This protocol covers gambiense human African trypanosomiasis (gHAT) in a specific sub-population: patients aged less than 6 years or with body weight less than 20 kg who have a CSF white blood cell count greater than 5/µL or trypanosomes detected in the cerebrospinal fluid.
The defining features are young age or low body weight together with confirmed CSF involvement — either CSF WBC count > 5/µL or trypanosomes present in the cerebrospinal fluid. This combination places the patient in a distinct treatment category. Treatment selection in this sub-population differs from standard adult gHAT management and requires specific consideration.
For this sub-population, one option involves the NECT-long regimen — a combination of intravenous eflornithine together with oral nifurtimox. An alternative approach uses a different intravenous agent alongside oral corticosteroid cover. The full regimen, including dosing, duration, decision algorithm, and the conditions under which each option applies, is available in the complete protocol.
Dosing and complete regimen details are in the full protocol below.