Impact of Single Dose Praziquantel Treatment on Schistosoma haematobium Infection among School Children in an Endemic Nigerian Community

Abstract

Schistosomiasis is prevalent in Nigeria, and the foremost pathogen is Schistosoma haematobium, which affects about 29 million people. Single dose of the drug praziquantel is often recommended for treatment but the efficacy has not been documented in certain regions. Therefore, this study was designed to assess the impact of single dose praziquantel treatment on S. haematobium infection among school children in an endemic community of South-Western Nigeria. Urine samples were collected from 434 school children and 10 ml was filtered through Nucleopore filter paper before examination for egg outputs by microscopy. The prevalence was 24.9% at pre-treatment. There was no statistically significant difference for the prevalence of infection between males (14.7%) and females (10.2%), although the mean egg count for the females (9.87) was significantly more (P<0.05) than the males (6.06). At 6 and 12 months post-treatment there was 74.4% and 86.4% reduction in the mean egg count, respectively. Interestingly, an increased prevalence of infection from 2.1% at 6 months to 7.7% at 12 months post-treatment was observed, nonetheless the mean egg count was reduced to 0.27 at 12th month from 1.98 at 6 months post-treatment. Resurgence in the prevalence rate between 6 and 12 months post-treatment with praziquantel is herein reported and the need for a follow-up treatment in endemic areas for adequate impact on schistosomiasis control is discussed.

Prevalence and Associated Risk Factors of Urinary Schistosomiasis among Primary School Pupils in the Jidawa and Zobiya Communities of Jigawa State, Nigeria

“…Locals depend on these water bodies for fishing, bathing, swimming, and other domestic needs, and the water contact provides opportunities for infection and reinfection. The infection pattern noted here showed a typical gender-related prevalence whereby males were infected more often than females [21,41,44]. This could be due to the higher tendencies of water contact activities among males through swimming, playing, and laundry in addition to the domestic activity of fetching water, which exposes both sexes to infection.…”

“…Prevalence values of 1-10%, 11-50%, and >50% are regarded as low, moderately, and hyper-endemic, respectively. The two communities have prevalences far greater than those determined earlier in Osun state (12.7%) [37], Benue State (42.6% in both Ogbadibo [38] and Katsina LGAs [39,40]), and the Ipogun community of Ondo State (24.9%) [41]. Our prevalence data are more in line with the findings of other studies, which reported high prevalences of urinary schistosomiasis in rural areas of Nigeria: 75.6% in Ogbesi-Ekiti, Ekiti State [42] and 72.0% in Dutsinma, Katsina State [43].…”

The Impact of Targeted Treatment and Mass Drug Administration Delivery Strategies on the Prevalence and Intensity of Schistosomiasis in School Aged Children in Africa: A Systematic Review

“…The intervention period varied in most of the articles, ranging from 1 round of MDA in one year to 6 rounds over six years. 13 , 27 , 43 Three studies used the annual intervention strategy. 3 , 5 , 6 In such cases a once-off intervention in a year and screening was done.…”

“…3 Targeted treatment on its own without other complementary interventions such as snail control, provision of safe water and proper sanitation and education on schistosomiasis prevention has failed to eliminate the disease. 14,21,27 A randomised cluster study by Knopp in Zanzibar which compared groups with addition of snail control and education on schistosomiasis prevention confirmed the importance of complementary interventions. The group that received snail control and education on schistosomiasis prevention in addition to MDA had a more significant decrease in the infection prevalence and intensity.…”

“… Arm 1(5–8yrs) Arm 2 (9–12yrs) Arm 3 adults Repeated cross-sectional 150 S. mansoni 5 5 rounds of MDA to the target groups Arm 1: ↓ (20,34–8,89) =56% Arm 2↓ (59,47–19,0) =68% Arm 3↓ :44,68–12,0 =72% Arm 1↓ (19,72–6,68) Arm 2↓ (50,40–10,31) Arm3↓ (50,0–7,93) N/A Moderate drop in prevalence and intensity but persistent hot spots were identified where there was no significant drop in infection burden 17 Zilahatou et al 25 Nigeria School children 8–11 yrs Cross-sectional survey 1 642 S. haematobium 1 One round of MDA ↓75.4–38,0%=50% Anemia ↓ 61,6–50,4% 68% Moderate decrease in infection burden and a partial decrease in anemia due to the treatment of schistosomiasis and STH 18 Toure et al 26 Burkina Faso School aged children 6–14yrs 1.Longitudical cohort survey 2.Cross-sectional survey 3. ComBT 1 727 S.haematobium 1 One round of MDA over 2 years Arm 1: ↓59.6–7.7%=87% Arm 2: ↓25-2 to 3%= 88% Arm 3: ↓41.6 14.2% = 66% 1.↓94.2–6,8eggs/10ml 3.↓63.5–13.7 eggs/10mls 90% Significant and sustainable reduction of S.haematobium was achieved by biennial treatment in SAC 19 Adewale et al 27 Nigeria School children 5 to 18 years Cross-section survey 434 S.haematobium 1 Single dose of praziquantel ↓ 24.4 to 2,1 at 6months then ↑ to 7,7% at 12 months = 68% ↓9,87 to 1.98 then 1,27 at 12 months …”