Treatment of Rhodesian sleeping sickness in Kenya

In a study of 269 sleeping sickness patients treated with Mel-B, 14 (5.2%) died during treatment. With total dosages of at least 30 ml (1.08 g), 1.4% relapsed and another 6.4% died, mostly of unknown causes, within three years of treatment, giving a success rate of 92.1% over the three years. Mel-B was used to treat 55 relapses after suramin therapy with 1.8% deaths during treatment, 3.6% relapses, and 92.7% success over at least three years. Apparent drug resistance to Mel-B was found in three patients who continued to relapse after repeated treatments. During 1980, 51 patients were treated with suramin on the basis of clinical condition without benefit of cerebrospinal fluid (CSF) analysis. Subsequently 49% of these patients relapsed within three years of treatment. When 29 patients were treated on the basis of CSF evaluation only two (7%) relapsed.