How is sleeping sickness treated?
Drug treatments are available based on the parasite subspecies and disease stage. First-line drugs for both first and second stages are highly effective. Pentamidine (Nebupent, Pentam), delivered into a vein or muscle, is used to treat first stage T. b. gambiense infection. Minor adverse effects include hypoglycemia, injection site pain, diarrhea, nausea and vomiting.

Suramin is used to treat first stage T. b. rhodesiense infection. Some adverse effects include rash, kidney toxicity, and peripheral neuropathy (nerve damage that causes a tingling or burning in your hands and feet).

Eflornithine (intravenous infusion) is used to treat second stage T. b. gambiense infection. Although highly effective, adverse effects include bone marrow suppression (which can reduce your immunity), gastrointestinal symptoms, and seizures.A combination treatment of nifurtimox and eflornithine has been introduced as well.

Melarsoprol, an organoarsenic compound, is the only drug available for treating second stage T. b. rhodesiense infection. Prednisolone (a corticosteroid) is administered with melarsoprol to reduce the risk of life-threatening encephalopathy. Other associated adverse effects include skin reactions, gastrointestinal upset, and peripheral neuropathy. Patients should undergo a spinal tap every 6 months (or sooner, if symptoms return) for 2 years after treatment to detect a relapse should it occur.

Further information
MASTA Travel Health: www.masta-travel-health.com.
Centers for Disease Control and Prevention: www.cdc.gov/parasites/sleepingsickness/health_professionals/index.html#tx
World Health Organization: www.who.int/mediacentre/factsheets/fs259/en/

Last Reviewed: May 2013