Treatment Of Intestinal Schistosomiasis Research Articles

Prevalence and intensity of Schistosoma mansoni infection in pediatric populations on antiretroviral therapy in north-western Tanzania: a cross-sectional study

BackgroundIn areas where HIV and intestinal schistosomiasis are highly endemic, co-infections of the two diseases in a single human host are frequent. Evidence in adult populations indicates that HIV and...

Effects of artemether on parasite burden and liver pathology in mice infected with Ibadan isolate of <i>Schistosoma mansoni</i>

This study aimed at evaluating the pathological features associated with Schistosoma mansoni infection and assessment of the efficacy of artemether in the treatment of intestinal schistosomiasis in laboratory mice. Cercariae harvested from naturally infected Biomphalaria pfeifferi obtained from Odo Ona River in Ibadan, Oyo State, Nigeria, were used to infect Swiss albino mice in the laboratory. A total of 50 mice were divided into 5 groups and artemether (300mg/kg) was administered to two of the groups at 15th and 42nd day post-infection respectively, Praziquantel (600mg/kg) was administered to a group as the control drug and another group was used as the infected control group while the last group was uninfected. Mice were sacrificed and perfused at 8th week post-infection for worm recovery, examination of the visceral organs and histopathology were conducted on liver and spleen of infected and uninfected groups. Schistosoma mansoni isolate from Ibadan, caused severe liver pathology in mice, and thus presents features indicative of epidemiological importance in human schistosomiasis. Worm burden reduction (98%) was observed in mice treated at day 15 post-infection with artemether (300 mg/kg) while 77% worm reduction was observed in the group of mice treated at day 42 post infection with artemether (300 mg/kg). Granulomas were not observed in the liver of mice treated at day 15 post-infection while those of untreated group, which had multiple granulomas. Inflammatory cellular infiltrations were observed in liver of infected mice however, the mice treated at day 15 post-infection had mild infiltration likely due to fewer eggs present in the liver. Praziquantel used as the routine control drug was less effective compared to artemether. Worm reduction (53%) was recorded for mice treated with praziquantel, gross and histopathology also revealed eggs diffusely deposited in the liver of the mice. Artemether, a derivative of artemisinin, showed a good antischistosomal effect that could be an alternative and/or complement praziquantel in the control of schistosomiasis in endemic areas.Keywords: Artemether; Schistosoma mansoni; Ibadan isolate; Swiss albino mice; gross pathology; histopathology.

Efficacy of praziquantel syrup versus crushed praziquantel tablets in the treatment of intestinal schistosomiasis in Ugandan preschool children, with observation on compliance and safety

Preschool children (aged ≤5 years) have so far been overlooked by mass treatment campaigns targeting schistosomiasis, even though praziquantel (PZQ) has been shown to be well tolerated and effective within this age group. The WHO provided the Ugandan Ministry of Health with a syrup formulation of PZQ with the aim of assessing its safety and efficacy in comparison with crushed PZQ tablets for the treatment of intestinal schistosomiasis in preschool children. This study included 1144 preschool children randomly assigned to two treatment arms (PZQ syrup or crushed PZQ tablet) regardless of infection status for direct comparison. Diagnosis of intestinal schistosomiasis was assessed using single stool sample, double Kato–Katz smear examinations. Parasitological cure was assessed 3 weeks after treatment. The observed cure rate was 80.9% for the PZQ syrup arm and 81.7% for the crushed PZQ tablet arm, with egg reduction rates of 86.1% and 89.0%, respectively. Pre-treatment infection intensity was observed to influence cure rates significantly, with cure rates of 88.6% for light infections, 74.5% for moderate infections and 67.4% for heavy infections. No significant difference was found in non-compliance between the PZQ syrup (11.1%) and crushed PZQ tablet (14.7%) arms. PZQ syrup and crushed PZQ tablets have very similar efficacies in the treatment of intestinal schistosomiasis in preschool children.

Serological analysis of the outcome of treatment ofSchistosomamansoniinfections with praziquantel

A serological assay was developed to assess the outcome of the treatment of intestinal schistosomiasis with praziquantel, in patients with Schistosoma mansoni infection. Each of 33 patients (seven found to be excreting S. mansoni eggs and 26 egg-negatives found seropositive for antibodies against antigens from S. mansoni eggs) had two to five serum specimens assayed, the sera being collected at the time of diagnosis and at least once after praziquantel treatment. The sera were tested in ELISA against three antigen preparations: the unfractionated soluble egg antigens of S. margrebowiei and S. mansoni (SmSEA) and a cationic antigen fraction (CEF6) purified from the SmSEA. The dynamics of the post-treatment antibody levels were variable. In a minority of the patients, antibody levels declined relatively rapidly (within 5-12 months), to ELISA negativity, with the levels of the anti-CEF6 antibodies declining more rapidly than those of the anti-SmSEA antibodies. In the remaining patients, however, the levels of these specific antibodies declined only slowly or not at all over a 2- to 3-year period. The post-treatment monitoring of the levels of anti-schistosome-egg antibodies, particularly those of anti-CEF6 antibodies, may help to distinguish the treatments that result in parasitological cure from those that are only partially successful.

Treatment of intestinal schistosomiasis in Ugandan preschool children: best diagnosis, treatment efficacy and side-effects, and an extended praziquantel dosing pole.

SummaryThe Ugandan national control programme for schistosomiasis has no clear policy for inclusion of preschool-children (≤5 years old) children. To re-balance this health inequality, we sought to identify best diagnosis of intestinal schistosomiasis, observe treatment safety and efficacy of praziquantel (PZQ), and extend the current WHO dose pole for chemotherapy. We examined and treated 363 preschool children from shoreline villages of Lakes Albert and Victoria, and found that 62·3% (CI95 57·1–67·3) of the children were confirmed to have intestinal schistosomiasis. One day after treatment, children were reported as having headaches (3·6%), vomiting (9·4%), diarrhoea (10·9%) and urticaria/rash (8·9%) with amelioration at 21-day follow-up, where the parasitological cure rate was found to be 100·0%. Height and weight data were collected from a further 3303 preschool children to establish and validate an extended PZQ dose pole that now includes two new height-intervals: 60–84 cm for one-half tablet and 84–99 cm for three-quarter tablet divisions; which would result in 97·6% of children receiving an acceptable dose (30–60 mg/kg). To conclude, preschool children in lakeshore communities of Uganda are at significant risk of intestinal schistosomiasis; we now strongly advocate for their immediate inclusion within the national control programme to eliminate this health inequity.

Current chemotherapy arsenal for schistosomiasis mansoni: alternatives and challenges

Schistosomiasis still represents a major health problem in many tropical and subtropical countries despite continuing control efforts. Due to the unavailability of a vaccine that is practically applicable to humans, the use of chemotherapy is the mainstay of schistosomiasis-associated morbidity control. This paper attempts to review the antischistosomal drugs currently used in the treatment of intestinal schistosomiasis caused by Schistosoma mansoni. Their antischistosomal properties, advantages, and disadvantages as well as issues regarding the evidence for drug resistance and combination studies are reviewed in a simple manner. The recent trends towards the identification of specific chemotherapeutic targets for the treatment of schistosomes are also discussed briefly.

Cure rates and egg reduction in treatment of intestinal schistosomiasis with oxamniquine and praziquantel in Maniema, Zaire

Cure rates and egg reduction in treatment of intestinal schistosomiasis with oxamniquine and praziquantel in Maniema, Zaire