The Efficacy of Single-Dose versus Double-Dose Praziquantel Treatments on<i>Schistosoma mansoni</i>Infections: Its Implication on Undernutrition and Anaemia among Primary Schoolchildren in Two On-Shore Communities, Northwestern Tanzania

Munisi, David Zadock; Buza, Joram; Mpolya, Emmanuel; Angelo, Teckla; Kinung’hi, Safari

doi:10.1155/2017/7035025

Cited by 36 publications

(39 citation statements)

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“…Praziquantel is efficacious on all species, therefore, it is the only recommended drug for preventing and treating schistosomiasis [ 2 ] despite some observed low cure rates and possible resistance recently reported. This review shows that for most of the studies praziquantel had high efficacy on both species [ 19 , 22 , 27 , 28 , 29 , 34 ]. However, higher efficacy was reported against S. haematobium [ 30 – 32 ] than it was with S. mansoni [ 24 ] in co-infection settings as shown in Additional file 4 : Table S3.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of praziquantel treatment regimens in pre-school and school aged children infected with schistosomes in sub-Saharan Africa: a systematic review

2018

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BackgroundSchistosomiasis is a serious public health burden in sub-Saharan Africa. Praziquantel is the only drug recommended by the World Health Organization to treat both urogenital and intestinal schistosomiasis. The reliance on a single drug to treat a disease with such a huge burden has raised concerns of possible drug resistance mainly in endemic areas. This systematic review was conducted to identify gaps and recent progress on the efficacy of different regimens of praziquantel in treating schistosomiasis among children in sub-Saharan Africa where Schistosoma mansoni and S. haematobium are endemic.Main textA literature search of peer-reviewed journals was done on Google Scholar, MEDLINE (under EBSCOhost) and PubMed databases using pre-defined search terms and Boolean operators. The search included studies published from 2008 to 2017 (August) with emphasis on the efficacy of praziquantel on S. haematobium and S. mansoni infections among preschool and school children. Nineteen publications satisfied the inclusion criteria for the review. The studies reviewed were from 10 sub-Saharan African countries and 7/19 of the studies (37%) were conducted in Uganda. Seven studies (37%) focused on Schistosoma mansoni, 6/19 (31.5%) on S. haematobium and another 6 on mixed infection. A single standard dose of 40 mg/kg body weight was the most used regimen (9) followed by the repeated single standard dose assessed for efficacy at 3–4 weeks post-treatment.ConclusionsA repeated standard dose of 40 mg/kg achieved satisfactory efficacy compared to a single dose against both parasite species. However, findings on efficacy of repeated doses in co-infection of S. mansoni and S. haematobium were not conclusive. Praziquantel administrated at 60 mg/kg was slightly more efficacious than the 40 mg/kg standard dose. Minor and transitory side-effects were reported for both regimens. The review indicates that further investigations are necessary to conclusively determine efficacy of praziquantel on coinfection of S. haematobium and S. mansoni to formulate concrete guidelines on the use of repeated doses at 40 or 60 mg/kg for treating schistosomiasis. We recommend the use of the egg reduction rate (ERR) formula recommended by the WHO for assessing praziquantel efficacy in order for the results to be comparable for different regions.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0448-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Efficacy of praziquantel treatment regimens in pre-school and school aged children infected with schistosomes in sub-Saharan Africa: a systematic review

2018

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“…The poor efficacy of praziquantel against immature parasites has been elucidated as a possible cause of low CRs, especially if the assessment of drug efficacy is done > three weeks post-drug administration particularly high transmission areas, where the residents are continuously exposed for new infections and harbor more immature parasites [16]. A recent study conducted in north-western Tanzania, where the assessment was done eight weeks post-treatment, reported a lower CR, i.e., 68.68% [31]. Similar low CR (60.9%) and ERR (61.4%) were reported from Côte d'Ivoire at six weeks post-treatment [25].…”

Section: Discussionmentioning

confidence: 99%

“…The poor efficacy of praziquantel against juvenile schistosomes is well recognized, and hence, the need for further treatment optimization research is evident. To enhance praziquantel performance, randomized clinical trials (RCTs) to investigate the combination of praziquantel with other drugs that are active against the juvenile worms (such as artemisinins) [32], or the use of repeated praziquantel doses, may be considered in endemic settings [16,31].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…Reinfections are not uncommon in areas of high schistosome transmission such as this one [6]. There is a greater chance of individuals being infected with immature schistosomes at the time of MDA treatment and parasites not being completely cleared by one dose of praziquantel [15]. Furthermore, high levels of reinfection can occur especially if the MDA occurs before the transmission period.…”

Section: Discussionmentioning

confidence: 99%

Positive impact of preventative chemotherapy during a national helminth control program: Perception and KAP

et al. 2020

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Helminth control at the national level is currently based on mass drug administration (MDA) programs. Perception of the MDA programs for helminth control by the affected populations influences compliance and future designs of the programs. We determined the perception of Zimbabwe's National Helminth Control Program (2012-2017) with a specific focus on schistosomiasis in the school children treated with praziquantel, schoolteachers and village health workers (VHW). The study enrolled 409 children from Grades 6 and 7 who had the full benefit of the 6 years of MDA from 2012 to 2017. Thirty-six schoolteachers and 22 VHW serving the schools were also recruited. A structured questionnaire developed in English, translated into the local language Shona, and validated prior to the study was administered to the children and the adults. The questions focused on the perceived impact on health, school attendance and performance and Knowledge Attitudes and Practice (KAP) among the school children. Data were captured electronically on android platforms using the Open Data Kit. Overall, 84% of the children responded that their awareness of schistosomiasis (transmission, disease, treatment and infection avoidance) had improved because of participating in the MDAs. Of the 151 children self-diagnosed with schistosomiasis, 74% reported that their health had improved following treatment with praziquantel. This included resolution of haematuria, painful urination, sore stomach, tiredness and falling asleep during class lessons. The children and teachers reported improvements in both pupil school attendance and performance at school while the VHW and teachers reported an increase in healthseeking behaviour amongst the school children for schistosomiasis treatment in-between MDAs. The majority of VHW (96%) reported improvement in handwashing behaviour, schistosomiasis awareness (96%) and treatment uptake (91%) within the communities where the school children belonged. However, only 59% of the VHW reported improvement in toilet use while only 50% of the VHW reported improvement in clean water use within their communities. This study indicated that the surveyed children perceived the MDA program had PLOS NEGLECTED TROPICAL DISEASES

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The Efficacy of Single-Dose versus Double-Dose Praziquantel Treatments onSchistosoma mansoniInfections: Its Implication on Undernutrition and Anaemia among Primary Schoolchildren in Two On-Shore Communities, Northwestern Tanzania

Cited by 36 publications

References 50 publications

Efficacy of praziquantel treatment regimens in pre-school and school aged children infected with schistosomes in sub-Saharan Africa: a systematic review

Efficacy of praziquantel treatment regimens in pre-school and school aged children infected with schistosomes in sub-Saharan Africa: a systematic review

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

Positive impact of preventative chemotherapy during a national helminth control program: Perception and KAP

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