Lindner A. K. auteur aut IRD Lejon Veerle auteur aut IRD Chappuis F. auteur aut IRD Seixas J. auteur aut IRD Kazumba L. auteur aut IRD Barrett M. P. auteur aut IRD Mwamba E. auteur aut IRD Erphas O. auteur aut IRD Akl E. A. auteur aut IRD Villanueva G. auteur aut IRD Bergman H. auteur aut IRD Simarro P. auteur aut IRD Ebeja A. K. auteur aut IRD Priotto G. auteur aut IRD Franco J. R. auteur aut IRD text journalArticle eng text/pdf born digital access 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 mu L. Nifurtimox-eflornithine combination therapy remains recommended for patients with 100 leucocytes per mu L 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. specialized AFRIQUE 052 050 20 2 E38-E46 2020 1473-3099 https://www.documentation.ird.fr/hor/fdi:010077901 10.1016/s1473-3099(19)30612-7 1473-3099 [F B010077901] https://www.documentation.ird.fr/hor/fdi:010077901 https://www.documentation.ird.fr/intranet/publi/2020/02/010077901.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2020-03-11 2020-03-11 fdi:010077901 fre