Use of praziquantel against schistosomiasis: a review of current status

Kumar, V.; Gryseels, B.

doi:10.1016/0924-8579(94)90032-9

Cited by 56 publications

(43 citation statements)

References 57 publications

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“…These values are in general within the usual cure rate ranges (63-95%) of PZQ against S. mansoni reported in different epidemiological settings [4,[26][27][28] . Some previous studies have reported efficacy higher than 85% for PZQ [29][30][31][32][33][34] , while others have reported lower (<63%) efficacy for the drug [13][14][15][16][17][18][19][20][21]35,36] .…”

Section: Discussionsupporting

confidence: 81%

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia

Erko

Degarege

Tadesse

et al. 2012

Asian Pacific Journal of Tropical Biomedicine

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Section: Discussionsupporting

confidence: 81%

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia

Erko

Degarege

Tadesse

et al. 2012

Asian Pacific Journal of Tropical Biomedicine

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“…9 Therefore, much attention was paid to the initial finding that parasitologic cure rates were Ͻ 20% after treatment of the first cohort at Ndombo. 2 The low efficacy of praziquantel treatment in this * 95% CI ϭ 95% confidence interval; epg ϭ eggs per gram of feces; BT ϭ before treatment with praziquantel; gmean ϭ geometric mean; AT ϭ after treatment with praziquantel; Freq WC ϭ total frequency of observed water contact; Dur WC ϭ total duration of observed water contact, expressed in minutes.…”

Section: Discussionmentioning

confidence: 99%

“…14 We also found cure rates to be significantly lower in children compared with adults (Table 2), a phenomenon that has been previously described in other areas. 9,14 There are no indications that this is due to different pharmacokinetics in children. 15 Children have higher worm loads than adults, but the difference in cure rates was still significant after stratifying in different egg count groups (Table 2).…”

Section: Discussionmentioning

confidence: 99%

The contribution of host-related factors to low cure rates of praziquantel for the treatment of Schistosoma mansoni in Senegal.

Lieshout¹,

Stelma²,

Guisse³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Surprisingly low cure rates were repeatedly observed after treatment with a standard dosage of praziquantel in a recently established Schistosoma mansoni focus in northern Senegal. In 4 discrete cohorts from the same population, cure rates were 18-36% and egg count reduction rates were 77-88%. Data and material of 920 compliant subjects from all 4 cohorts were further analyzed to identify possible host-related factors associated with low cure rates. The lowest cure rates were found in the highest egg count groups. However, in low and moderate egg count groups, drug efficacy was also below normal values. Cure rates were similar in males and females, showed no seasonal variation, and were independent of previous praziquantel treatment. They were significantly higher in adults than in children, also after allowing for intensity of infection. Individual water contact behavior and specific humoral immune responses were examined in 2 extreme subgroups, either without significant egg count reduction or showing complete parasitologic cure. There was no significant difference in frequency and duration of water contact between those individuals with complete cure and those that showed little effect of praziquantel treatment. Levels of IgG, IgG1, IgG3, IgG4, IgM, and IgE against adult worm antigen were not different between the 2 subgroups. Thus, the abnormally frequent failure of treatment observed in this focus could not be associated with any host-related factor, other than age and pretreatment egg counts.In a recently established focus of Schistosoma mansoni in the Senegal River Basin, praziquantel treatment apparently showed a lower efficacy and induced more side effects than usually reported. 1,2 In an initial cohort of 400 subjects, only 18% was found to be parasitologically negative 12 weeks after treatment with the standard single oral dosage of 40 mg/kg. However, egg reduction rates were substantial (86%) in those remaining positive. Results were confirmed by determination of circulating antigens excreted by metabolically active adult worms.2 Similar low cure rates were found in 3 subsequent cohorts from the same focus (Stelma FF, unpublished data). An increased dosage of praziquantel, given at the same day, showed no significant improvement, 3 while normal cure rates were found after treatment with oxamniquine, 4 or after repeated treatment with praziquantel within a period of 40 days. 5Possible explanations for these findings can be divided into 3 main categories: 1) parasite-related, including reduced strain susceptibility to praziquantel, 2) drug-related, including drug quality or bioavailability, and 3) host-related, including high initial intensity of infection, prepatent infections, rapid reinfection, and still under-developed pharmacosynergistic humoral immune responses. 2 This paper focuses on the third category of hypotheses. We use data from all four cohorts to analyze the contribution of host-related factors on the efficacy of praziquantel treatment in this area, with emphasis on the variabl...

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“…Praziquantel (PZQ) is the most common drug for the treatment of human schistosomiasis (32,89,155), since it is active against all the Schistosoma species (Schistosoma mansoni, S. haematobium, S. japonicum, S. intercalatum, and S. mekongi). In the field, particularly in community treatment, the usual dosage is 40 mg/kg of body weight in a single dose; higher dosages or split regimens result in lower compliance (89). In hospitalized patients, particularly for S. japonicum and S. mekongi, and for heavy infections with the other species, the recommended dose is 30 mg/kg, up to (32,71,89).…”

Section: Drug Resistance In Schistosomesmentioning

confidence: 99%

“…In the field, particularly in community treatment, the usual dosage is 40 mg/kg of body weight in a single dose; higher dosages or split regimens result in lower compliance (89). In hospitalized patients, particularly for S. japonicum and S. mekongi, and for heavy infections with the other species, the recommended dose is 30 mg/kg, up to (32,71,89). In endemic conditions, reinfection is the rule rather than the exception, particularly in children, who are heavily exposed and appear to be (innately or immunologically) more susceptible to infection than adults (72).…”

Section: Drug Resistance In Schistosomesmentioning

confidence: 99%

Drug Resistance in Human Helminths: Current Situation and Lessons from Livestock

Geerts

Gryseels

2000

Clinical Microbiology Reviews

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Use of praziquantel against schistosomiasis: a review of current status

Cited by 56 publications

References 57 publications

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia

The contribution of host-related factors to low cure rates of praziquantel for the treatment of Schistosoma mansoni in Senegal.

Drug Resistance in Human Helminths: Current Situation and Lessons from Livestock

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