Future prospects for the chemotherapy of human trypanosomiasis

This paper reviews the progress which has been achieved with combination chemotherapy of experimental murine central nervous system trypanosomiasis. Successful treatments have been achieved with suramin followed by 5-nitroimidazoles; difluoromethylornithine in combination with bleomycin, 9-deazainosine, suramin, arsenicals, antimonials and diamidines; and also the arsenicals in combination with the 5-nitroimidazoles or nifurtimox. Pretreatment with prednisolone and azathioprine, to minimize reactive encephalopathies, and supportive treatment with oxygen are both indicated.