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

Treatment of Rhodesiense Human African Trypanosomiasis in Pregnancy

Rhodesiense human African trypanosomiasis (HAT) presenting in a pregnant patient requires careful clinical judgment. The physiological demands of pregnancy significantly constrain which therapeutic approaches are acceptable, and management decisions must weigh the risks to both patient and pregnancy.

Clinical Scenario This protocol addresses rhodesiense HAT in a patient who is pregnant. Treatment selection in this setting is markedly limited: options acceptable in non-pregnant patients may not be suitable here, and the availability of alternatives varies by trimester. Certain agents may only be considered under specific, urgent circumstances.
Treatment Overview (Partial) Management may involve intravenous agents that are otherwise theoretically contraindicated in pregnancy and are reserved for rescue situations. Full selection criteria, clinical thresholds, and the complete structured regimen are available via the protocol below.
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References

Fexinidazole and pentamidine can be given after the first trimester.

Suramin and melarsoprol are theoretically contraindicated, but their use may become necessary as a rescue treatment.

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