Management
The drug therapy is determined by whether there is central nervous involvement:
- trypanosomiasis without CNS involvement:
- suramin is the first line drug, it kills parasites in the blood, lymphoid system and bone marrow but does not penetrate the CNS
- pentamidine is a second line agent
- trypanosomiasis with CNS involvement:
- melarsoprol kills peripheral and central parasites but is toxic
- eflornitine is a new drug which may be used in CNS infections with T. gambiense
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