Table 2 HAT Treatment for Late Stage Disease from 1949 to 2018 [58]

Melarsoprol

Only treatment available for years, can be used for both g-HAT^a and r-HAT^b

Derived from arsenic and can cause reactive encephalopathy, fatal in 3–10%

Eflornithine Monotherapy

Less toxic than melarsoprol

Can only be used for the treatment of g-HAT, requires 56 infusions over 14 days, inpatient admission, sterile equipment and trained hospital staff

Nifurtimox-Eflornithine Combination Therapy (NECT)^b

Decreased the overall incidence of disease and relapse rates at 18 months as compared to eflornithine alone, and is less toxic than melarsoprol

Can only be used for the treatment of g-HAT (1st line), requires inpatient admission, sterile equipment and trained hospital staff