This protocol applies to patients with confirmed rhodesiense human African trypanosomiasis (HAT) who are under 6 years of age or weigh less than 20 kg, with CSF findings showing no central nervous system involvement — specifically, a white blood cell count of 5/µL or below and no trypanosomes detected in the CSF.
First-line management in this paediatric sub-population is based on a parenteral antiparasitic agent administered by slow intravenous injection, following a multi-week structured injection sequence. A second-choice intramuscular option is available when the primary agent cannot be used.
The complete regimen, full injection schedule, and clinical decision pathway are in the structured protocol below.
Suramin is the first-choice treatment in patients aged < 6 years or body weight < 20 kg presenting with ≤ 5 WBC/µL in CSF and no trypanosomes in CSF.
The second choice to suramin is pentamidine.