Treatment of Rhodesiense Human African Trypanosomiasis in Patients Aged ≥ 6 Years with Body Weight ≥ 20 kg

This protocol covers first-line treatment of confirmed rhodesiense human African trypanosomiasis (HAT) in a specific patient population defined by age and body weight criteria.

Clinical Scenario

The treatment approach described here applies when all of the following conditions are met:

Rhodesiense human African trypanosomiasis confirmed
Patient age ≥ 6 years
Body weight ≥ 20 kg

Treatment Approach

The first-choice treatment in this population is an oral therapy taken with food, structured according to body weight. The regimen involves a loading phase followed by a maintenance phase. When the first-choice approach is not suitable, second-choice alternatives are selected based on cerebrospinal fluid findings. The complete weight-based dosing schedule, drug selection criteria, and full algorithm are in the structured protocol below.

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References

Fexinidazole is the first-choice treatment in rhodesiense HAT patients aged ≥ 6 years and body weight ≥ 20 kg.
Fexinidazole must be taken once daily for 10 days, with a loading dose over four days and a lower maintenance dose over the last six days.
The second choice to fexinidazole is suramin (if ≤ 5 WBC/µL and no trypanosomes in CSF) or melarsoprol (if > 5 WBC/µL or trypanosomes in CSF).

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