Table 1. Five current anti-human African trypanosomiasis (HAT) chemotherapies.

Drugs	Mechanism	Advantages	Disadvantages
Pentamidine (pentamidine Isethionate)	Accumulates in trypanosomes; disrupts mitochondrial processes	Effective against stage I Trypanosoma brucei gambiense	Ineffective against stage II T. b. gambiense and both stages of Trypanosoma brucei rhodesiense
Suramin* (Bayer 205, Germanin)	Binds to enzymes in the glycosome; disrupts glycolysis	Effective against stage I T. b. rhodesiense	Ineffective against stage II T. b. rhodesiense and stage II T. b. gambiense
Melarsoprol (Mel B)	Disrupts trypanosomal redox metabolism and glycolysis	Effective against both subspecies at both stages	Toxic; around 5% of patients die as a result of post-treatment reactive encephalopathy (PTRE); trypanosomal resistance reported to be as high as 30%
Eflornithine (difluoromethylornithine)	Irreversibly inhibits ODC; disruption of proliferation and vulnerability to oxidative attack	Effective against stage II T. b. gambiense	Ineffective against both stages of T. b. rhodesiense; treatment is time-consuming
NECT (nifurtimox–eflornithine combination treatment)	Eflornithine inhibits ODC; nifurtimox induces oxidative attack upon weakened trypanosomes	High cure rate for both stages of T. b. gambiense; low rate of adverse effects; no death rates	Potential for resistance to the treatment in the field

^*Suramin is also effective against stage I T. b. gambiense, but its use remains confined to infections causes by stage I T. b. rhodesiense