High Efficacy of Praziquantel in Schistosoma haematobium-Infected Children in Taraba State, Northeast Nigeria: A follow-up study

Abstract

Objectives: This study aimed to assess the efficacy of praziquantel in reducing urinary schistosomiasis prevalence, parasite burden and morbidity rates among a previously reported sample of Schistosoma haematobium-infected children. In addition, predisposing factors for reinfection one year post-treatment were also determined. Methods: This prospective follow-up study was conducted between March 2014 and February 2015 among 675 previously reported children with urinary schistosomiasis in the Murbai and Surbai communities of Ardo Kola, Taraba State, Nigeria. A single dose of 40 mg/kg of praziquantel was administered to each infected child, with a second dose administered one month later if necessary. The number of S. haematobium eggs in urine samples was calculated at baseline and post-treatment. Results: At four weeks post-treatment, the overall cure rate was 98.1%. Among children with low and heavy parasite burdens at baseline, egg reduction rates (ERRs) were 100% and 96.5%, respectively. The vast majority of children with microhaematuria (98.7%) and proteinuria (98.6%) at baseline were cured at follow-up. Following a second dose, the ERR, overall and morbidity cure rates increased to 100%. At one year post-treatment, 272 infected children (40.3%) were re-assessed; of these, 51 children (18.8%) were reinfected. Close proximity to bodies of water (odds ratio [OR] = 1.23, 95% confidence interval [CI]: 0.998–1.530; P = 0.05) and fishing (OR = 2.23, 95% CI: 0.828–6.040; P = 0.01) were significant factors that predisposed children to reinfection. Conclusion: A moderate rate of reinfection was noted. Governmental and nongovernmental organisations in Nigeria should collaborate on mass treatment and health education campaigns to reduce the incidence of urinary schistosomiasis reinfections.Keywords: Urinary Schistosomiasis; Praziquantel; Treatment Outcome; Follow-Up Study; Nigeria.

Efficacy of Praziquantel and Schistosomiasis Reinfection Rate Among School-Aged Children in Ondo State, Nigeria; how feasible is the WHO 2030 elimination roadmap?

“…This was higher than the cure rate of 82 % reported by N'Goran et al, 2001 19 . However, in the study by Houmsou et al 14 , the cure rate (98.1%) after 4 weeks post-treatment with PZQ was higher than what we obtained in this study. This could be due to the fact that none of the participants has had previous exposure to PZQ use in the reported study as against our study which represents the 13 th round of PZQ administration.…”

“…By gender and age distribution, there was no significant difference in parasite burden (p>0.05). The Geometric Egg mean of this study (GEMC = 18.5 ±1.355 Eggs/10mL of urine; male = 18.9 Eggs/10mL of urine; Female = 18.2 Eggs/10mL of urine) was lower than the 58.8 Eggs/10mLof urine reported by Homsou et al, 2018 14 . We obtained a high parasitological cure of 87.91 % in this study.…”

“…For infection intensity values, the Geometric Means of Williams was used to calculate the Geometric Eggs Mean Count (GEMC) in only positive individuals. PZQ efficacy was measured by determining both cure rate (CR) and Egg Reduction Rate (ERR) 14 . The CR is the percentage of children positive for egg-patent infection becoming negative after treatment.…”

“…The intensity of S. haematobium eggs was recorded as egg output per 10 ml of urine 12 . The infection intensity of the positive sample was classified, as defined by the World Health Organization 13 either a low (1-49 eggs/10 mL of urine) or high (>50 eggs/10 mL of urine) parasite burden 14 . Administration of Medicine: All the recruited participants were treated with a single oral dose of praziquantel (600 mg) at a dose of 40 mg/kg body weight immediately after submitting urine samples by Directly Observed Treatment (DOT).…”

Transmission Dynamics of Schistosoma haematobium among School-Aged Children: A Cohort Study on Prevalence, Reinfection and Incidence after Mass Drug Administration in the White Nile State of Sudan

“…Another reason for applying caution when interpreting the reinfection rate lies in the high attrition rate in this cohort study. A considerable number of enrolled children were lost to the follow-up examination, although the attrition rate (32%) was lower than in some previous studies [ 35 , 36 , 37 ]. Absence of the enrolled students at school at the time of the follow-up survey was the only reason for loss to follow-up.…”