BackgroundFascioliasis is an emerging zoonotic disease of considerable veterinary and public health importance. Triclabendazole is the only available drug for treatment. Laboratory studies have documented promising fasciocidal properties of the artemisinins (e.g., artemether).MethodologyWe carried out two exploratory phase-2 trials to assess the efficacy and safety of oral artemether administered at (i) 6×80 mg over 3 consecutive days, and (ii) 3×200 mg within 24 h in 36 Fasciola-infected individuals in Egypt. Efficacy was determined by cure rate (CR) and egg reduction rate (ERR) based on multiple Kato-Katz thick smears before and after drug administration. Patients who remained Fasciola-positive following artemether dosing were treated with single 10 mg/kg oral triclabendazole. In case of treatment failure, triclabendazole was re-administered at 20 mg/kg in two divided doses.Principal FindingsCRs achieved with 6×80 mg and 3×200 mg artemether were 35% and 6%, respectively. The corresponding ERRs were 63% and nil, respectively. Artemether was well tolerated. A high efficacy was observed with triclabendazole administered at 10 mg/kg (16 patients; CR: 67%, ERR: 94%) and 20 mg/kg (4 patients; CR: 75%, ERR: 96%).Conclusions/SignificanceArtemether, administered at malaria treatment regimens, shows no or only little effect against fascioliasis, and hence does not represent an alternative to triclabendazole. The role of artemether and other artemisinin derivatives as partner drug in combination chemotherapy remains to be elucidated.

This trial investigated the anti-schistosomal activity of mirazid in comparison with that of praziquantel in Schistosoma mansoni-infected Egyptian patients. The sample population was composed of 1,131 individuals (459 school children and 672 household members). Screening for S. mansoni was conducted using the standard Kato Katz technique. Four slides from a single stool sample were examined before treatment, and four slides per sample from stool samples obtained on three consecutive days were examined post-treatment. All positive eligible subjects were randomly assigned into two groups, the first received mirazid at a dose of 300 mg/day for three consecutive days, and the second received praziquantel at a single dose of 40 mg/kg. All treated subjects were examined 4-6 weeks post-treatment. Mirazid showed low cure rates of 9.1% and 8.9% in S. mansoni-infected school children and household members, respectively, compared with cure rates of 62.5% and 79.7%, respectively, in those treated with praziquantel. Therefore, we do not recommend mirazid as an agent to control schistosomiasis.

Background: Waterborne protozoal infections are common health problems in many parts of the world especially in developing countries. Water is a major vehicle for transmission of protozoa such as G. lamblia, Cryptosporidium spp. as well as pathogenic and opportunistic free living amoeba (FLA). Objective: This study aims to detect the presence of protozoal agents in tap water and storage water tanks at Fayoum Governorate, Egypt. Material and Methods: A total of ninety five water samples were collected from different water sources, taps (65) and tanks (30), from 6 Fayoum districts. The samples were processed to detect the presence of G. lamblia cysts by Lugol's iodine stain, Cryptosporidium oocysts by modified Ziehl-Neelsen stain and FLA by cultivation. After cultivation, Acanthamoeba spp. were identified according to their morphological features and flagellation test was performed to detect amoeboflagellates. Results: All water samples collected from tanks (100%) were contaminated by protozoa of medical importance, while only 6 (9.2%) of the tap water samples were pathogen free. The majority of water samples were contaminated with mixed protozoal infections. The overall detection rates of contaminants in water sources were 86.3%, 52.6%, 13.7% by FLA, Cryptosporidium spp. and G. lamblia, respectively. Conclusions: The recorded detection rates of waterborne protozoa present a hazard to the community resulting in silent morbidities and mortalities. It is strongly recommended to adopt proper water safety measures.

No abstract

No abstract