African trypanosomiasis
ICD-10 B56 · ICD-11 1F51

Treatment of Rhodesiense HAT in Children Under 6 Years or Under 20 kg

This protocol covers rhodesiense human African trypanosomiasis (HAT) in a specific paediatric sub-population — children aged under 6 years or weighing less than 20 kg — who present with a cerebrospinal fluid white blood cell count of 5/µL or fewer and no trypanosomes detected in the CSF.

  • Rhodesiense human African trypanosomiasis
  • Age < 6 years or body weight < 20 kg
  • CSF white blood cell count ≤ 5/µL
  • No trypanosomes detected in CSF

Management in this sub-population is stage-dependent. First-stage and second-stage disease each require a distinct parenteral regimen; the second-stage approach also incorporates a concomitant oral agent. The complete evidence-based regimen — including drug selection, dosing, schedule, and route — is in the full protocol below.

References

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.

If the patient is a child < 6 years or < 20 kg who relapses after treatment with suramin, depending on the stage, pentamidine or melarsoprol should be given.

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