Specific schistosomiasis treatment as a strategy for disease control

Epidemiology of Schistosomiasis Mansoni in Brazil

“…The authors concluded that to reach best results it was necessary to improve the sanitary conditions as well as give specific treatment. Similar discussions on schistosomiasis mansoni control were emphasized by WHO (2002), Coura & Amaral (2005), Rey (2007), , and by Coura & Conceição (2010), showing the Brazilian contribution on the clinical therapy. Co-morbidities like infections by hepatitis B and C virus, Salmonella spp.…”

In vitro produced glycoalkaloids from Solanum nigrum L. and evaluation of their potential role as antibilharziasis

“…Other chemotherapy agents were reported to have severe side effects as hepatotoxicity and cardiac muscle toxicity. Among these agents, Miracil D (thioxanthone derivatives) is taken orally and antimonial compounds which are taken via intravenous or intramuscular routes [63].…”

Directives for Schistosomiasis Control in Endemic Areas of Brazil

“…The periodicity of school-based treatment varies according to the prevalence class: annual for high prevalence, biennial for moderate prevalence and twice during elementary schooling (on entry and on leaving) for low prevalence. This strategy of targeted preventive chemotherapy is viewed by the MS as a step backward for the Americas, as studies conducted in Brazil had shown that mass chemotherapy had only a transitory effect on schistosomiasis indicators (Coura & Conceição, 2010); instead, the focus should be on strengthening capacity for diagnosis and treatment of infection carriers at the primary care level and on improving environmental sanitation (PAHO, 2009). As pointed out by Rabello & Enk (2006), targeted treatment irrespective of infection status has the following implications: (i) risk of increasing drug resistance; (ii) relative high cost and low sustainability as compared to individual treatment integrated into the primary health care system; (iii) ethical requirement of informing the patient about the risks and benefits of unnecessary treatment and the right to refuse it without positive diagnosis.…”

“…Moreover, in five schools more than 80% of the children would be treated with negative diagnosis. It is noteworthy that, although the side effects of PZQ are considered to be mild and transient (Coura & Conceição, 2010), they are a major factor discouraging people from taking the drug (Fleming et al, 2009;Garba et al, 2009;Souza-Figueiredo et al, 2010 Table 2. Differences in treatment delivery to school-aged children between selective (positive only) and targeted (positive and negative) chemotherapy.…”

“…However, to obtain sustained, satisfactory results mass treatment coverage should be kept around 90%, which has proven challenging over the years. In Brazil, selective treatment has reduced prevalence of infection in the short-term and morbidity in medium to long-term periods, but has not been sufficient to control disease transmission (Coura & Conceição, 2010). Studies from different endemic areas have shown that treatment strategies should be accompanied by auxiliary measures according to the epidemiological and geographical settings of each region (Guo et al, 2005;Wang et al, 2009;Sarvel et al, 2011).…”