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Performance and safety of praziquantel for treatment of intestinal schistosomiasis in infants and preschool children.

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Sousa-Figueiredo, J.C., Betson, Martha, Atuhaire, Aaron, Arinaitwe, Moses, Navaratnam, Annalan M D, Kabatereine, Narcis B, Bickle, Quentin and Stothard, J Russell ORCID: https://orcid.org/0000-0002-9370-3420 (2012) 'Performance and safety of praziquantel for treatment of intestinal schistosomiasis in infants and preschool children.'. PLoS Neglected Tropical Diseases, Vol 6, Issue 10, e1864.

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Abstract

BACKGROUND

In 2012 the WHO formally recognised that infants and preschool children are at significant risk of schistosomiasis and qualify for treatment with praziquantel (PZQ). Targeted surveys determining both the performance and safety of this drug are now needed in endemic areas. We have formally assessed parasitological cure and putative side-effects in a prospective cohort of Schistosoma mansoni-infected children (aged 5 months-7 years old) in lakeshore settings of Uganda.

METHODOLOGY/PRINCIPAL FINDINGS

From a total of 369 children found to be egg-patent for intestinal schistosomiasis, 305 were followed-up three to four weeks after PZQ treatment and infection status re-assessed. Separately, a previously tested side-effect questionnaire was employed before and 24 hours after PZQ treatment to assess incidence and amelioration of symptoms in young children and their mothers. While the overall observed parasitological cure was 56.4%, a significant difference was found between a sub-set of children who had a history of multiple PZQ treatments (between one and four in an 18 month period), where cure rate was 41.7%, and those who had never received treatment (cure rate was 77·6%). PZQ proved to be safe, with only mild reported side effects which cleared within a month after treatment. Prevalence of reported symptoms was significantly lower in children than in mothers, and fewer side-effects were reported upon subsequent rounds of PZQ treatment.

CONCLUSION/SIGNIFICANCE

Our findings show that PZQ treatment of young children resulted in satisfactory cure rates, and marked reduction in egg-output, with only mild and transient reported side-effects. However, the cure rate is clearly lower in younger children and those with history of previous treatment. Cure rate, but not egg reduction rate, was also lower in children with heavier pre-intervention infection intensity. With chemotherapy now recommended as a long-term strategy for disease control in young children, research into optimising the periodicity of targeted treatment strategies is now crucial.

Item Type: Article
Subjects: QV Pharmacology > Drug Standardization. Pharmacognosy. Medicinal Plants > QV 771 Standardization and evaluation of drugs
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WB Practice of Medicine > Therapeutics > WB 340 Drug Administration
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 810 Schistosomiasis
WS Pediatrics > By Age Groups > WS 421 Diseases of newborn infants
WS Pediatrics > By Age Groups > WS 440 Preschool child
Faculty: Department: Groups (2002 - 2012) > Disease Control Strategy Group
Groups (2002 - 2012) > Molecular & Biochemical Parasitology Group
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0001864
Depositing User: Mary Creegan
Date Deposited: 20 Feb 2013 12:06
Last Modified: 06 Feb 2018 13:05
URI: http://archive.lstmed.ac.uk/id/eprint/3269

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