Objective To assess the effect of combined Echinacea purpurea (EP) and mefloquine (MQ) in the treatment of experimental Schistosoma mansoni infection. Background Schistosomiasis is a prevalent parasitic disease in tropical and subtropical areas caused by the flatworm S. mansoni. Several medications are used in the treatment of schistosomiasis. Praziquantel (PZQ) is the drug of choice because of its safety and broad-spectrum activity. Materials and methods The current study was carried out on 120 laboratory-bred Swiss albino female mice. They were classified into six groups: group I (control), group II (PZQ treated), group III (MQ treated), group IV (EP treated), group V (PZQ and EP), and group VI (MQ and EP). Evaluation was done parasitologically using the worm count technique, ova count technique in intestine and liver, and oogram pattern and histopathological examination of liver sections for assessment of granuloma size and diameter. Moreover, electron microscopic changes of the adult worms were evaluated. Results The highest worm burden reduction of male (79.41%), female (82.28%), couples (86.6%), and total (92%) worms was obtained in the combined MQ and EP treated group. The highest reduction in the mean number of ova count/g tissue in either the intestine (93%) or the liver (89%) was detected in MQ and EP treated group. In combined treated groups, the highest percentage of reduction in the immature and mature eggs was detected in the group MQ and EP; it was 9.16 ± 4.11 and 5.25 ± 2.56, respectively. Moreover, there was an increase in the percentage of dead eggs (85.58 ± 6.43). The highest reductions in hepatic granuloma diameter and number were seen in the combination of MQ and EP at 67 and 85%, respectively (P Conclusion MQ has effective schistosomicidal properties through reduction of worm burden and tissue egg load. Moreover, EP extract showed promising antischistosomal activity on S. mansoni-infected mice. It is recommended to study the exact mechanism of action of EP on S. mansoni and its possible effects on other parasitic infections.
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