New WHO guidelines for treatment of gambiense human African trypanosomiasis including fexinidazole: substantial changes for clinical practice

Human African trypanosomiasis caused by Trypanosoma brucei gambiense is a parasitic infection that usually progresses to coma and death unless treated. WHO has updated its guidelines for the treatment of this infection on the basis of independent literature reviews and using the Grading of Recommend...

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Veröffentlicht in:The Lancet infectious diseases 2020-02, Vol.20 (2), p.e38-e46
Hauptverfasser: Lindner, Andreas K, Lejon, Veerle, Chappuis, François, Seixas, Jorge, Kazumba, Leon, Barrett, Michael P, Mwamba, Erick, Erphas, Olema, Akl, Elie A, Villanueva, Gemma, Bergman, Hanna, Simarro, Pere, Kadima Ebeja, Augustin, Priotto, Gerardo, Franco, Jose Ramon
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container_title The Lancet infectious diseases
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creator Lindner, Andreas K
Lejon, Veerle
Chappuis, François
Seixas, Jorge
Kazumba, Leon
Barrett, Michael P
Mwamba, Erick
Erphas, Olema
Akl, Elie A
Villanueva, Gemma
Bergman, Hanna
Simarro, Pere
Kadima Ebeja, Augustin
Priotto, Gerardo
Franco, Jose Ramon
description Human African trypanosomiasis caused by Trypanosoma brucei gambiense is a parasitic infection that usually progresses to coma and death unless treated. WHO has updated its guidelines for the treatment of this infection on the basis of independent literature reviews and using the Grading of Recommendations Assessment, Development and Evaluation methodology. The first-line treatment options, pentamidine and nifurtimox–eflornithine combination therapy, have been expanded to include fexinidazole, an oral monotherapy given a positive opinion from the European Medicines Agency. Fexinidazole is recommended for individuals who are aged 6 years and older with a bodyweight of 20 kg or more, who have first-stage or second-stage gambiense human African trypanosomiasis and a cerebrospinal fluid leucocyte count less than 100 per μL. Nifurtimox–eflornithine combination therapy remains recommended for patients with 100 leucocytes per μL or more. Without clinical suspicion of severe second-stage disease, lumbar puncture can be avoided and fexinidazole can be given. Fexinidazole should only be administered under supervision of trained health staff. Because these recommendations are expected to change clinical practice considerably, health professionals should consult the detailed WHO guidelines. These guidelines will be updated as evidence accrues.
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Because these recommendations are expected to change clinical practice considerably, health professionals should consult the detailed WHO guidelines. 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subjects Adolescent
Adult
Adults
African trypanosomiasis
Aged
Aged, 80 and over
Antiprotozoal Agents - therapeutic use
Cerebrospinal fluid
Child
Child, Preschool
Children & youth
Clinical medicine
Coma
Drug dosages
Eflornithine
Eflornithine - therapeutic use
Female
Guidelines
Humans
Infant
Infant, Newborn
Infectious diseases
Leukocytes
Literature reviews
Male
Medical personnel
Middle Aged
Nifurtimox
Nifurtimox - therapeutic use
Nitroimidazoles - therapeutic use
Parasitic diseases
Pentamidine
Practice Guidelines as Topic
Public health
Therapy
Trypanosoma brucei gambiense - isolation & purification
Trypanosomiasis, African - drug therapy
Trypanosomiasis, African - etiology
Vector-borne diseases
World Health Organization
Young Adult
title New WHO guidelines for treatment of gambiense human African trypanosomiasis including fexinidazole: substantial changes for clinical practice
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