02403nas a2200409   4500000000100000008004100001260001600042653004000058653001700098653003900115653002500154100001500179700001200194700001500206700001500221700001500236700001500251700001300266700001400279700001200293700001800305700001100323700001200334700001300346700001100359700001300370700001700383700001500400700001900415700001400434700001400448245013300462856007500595300000800670520130100678022001401979       2024                            d  bElsevier BV10aHuman African Trypanosomiasis (HAT)10aFexinidazole10aNeglected tropical diseases (NTDs)10aTreatment guidelines1 aLindner AK1 aLejon V1 aBarrett MP1 aBlumberg L1 aBukachi SA1 aChancey RJ1 aEdielu A1 aMatemba L1 aMesha T1 aMwanakasale V1 aPasi C1 aPhiri T1 aSeixas J1 aAkl EA1 aProbyn K1 aVillanueva G1 aSimarro PP1 aKadima Ebeja A1 aFranco JR1 aPriotto G00aNew WHO guidelines for treating rhodesiense human African trypanosomiasis: expanded indications for fexinidazole and pentamidine  uhttps://www.thelancet.com/action/showPdf?pii=S1473-3099%2824%2900581-4  a1-93 a<p>Human African trypanosomiasis is a neglected tropical disease that is usually fatal without treatment. WHO has revised its rhodesiense human African trypanosomiasis treatment guidelines on the basis of an independent systematic literature review and following the GRADE methodology. This Review reports on the decision-making process and summarises the new recommendations and their potential implications for health-care professionals and policy makers. Due to data scarcity, all recommendations are conditional and based on very low certainty of evidence. Fexinidazole replaces suramin and melarsoprol as the first-line therapy in individuals aged 6 years and older with a bodyweight of 20 kg or more. As fexinidazole is effective in both stages of rhodesiense human African trypanosomiasis, a lumbar puncture for staging is no longer required. In settings in which first-choice drugs are not readily available, immediate interim treatment with pentamidine is suggested. The introduction of oral fexinidazole represents an advancement in the management of rhodesiense human African trypanosomiasis considering the life-threatening adverse reactions individuals can have to melarsoprol. However, children below the age or weight limits remain ineligible for treatment with fexinidazole.</p>
  a1473-3099