Efficacy and Safety of Praziquantel for Treatment of Schistosoma mansoni Infection among School Children in Tanzania.

Rajabu Hussein Mnkugwe,Omary S Minzi,Eleni Aklillu,Appolinary A Kamuhabwa,Safari M Kinung’Hi

doi:10.3390/pathogens9010028

Abstract

Single-dose targeted praziquantel preventive chemotherapy is the WHO-recommended intervention for schistosomiasis control in endemic countries. The objective of this study was to assess the efficacy and safety of single-dose praziquantel among Schistosoma mansoni-infected children in north-western Tanzania. A prospective safety and efficacy surveillance study was conducted among 341 school-going children treated with a single-dose praziquantel 40 mg/kg body weight. Socio-demographic, pre-treatment, and post-treatment stool examination and safety data were collected. The primary and secondary outcomes were treatment efficacy (parasitological cure and egg reduction rates at three weeks post-treatment) and treatment-related adverse events, respectively. The overall cure rate and egg reduction rate were 81.2% (76.8–85.3%) and 95.0% (92.7–97.3%), respectively. There was no significant association between cure rate and pre-treatment infection intensity. The incidence of treatment-associated adverse events was 28.5% (23.7–33.3%), with abdominal pain being the most common. Post-treatment abdominal pain and vomiting were significantly associated with pre-treatment infection intensity (p < 0.001) and anemia (p = 0.03), respectively. Praziquantel single-dose is still safe and efficacious against Schistosoma mansoni infection. However, the lack of cure in about one-fifth and adverse events in a quarter, of the infected children indicate the need for close praziquantel safety monitoring and treatment optimization research to improve efficacy.

Highlights

Schistosomiasis is a treatable and preventable neglected tropical disease (NTD) which continues to affect the health and lives of many people, especially children in Sub-Saharan Africa (SSA) [1,2].The disease is among parasitic diseases of public health importance globally and inSub-Saharan African countries, including Tanzania [1]
A total of 341 school children infected with intestinal schistosomiasis were enrolled in this study
40 mg/kg body weight administered for the treatment of intestinal schistosomiasis among school children living in a rural area along the shore of Lake Victoria in north-western Tanzania

Summary

Introduction

Schistosomiasis is a treatable and preventable neglected tropical disease (NTD) which continues to affect the health and lives of many people, especially children in Sub-Saharan Africa (SSA) [1,2].The disease is among parasitic diseases of public health importance globally and inSub-Saharan African countries, including Tanzania [1]. Schistosomiasis is a treatable and preventable neglected tropical disease (NTD) which continues to affect the health and lives of many people, especially children in Sub-Saharan Africa (SSA) [1,2]. The disease is among parasitic diseases of public health importance globally and in. Sub-Saharan African countries, including Tanzania [1]. More than 779 million people are at risk of schistosomiasis infection, and more than 240 million people are infected [3,4,5,6]. Of the global burden of schistosomiasis is contributed by cases in SSA [7]. Despite being a treatable and preventable disease, schistosomiasis still causes up to 280,000 deaths annually in SSA [4,8]. In Tanzania, Pathogens 2020, 9, 28; doi:10.3390/pathogens9010028 www.mdpi.com/journal/pathogens

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