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 μL. Nifurtimox-eflornithine combination therapy remains recommended for patients with 100 leucocytes per μL 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.

中文翻译：

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世界卫生组织新的治疗冈比亚人非洲锥虫病（包括非辛达唑）的新指南：临床实践的重大变化。

由布氏布鲁氏疟原虫引起的人类非洲锥虫病是一种寄生虫感染，除非进行治疗，否则通常会发展为昏迷和死亡。世卫组织已在独立文献审查的基础上，并使用了建议评估，发展和评估方法的分级标准，更新了该感染的治疗指南。一线治疗选择包括喷他idine和尼呋替莫昔-氟鸟氨酸联合治疗，已扩大到包括非辛达唑，这是一种口服单药，得到了欧洲药品管理局的积极评价。对于年龄在20岁或以上且体重20公斤或以上，患有第一阶段或第二阶段冈比亚人类非洲锥虫病且脑脊液白细胞计数少于100μL的个体，建议使用非辛达唑。对于每μL或更多具有100个白细胞的患者，仍建议使用Nifurtimox-eflornithine联合疗法。在没有临床怀疑的严重第二阶段疾病的情况下，可以避免腰椎穿刺，并可以使用非那达唑。非辛达唑只能在训练有素的卫生人员的监督下进行管理。由于预计这些建议将极大地改变临床实践，因此卫生专业人员应查阅详细的WHO指南。这些指南将随着证据的积累而更新。由于预计这些建议将极大地改变临床实践，因此卫生专业人员应查阅世卫组织的详细指南。这些指南将随着证据的积累而更新。由于预计这些建议将极大地改变临床实践，因此卫生专业人员应查阅详细的WHO指南。这些指南将随着证据的积累而更新。