An evaluation of prednisolone as a routine adjunct to the treatment of T. rhodesiense.

The purpose of this exercise was to evaluate the efficacy of a cortico-steroid in protecting the patient suffering from Rhodesian sleeping sickness from the complications of melarsoprol treatment. It is quite clearly shown that prednisolone was not effective in offering protection against the most serious treatment problem, encephalopathy. The apparent total success of the steroid in protecting the first group from the less severe treatment complications and in minimising early death need to be interpreted with some scepticism due to the smallness of the series. Nevertheless, it does help to substantiate the observations of others that in the case of the moribund patient, the immediate use of steroids might be life saving. On the basis of these findings the routine use of prednisolone as an adjunct to the treatment of T. rhodesiense was discontinued. The use of a cortico-steroid has been continued, however, as treatment for reactive encephalopathy, arsenical dermatitis and arsenical enteritis and with patients who are moribund on admission.