High-dose nifurtimox for arseno-resistant Trypanosoma brucei gambiense sleeping sickness: an open trial in central Zaire.
Thirty patients with arseno-resistant Trypanosoma brucei gambiense sleeping sickness were treated with high-dose nifurtimox (30 mg/kg/d for 30 d). During treatment, the cerebrospinal fluid (CSF) white blood cell (WBC) count decreased in all patients except one (mean CSF WBC count before nifurtimox: 117/mm3; after nifurtimox: 25/mm3), and trypanosomes disappeared from the CSF of all 9 patients in whom parasites had been demonstrated before nifurtimox. Among 25 patients seen at least once after treatment, 9 (36%) have relapsed so far. High-dose nifurtimox was significantly toxic: one patient died during treatment and 8 others developed adverse neurological effects. High-dose nifurtimox seems more effective than the previously used regimen (15 mg/kg/d for 60 d), but at the expense of significant toxicity.
Pépin
J
J
Université de Sherbrooke, Québec, Canada.
Milord
F
F
Meurice
F
F
Ethier
L
L
Loko
L
L
Mpia
B
B
D000818:Animals; D015023:Democratic Republic of the Congo; D004351:Drug Resistance; D000518:Eflornithine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008549:Melarsoprol / Q000627:therapeutic use*; D009547:Nifurtimox / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D014347:Trypanosoma brucei gambiense / Q000302:isolation & purification; D014353:Trypanosomiasis, African / Q000188:drug therapy*
D009547:Nifurtimox; D008549:Melarsoprol; D000518:Eflornithine