Treatment of Gambiense HAT with CSF White Blood Cell Count ≥ 100/µL or Unavailable CSF Data

This protocol addresses patients with confirmed gambiense human African trypanosomiasis (HAT) aged 6 years or older and weighing at least 20 kg who present with a cerebrospinal fluid (CSF) white blood cell count of 100/µL or above — or in whom lumbar puncture could not be completed or CSF results are otherwise unavailable.

Clinical scenario

A CSF white blood cell count of ≥ 100/µL is consistent with severe meningo-encephalitic involvement in gambiense HAT. When lumbar puncture fails or CSF data are not obtainable, the same management pathway applies. This threshold defines a distinct, high-acuity presentation that determines treatment selection.

Gambiense HAT, age ≥ 6 years, body weight ≥ 20 kg
CSF WBC ≥ 100/µL or lumbar puncture not feasible / CSF data unavailable

Treatment approach (partial overview)

For patients meeting these criteria, the evidence-based first-choice approach is NECT — a specific combination regimen. An alternative exists for patients who cannot receive the first-choice option. The complete sequencing, eligibility criteria, and full regimen details are available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

NECT is the first-choice treatment in gambiense HAT patients presenting clinical features consistent with severe meningo-encephalitic HAT and with ≥ 100 WBC/µL in CSF or where CSF data are unavailable.

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