Efficacy of praziquantel on Schistosoma haematobium and re-infection rates among school-going children in the Ndumo area of uMkhanyakude district, KwaZulu-Natal, South Africa

Kabuyaya, Muhubiri; Chimbari, Moses John; Manyangadze, Tawanda; Mukaratirwa, Samson

doi:10.1186/s40249-017-0293-3

Cited by 46 publications

(48 citation statements)

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“…The findings of this study, which indicated a total reinfection percentage of 10.4% from the two sites suggests that school children living in endemic areas could still be exposed to S. haematobium infection, even after praziquantel treatment. This reinfection percentage (10.4%) corroborates similar work done by Senghor et al [29] and Kabuyaya et al [30], who also reported reinfection rates of 12.6% and 8.1%, respectively. Woldegerima et al [31] also reported a reinfection rate of 13.9%, after 6 months of post-treatment, although this was in S. mansoni.…”

Section: Discussionsupporting

confidence: 91%

“…In the study by Kabuyaya et al [30], the low reinfection percentage observed was associated with the persistent drought throughout their study period. Also, Midzi et al [34] showed that a considerable number of the transmission hotspots (water sources) dried up during their study period, thus limiting the exposure of children to water contact, which might have contributed to the low reinfection percentage.…”

Section: Discussionmentioning

confidence: 73%

“…Also, Midzi et al [34] showed that a considerable number of the transmission hotspots (water sources) dried up during their study period, thus limiting the exposure of children to water contact, which might have contributed to the low reinfection percentage. On the other hand, other factors, such as the ecology and being in an area with a high intensity of infection, have been implicated in the high reinfection rates observed in other studies [15,30,35].…”

Section: Discussionmentioning

confidence: 97%

“…Meanwhile, a high reinfection percentage of 58% was reported by Oniya and Odaibo [15]. Studies has shown that, low reinfection percentage of S. haematobium can be attributed to the effectiveness of the treatment, particularly in school-age children [32,33], and the season in which sampling was done [30,34].…”

Section: Discussionmentioning

confidence: 99%

“…According to Kabuyaya and colleagues, people might become re-infected when they revert to their previous daily activities, involving contact with water infested with intermediate hosts, after a successful treatment with praziquantel [30]. Similarly, residents in the study sites use the lakes located in the communities for washing and bathing, as well as occupational and other domestic purposes.…”

Section: Discussionmentioning

confidence: 99%

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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: 91%

Section: Discussionmentioning

confidence: 73%