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Management

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The drug therapy is determined by whether there is central nervous involvement:

  • trypanosomiasis without CNS involvement:
    • suramin is the first line drug, it kills parasites in the blood, lymphoid system and bone marrow but does not penetrate the CNS
    • pentamidine is a second line agent

  • trypanosomiasis with CNS involvement:
    • melarsoprol kills peripheral and central parasites but is toxic
    • eflornitine is a new drug which may be used in CNS infections with T. gambiense

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