Inclusion Criteria:

• confirmed second-stage T.b. gambiense infection : presence of the parasite in blood, lymph node fluid or CSF and >20 white blood cells/µL in CSF. In presence of blood in the CSF, lumbar puncture must be done again or the patient cannot be included in the study (see 10.9.1).
• and of age 15 years or older.
• and resident in __________ (each site will define boundaries or maximum distance)
• and written informed consent of the patient or of a legally acceptable representative if the patient is a minor (<18 years for both genders in Uganda and Angola, <18 years for males and <16 years for females in the Democratic Republic of Congo) or unable to communicate.

Exclusion Criteria:

• pregnant woman (systematic testing of women of childbearing potential)
• treated for late-stage HAT during the last 36 months. Patients previously treated for first-stage (pentamidine) can be included.
• unlikely to have access to the treatment centre or be accessible at their place of residence for 18 months after treatment
• unable to take oral medication
• suffering from conditions other than second stage HAT that seriously limit the chances of survival over 18 months time
• Severe anemia (Hb< 5g/dl)
• Severe underlying diseases upon admission (e.g. Active tuberculosis and/or being treated for TB; Bacterial or cryptococcal meningitis; Stages 3 or 4 HIV/AIDS according to the WHO clinical definition) (WHO, 1986).
• Severe renal failure based on clinical examination combined with biochemistry if available: creatinine clearance <20mL/min
• Severe hepatic failure based on clinical examination combined with biochemistry if available: total bilirubin >50 µmol/L, ALAT/GPT >70 UI/L, unless these laboratory values are determined by the investigator as likely due to conditions other than hepatic failure.