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

Stete, K., Krauth, S. J. , Coulibaly, J. T., Knopp, S., Hattendorf, J., Müller, I., Lohourignon, L. K., Kern, W. V., N’Goran, E. K. and Utzinger, J. (2012) Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children. Parasites and Vectors, 5, 298. (doi:10.1186/1756-3305-5-298) (PMID:23259435) (PMCID:PMC3558406)

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Abstract

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.

Item Type:Articles
Additional Information:This study received financial support from the Swiss Tropical and Public Health Institute (Teaching & Training), Fairmed, and the University of Georgia Research Foundation, Inc, which is funded by the Bill & Melinda Gates Foundation for the SCORE project. EKN and JU acknowledge financial support from the Swiss National Science Foundation (project no. IZ70Z0_123900).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Krauth, Dr Stefanie
Authors: Stete, K., Krauth, S. J., Coulibaly, J. T., Knopp, S., Hattendorf, J., Müller, I., Lohourignon, L. K., Kern, W. V., N’Goran, E. K., and Utzinger, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:Parasites and Vectors
Publisher:BMC
ISSN:1756-3305
ISSN (Online):1756-3305
Published Online:21 December 2012
Copyright Holders:Copyright © 2012 Stete et al.
First Published:First published in Parasites and Vectors 5:298
Publisher Policy:Reproduced under a Creative Commons license

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