People diagnosed with trypanosome-caused disease should be treated with an anti-trypanosomal. Treatment is based on stage, 1 or 2, and parasite,T. b. rhodesiense or T. b. gambiense. In stage 1 disease, trypanosomes are present only in the peripheral circulation. In stage 2 disease, trypanosomes have crossed the blood-brain barrier and are present in the central nervous system. The following are considerable treatment options:<unk>  is a treatment used during the second stage of the disease. So far, it is the only treatment available for late-stage T. b. rhodesiense. Due to high toxicity,<unk>  is reserved only for the most dangerous cases. Other agents associated with lower toxicity levels are used during stage 1 of the disease. The approval of the nifurtimox-eflornithine combination therapy (NECT) in 2009 for the treatment of T. b. gambiense limited the use of<unk>  to the treatment of second-stage T. b. rhodesiense. Failure rates of 27% in certain African countries have been reported. This was caused by both drug resistance and additional mechanisms that have not yet been elucidated. Resistance is likely due to transport problems associated with the P2 transporter, an adenine-adenosine transporter. Resistance can occur with point mutations within this transporter. Resistance has been present since the 1970s.
Melarsoprol
Trenbolone hexahydrobenzylcarbonate
Prosultiamine
Fursultiamine
Artemether
Quinine
Dimetacrine
Boron trichloride