Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children

Stete, Katarina; Krauth, Stefanie J.; Coulibaly, Jean T.; Knopp, Stefanie; Hattendorf, Jan; Müller, Ivan; Lohourignon, Laurent K.; Kern, Winfried V.; N’Goran, Eliézer K.; Utzinger, Jürg

doi:10.1186/1756-3305-5-298

Cited by 49 publications

(48 citation statements)

References 50 publications

(69 reference statements)

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“…In the current study, the morbidity parameters, such as haematuria, proteinuria and pyuria (leucocytes) were associated with S. haematobium infection, and this agrees with work done by Gryseels et al (2006) [1], Stete et al [39], Mekonnen et al [40] and Wami et al [41], who also reported the association between haematuria, proteinuria and pyuria with urogenital schistosomiasis. The percentage increase in proteinuria (from 19.19% to 71.4%) and the decrease in haematuria (from 76.2% to 57.1%) in follow-up samples could be attributed to the activity of praziquantel in the body.…”

Section: Discussionsupporting

confidence: 93%

“…In this study, the mean egg count at the baseline being higher than that of the subsequent follow-ups agrees with a study conducted in the Cote d'Ivoire, which reported a higher mean egg count of 84.8 eggs/10 mL at the baseline, relative to a range of 40.5 to 0.3 eggs/10mL in the post-treatment phase [39]. However, the observation of eggs shed even after weeks of treatment in this study does not imply that the praziquantel treatment was ineffective and, thus, clinicians should not be very worried if eggs are detected in the laboratory, even after they have treated the patients.…”

Section: Discussionsupporting

confidence: 92%

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Persistent Urogenital Schistosomiasis and Its Associated Morbidity in Endemic Communities within Southern Ghana: Suspected Praziquantel Resistance or Reinfection?

et al. 2020

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Background: schistosomiasis is a neglected tropical disease caused by helminths of the genus Schistosoma. The disease has a worldwide distribution, with more cases occurring in Africa. Urogenital schistosomiasis caused by S. haematobium with its associated morbidity is prevalent in many areas of Ghana. Praziquantel is still the recommended drug of choice for schistosomiasis treatment, although a number of studies have reported sub-therapeutic effects and associated treatment failure. The current study, therefore, assessed whether persistent schistosomiasis, with its associated morbidity among children living in endemic areas within the Greater Accra Region of Ghana, is as a result of reinfection or suspected praziquantel resistance. Methodology: this was a longitudinal study involving a baseline and follow-up sampling after praziquantel treatment. Urine samples were collected from school children (whose parents had also consented) for the detection of S. haematobium ova using a sedimentation technique. The morbidity parameters were examined with urine chemistry strips, as well as microscopy. Viability was assessed using a modified hatchability technique, vital staining (0.4% trypan blue and 1% neutral red) and fluorescent (Hoechst 33258) microscopy. Infected individuals were treated with a single dose of praziquantel (40mg/kg). Resampling to determine reinfection was done sixth months post-treatment, after evidence of total egg clearance. For possible resistance assessment, egg counts and viability testing were conducted on the positive samples at the baseline, as well as weekly post-treatment follow-ups for 12 weeks. Results: out of the 420 school children sampled, 77 were initially positive but, after the sixth month sampling for reinfection assessment, eight out of the initial positives were infected again, giving a reinfection percentage of 10.4%. No suspected praziquantel resistance was recorded in the 21 positives detected out of the 360 sampled for suspected resistance assessment. The egg reduction rate increased weekly in the follow-up samples with a gradual reduction in the egg count. The study also recorded a gradual decrease in the percentage of live eggs after the first week; with all viability testing methods used complimenting each other. The morbidity parameters (proteinuria, haematuria and pyuria) changed between the baseline and post-treatment samples, eventually reducing to zero. Conclusions: the outcome of this study suggests that the persistent schistosomiasis, with its associated morbidity observed in these endemic communities, is not likely to be as a result of praziquantel resistance, but reinfection. Even though there was no suspected resistance observed in the study, there remains the need to continuously intensify the monitoring of praziquantel in other endemic communities.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Persistent Urogenital Schistosomiasis and Its Associated Morbidity in Endemic Communities within Southern Ghana: Suspected Praziquantel Resistance or Reinfection?

et al. 2020

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“…Limitations of the original studies related to the diagnosis of Plasmodium and Schistosoma infection could also affect the present results [44,45]. In addition, some studies which examined S .…”

Section: Discussionmentioning

confidence: 95%

Plasmodium falciparum Infection Status among Children with Schistosoma in Sub-Saharan Africa: A Systematic Review and Meta-analysis

Degarege

Veledar

et al. 2016

PLoS Negl Trop Dis

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BackgroundIt has been suggested that Schistosoma infection may be associated with Plasmodium falciparum infection or related reduction in haemoglobin level, but the nature of this interaction remains unclear. This systematic review synthesized evidence on the relationship of S. haematobium or S. mansoni infection with the occurrence of P. falciparum malaria, Plasmodium density and related reduction in haemoglobin level among children in sub-Saharan Africa (SSA).Methodology/Principal findingsA systematic review in according with PRISMA guidelines was conducted. All published articles available in PubMed, Embase, Cochrane library and CINAHL databases before May 20, 2015 were searched without any limits. Two reviewers independently screened, reviewed and assessed all the studies. Cochrane Q and Moran’s I2 were used to assess heterogeneity and the Egger test was used to examine publication bias. The summary odds ratio (OR), summary regression co-efficient (β) and 95% confidence intervals (CI) were estimated using a random-effects model. Out of 2,920 citations screened, 12 articles (five cross-sectional, seven prospective cohort) were eligible to be included in the systematic review and 11 in the meta-analysis. The 12 studies involved 9,337 children in eight SSA countries. Eight studies compared the odds of asymptomatic/uncomplicated P. falciparum infection, two studies compared the incidence of uncomplicated P. falciparum infection, six studies compared P. falciparum density and four studies compared mean haemoglobin level between children infected and uninfected with S. haematobium or S. mansoni. Summary estimates of the eight studies based on 6,018 children showed a higher odds of asymptomatic/uncomplicated P. falciparum infection in children infected with S. mansoni or S. haematobium compared to those uninfected with Schistosoma (summary OR: 1.82; 95%CI: 1.41, 2.35; I2: 52.3%). The increase in odds of asymptomatic/uncomplicated P. falciparum infection among children infected with Schistosoma remained significant when subgroup analysis was conducted for S. haematobium (summary OR: 1.68; 95%CI: 1.18, 2.41; I2: 53.2%) and S. mansoni (summary OR: 2.15; 95%CI: 1.89, 2.46: I2: 0.0%) infection. However, the density of P. falciparum infection was lower in children co-infected with S. haematobium compared to those uninfected with Schistosoma (summary-β: -0.14; 95% CI: -0.24, -0.01; I2: 39.7%). The mean haemoglobin level was higher among children co-infected with S. haematobium and P. falciparum than those infected with only P. falciparum (summary-mean haemoglobin difference: 0.49; 95% CI: 0.04, 0.95; I2: 66.4%)Conclusions/SignificanceThe current review suggests S. mansoni or S. haematobium co-infection may be associated with increased prevalence of asymptomatic/uncomplicated P. falciparum infection in children, but may protect against high density P. falciparum infection and related reduction in haemoglobin level.

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“…Due to its simplicity, syringe filtration is preferred in community and school surveys and requires less equipment than urine concentration with centrifugation. Similar to stool smear testing for fecal eggs, these tests are also prone to low sensitivity (74), although the eggs can generally be identified readily, as a relatively large volume of urine is used and there is an absence of the disturbing solid materials found in stool (42). Indeed, KK and urine egg detection techniques are particularly compatible in environments with high schistosome transmission levels, in light of their simplicity and cost-effectiveness.…”

Section: Direct Parasitological Diagnosismentioning

confidence: 99%

Advances in the Diagnosis of Human Schistosomiasis

et al. 2015

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SUMMARY Schistosomiasis is a major neglected tropical disease that afflicts more than 240 million people, including many children and young adults, in the tropics and subtropics. The disease is characterized by chronic infections with significant residual morbidity and is of considerable public health importance, with substantial socioeconomic impacts on impoverished communities. Morbidity reduction and eventual elimination through integrated intervention measures are the focuses of current schistosomiasis control programs. Precise diagnosis of schistosome infections, in both mammalian and snail intermediate hosts, will play a pivotal role in achieving these goals. Nevertheless, despite extensive efforts over several decades, the search for sensitive and specific diagnostics for schistosomiasis is ongoing. Here we review the area, paying attention to earlier approaches but emphasizing recent developments in the search for new diagnostics for schistosomiasis with practical applications in the research laboratory, the clinic, and the field. Careful and rigorous validation of these assays and their cost-effectiveness will be needed, however, prior to their adoption in support of policy decisions for national public health programs aimed at the control and elimination of schistosomiasis.

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Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children

Cited by 49 publications

References 50 publications

Persistent Urogenital Schistosomiasis and Its Associated Morbidity in Endemic Communities within Southern Ghana: Suspected Praziquantel Resistance or Reinfection?

Persistent Urogenital Schistosomiasis and Its Associated Morbidity in Endemic Communities within Southern Ghana: Suspected Praziquantel Resistance or Reinfection?

Plasmodium falciparum Infection Status among Children with Schistosoma in Sub-Saharan Africa: A Systematic Review and Meta-analysis

Advances in the Diagnosis of Human Schistosomiasis

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