The improvement of conventional POC methodology by a fast and simple urine concentration step provided not only an increase in its accuracy before and after praziquantel treatment, but also preserved its applicability in low-prevalence endemic areas, allowing the definition of trace readings as negative cases.
Current schistosomiasis control strategies are largely based on chemotherapeutic
agents and a limited number of drugs are available today. Praziquantel (PZQ) is
the only drug currently used in schistosomiasis control programs. Unfortunately,
this drug shows poor efficacy in patients during the earliest infection phases.
The effects of PZQ appear to operate on the voltage-operated Ca2+channels, which
are located on the external Schistosoma mansoni membrane.
Because some Ca2+channels have dihydropyridine drug class (a class that includes
nifedipine) sensitivity, an in vitro analysis using a calcium channel antagonist
(clinically used for cardiovascular hypertension) was performed to determine the
antischistosomal effects of nifedipine on schistosomula and adult worm cultures.
Nifedipine demonstrated antischistosomal activity against schistosomula and
significantly reduced viability at all of the concentrations used alone or in
combination with PZQ. In contrast, PZQ did not show significant efficacy when
used alone. Adult worms were also affected by nifedipine after a 24 h incubation
and exhibited impaired motility, several lesions on the tegument and intense
contractility. These data support the idea of Ca2+channels subunits as drug
targets and favour alternative therapeutic schemes when drug resistance has been
reported. In this paper, strong arguments encouraging drug research are
presented, with a focus on exploring schistosomal Ca2+channels.
The population of Brazil is currently characterised by many individuals harbouring low-intensity
Schistosoma mansoni
infections. The Kato-Katz technique is the diagnostic method recommended by the World Health Organization (WHO) to assess these infections, but this method is not sensitive enough in the context of low egg excretion. In this regard, potential alternatives are being employed to overcome the limits of the Kato-Katz technique. In the present review, we evaluated the performance of parasitological and immunological approaches adopted in Brazilian areas. Currently, the diagnostic choices involve a combination of strategies, including the utilisation of antibody methods to screen individuals and then subsequent confirmation of positive cases by intensive parasitological investigations.
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