclusions:
- Eflornithine and NECT are poised to supersede melarsoprol for second-stage Gambiense HAT, contingent on local availability and parasite resistance monitoring.
- Further research is crucial for mitigating adverse effects of existing drugs, exploring alternative regimens, and developing novel compounds effective for both stages of HAT.
