Efficacy of two praziquantel treatments among primary school children in an area of highSchistosoma mansoniendemicity, Nile Delta, Egypt

Abstract

Praziquantel is the cornerstone of schistosomiasis control. A number of reports from endemic areas suggest that resistance or tolerance to praziquantel might exist in Schistosoma mansoni. Several explanations were postulated. The present work was designed to test the hypothesis that a low praziquantel (pzq) cure rate in Egypt is due to survival and maturation of immature stages that escaped pzq, which is effective against mature S. mansoni worms only. The study sample included 1351 children attending El Rouse primary school located in El Rouse village, Nile Delta, Egypt. All children received 2 pzq doses (40 mg/kg) 4 weeks apart. Diagnosis of S. mansoni infection and cure assessment were based on examination of 2 Kato slides prepared from a single stool sample collected before and 4 weeks after the first and second treatments. The cure rate was 78·8% after the first treatment and increased significantly to 90·8% after the second treatment. Egg reduction rates were 71·2% and 77·2% after 1 and 2 treatments respectively. Pre-treatment intensity of infection has a great influence on cure and egg reduction rates. Our results confirmed that low praziquantel cure rate, in Egypt, might be attributed, even partially, to survival and maturation of the immature S. mansoni stages that escaped pzq that is effective against mature worms only.

Efficacy and Safety of Arachidonic Acid for Treatment of Schistosoma mansoni-Infected Children in Menoufiya, Egypt

“…6,7 Transient and self-limiting abdominal pain, nausea, and vomiting were also the most frequent symptoms observed in patients treated with mefloquine and mefloquine combined with artesunate. 38,40 Conversely, not a single child reported the slightest adverse event during or after therapy with ARA, totally confirming our observations in experimental hosts [15][16][17] and in accordance with the results of plasma polyunsaturated fatty acids analyses.…”

“…1,3,[5][6][7][8] The side effects are relatively mild, involving essentially headache, dizziness, rashes, nausea, abdominal pain, and diarrhea, symptoms that could be easily explained by the propensity of PZQ to bind to actin. 9,10 Failure of cure after PZQ chemotherapy was consistently associated with high intensity of infection, [5][6][7][8] which required repeated treatments and accelerated the impending threat of schistosome resistance to the drug. 11 Accordingly, use of other schistosomicides alone or combined with PZQ was sought with variable results.…”

Efficacy of praziquantel in the treatment of Schistosoma haematobium infection among school-age children in rural communities of Abeokuta, Nigeria

“…Already countries such as Egypt [11], Zimbabwe [5] and Cameroon [12] have reported low cure rates of PZQ. There is therefore a need for constant and continuous monitoring of PZQ under the pressure of widespread use.…”

Urine heme dipsticks are useful in monitoring the impact of Praziquantel treatment on Schistosoma haematobium in sentinel communities of Delta State, Nigeria

“…PZQ administration has been shown to result in short term cure rates as high as 70–98% (Augusto et al, 2009; Barakat and Morshedy, 2011; Tchuente et al, 2004), although if longer periods of follow-up are used, cure rates decrease over time (Sacko et al, 2009). PZQ has been shown to have a beneficial impact on the health status of treated children, resulting in improved growth and cognitive function of treated children (McGarvey et al, 1996; Nokes et al, 1999).…”