Efficacy of oxamniquine, praziquantel and a combination of both drugs in schistosomiasis mansoni in Brazil

Zwingenberger, K.; Queiroz, José Ájax Nogueira; Poggensee, Ulrich; Alencar, J. E. De; Valdegunas, J.; Esmeralda, F.; Feldmeier, Hermann

doi:10.1590/s0036-46651987000500007

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…The treatment for schistosomiasis is simple, consisting of a single dose of oxamniquine or praziquantel. In spite of some authors having demonstrated a synergistic action with these drugs [51,52], this association does not necessarily hold true [53,54]. In Brazil, oxamniquine is used more often, and destruction of the parasite is obtained in 80-90% of the cases [3,[55][56][57].…”

Section: Treatmentmentioning

confidence: 99%

Portal hypertension in mansonic schistosomiasis

1991

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Mansonic schistosomiasis is an endemic disease in Brazil, with an estimated 10-12 million people infested. Among its clinical manifestations, the hepatosplenic form causes portal hypertension which, in turn, brings about severe digestive hemorrhage, the most serious complication of the disease. Normally, the patients are young, and have hepatosplenomegaly, hypersplenism without clinical manifestations, and slightly reduced hepatic function. The angiographic findings are characteristic, differing from those of hepatic cirrhosis. In Brazil, the definitive treatment for gastrointestinal hemorrhage is surgery, which should be done under elective conditions whenever possible. During a short period of time, known as the "risk period" (the time between the hemorrhagic episode and the surgery), propranolol has been used to prevent further bleeding. Surgical treatment is indicated only after the first episode, and never on a prophylactic basis. In 1977, a prospective, randomized trial was begun in order to assess the delayed results of the 3 surgical operations most widely used in this country. The study was interrupted after 94 patients had been operated on due to the high incidence of encephalopathy in the group who underwent classical splenorenal shunt. After a follow-up of at least 60 months and, at most, 130 months, the results showed that classical splenorenal shunt caused encephalopathy in 39.3% of the cases and distal splenorenal shunt in 14.8%. None of those submitted to esophagogastric devascularization with splenectomy developed encephalopathy. The 3 procedures showed similar rates of hemorrhagic recurrence.

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Section: Treatmentmentioning

confidence: 99%

Portal hypertension in mansonic schistosomiasis

1991

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“…In some studies, it has been observed that there are no differences in the efficacy of these two drugs (Branchini et al 1982;Silva et al 1986;Zwingenberger et al 1987;Incani et al 1987;Santiago et al 1988). Some authors have reported a synergistic effect experimentally when these drugs are used in combination due to the preferential effect of each drug over female or male adult parasites (Delgado et al 1992).…”

Section: Discussionmentioning

confidence: 99%

The efficacy of human schistosomicide treatment may depend on the rate of transmission

et al. 2006

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The efficacy of different treatment protocols in humans infected with Schistosoma mansoni at sites with different transmission conditions was evaluated by the disappearance of anti-worm intestine IgM antibodies in an indirect fluorescence antibody test (IgM-IFT) and anti-egg antibodies in the circumoval precipitin test (COPT). Patient sera coming from sites of active low transmission (ALT), active high transmission (AHT) and low interrupted transmission (LIT) from Venezuela were studied. Chemotherapy protocols were (1) ALT, 60 mg/kg praziquantel (Pzq60); (2) AHT, one dose of 40 mg/kg Pzq followed by one dose of 20 mg/kg oxamniquine for one group and one dose of 40 mg/kg Pzq alone for the other group; (3) LIT, one dose of 40 mg/kg Pzq repeated every 3 months up to three doses. Cure rates occurred mostly between 3 and 12 months with the exception of Pzq60-ALT where it was evident before 3 months. Higher cure rates were evident in both places of low transmission (ALT and LIT) and the lowest in the AHT regardless of the treatment protocol. Cure was more evident with COPT compared to IgM-IFT. The rate of serological cure appears then to depend on the previous state of transmission. The differential cure rate evaluated by both techniques is probably due to the persistence of antibodies against antigens in different stages of the parasite.

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“…During a field trial to compare the efficacy of praziquantel and oxamniquine in Schistosoma mansoni infection, 32 individuals were identified in Aracoiaba, a small town located 60 km west of Fortaleza (Zwingenberger et al 1987). Of these, 24 were found to be coinfected with intestinal helminths.…”

Section: Groups Examinedmentioning

confidence: 99%

Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: III. Cytokine levels in peripheral blood of infected humans

Feldmeier

Heukelbach

Eisele

et al. 2003

Parasitology Research

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Tungiasis is caused by penetration of the female jigger flea, Tunga penetrans, into the skin of its host. This parasitic skin disease is almost invariably associated with intense inflammation around embedded fleas, the underlying mechanisms being unknown. A study was undertaken to determine whether the inflammatory process can be attributed to immune activation induced by a biologically active foreign body. We determined the concentrations of Th1-mediated (IFN-gamma, TNF-alpha) and Th2-mediated (IL-4) cytokines in the sera of patients with tungiasis. The results were compared with those of controls infected with different helminths or exposed to soil-transmitted helminths. The results show that tungiasis causes a mixed Th1 and Th2 immune response, characterized by significantly increased concentrations of the pro-inflammatory cytokines IFN-gamma and TNF-alpha, with a slightly increased concentration of IL-4. The preponderance of the Th1 immune response was indicated by a significantly increased TNF-alpha/IL-4 ratio in patients with tungiasis, as compared with the control groups.

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Efficacy of oxamniquine, praziquantel and a combination of both drugs in schistosomiasis mansoni in Brazil

Abstract: A rândomized clinicâl trialÏvas carried out to compâ¡e the efficâcy ofa low-dosage combinâtion of oxâmniquine (7.5

Cited by 9 publications

References 24 publications

Portal hypertension in mansonic schistosomiasis

Portal hypertension in mansonic schistosomiasis

The efficacy of human schistosomicide treatment may depend on the rate of transmission

Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: III. Cytokine levels in peripheral blood of infected humans

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