Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children

Particle and Fibre Toxicology

Jürg Utzinger¹  Eliézer K N’Goran³  Winfried V Kern²  Laurent K Lohourignon³  Ivan Müller¹  Jan Hattendorf¹  Stefanie Knopp¹  Jean T Coulibaly³  Stefanie J Krauth¹  Katarina Stete¹ 

[1] University of Basel, P.O. Box, CH–4003 Basel, Switzerland;Center for Infectious Diseases and Travel Medicine, Department of Medicine, Albert-Ludwigs-University, Hugstetter Strasse 55, D-79106, Freiburg, Germany;Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 770, Abidjan 22, Côte d'Ivoire

关键词: Côte d’Ivoire;    School-aged children;    Leukocyturia;    Proteinuria;    Microhaematuria;    Macrohaematuria;    Drug efficacy;    Praziquantel;    Schistosoma haematobium;    Schistosomiasis;   

Others  :  1228107
DOI  :  10.1186/1756-3305-5-298

 received in 2012-09-04, accepted in 2012-12-11,  发布年份 2012

【 摘 要 】

Background

Praziquantel is the drug of choice in preventive chemotherapy targeting schistosomiasis. Increasing large-scale administration of praziquantel requires monitoring of drug efficacy to detect early signs of development of resistance. Standard protocols for drug efficacy monitoring are necessary. Here, we determined the optimal time point for praziquantel efficacy assessment against Schistosoma haematobium and studied the dynamics of infection parameters following treatment.

Methods

Ninety school-aged children from south Côte d’Ivoire with a parasitologically confirmed S. haematobium infection were treated with a single oral dose of praziquantel (40 mg/kg) and followed up for 62 days post-treatment. Urine samples were collected on 23 schooldays during this period and were subjected to visual examination (macrohaematuria), urine filtration and microscopy (S. haematobium eggs) and reagent strip testing (microhaematuria, proteinuria and leukocyturia).

Results

Observed cure and egg reduction rates were highly dependent on the time point post-treatment. Egg reduction rates were high (>97%) in weeks 3–9 post-treatment. Cure rates were highest in weeks 6 (92.9%) and 9 (95.0%) post-treatment. The prevalence of infection-associated parameters decreased after treatment, reaching a minimum of 2.4% in weeks 5 (proteinuria) and 7 (leukocyturia) post-treatment, and 16.3% at the end of week 8 (microhaematuria). Macrohaematuria disappeared between weeks 3 and 6 post-treatment.

Conclusions

For monitoring praziquantel efficacy against S. haematobium, we recommend that the cure rate is assessed at week 6 post-treatment. The egg reduction rate can be evaluated earlier, from day 14 post-treatment onwards. Reagent strips are a useful additional tool for evaluating treatment outcomes in areas with high endemicity, preferably at weeks 5 and 6 post-treatment. The delayed decrease of microhaematuria confirms that lesions in the urinary tract persist longer than egg excretion post-treatment.

【 授权许可】

   
2012 Stete et al.; licensee BioMed Central Ltd.

【 图 表 】

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