The nitroimidazoles and human African trypanosomiasis

The arsenal of compounds available for the chemotherapy of human African trypanosomiasis (HAT) [1,2] is essentially limited to suramin and pentamidine, which are active in the hematological stage of the disease, and melarsoprol and eflornithine (DFMO) which have efficacy in the terminal (meningoencephalitic) phase. The first two agents are ineffective at eradicating the parasite if it already has surmounted the blood-brain barrier and the toxicity of melarsoprol too frequently causes a lethal encephalopathy; as for the promising DFMO molecule, it necessitates an expensive and difficult protocol for the less developed countries where HAT is most rampant. There is thus urgent need to develop other drug molecules adapted to the socioeconomic conditions of these countries.