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Treatment of urinary schistosomiasis: methodological issues and research needs identified through a Cochrane systematic review

Danso-Appiah, A., Garner, Paul ORCID:, Olliaro, P. L. and Utzinger, J. (2009) 'Treatment of urinary schistosomiasis: methodological issues and research needs identified through a Cochrane systematic review'. Parasitology, Vol 136, pp. 1837-1849.

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SUMMARY Guidelines recommend praziquantel (PZQ) for the treatment and control of schistosomiasis, with no real alternative. Metrifonate was still widely used against Schistosoma haematobium in the 1990s, and then withdrawn. Experimental studies and clinical trials suggest that artemisinin compounds are active against S. haematobium. In a Cochrane systematic review assessing the efficacy and safety of drugs for treating urinary schistosomiasis, 24 randomized controlled trials (n=6315 individuals) met our inclusion criteria. These trials compared a variety of single agent and combination regimens with PZQ, metrifonate or artemisinin derivatives. The review confirmed that both the standard recommended doses of PZQ (single 40 mg/kg oral dose) and metrifonate (3×7·5-10 mg/kg oral doses administered fortnightly) are efficacious and safe in treating urinary schistosomiasis, but there is no study comparing these two regimens head-to-head. There is currently not enough evidence to evaluate artemisinin compounds. Most of the studies included in the Cochrane systematic review were insufficiently powered, lacked standardization in assessing and reporting outcomes, and had a number of methodological limitations. In this paper we discuss the implications of these findings with respect to public health and research methodology and propose priority research needs.

Item Type: Article
Additional Information: Cited By (since 1996): 2 Export Date: 24 November 2009 Source: Scopus Article in Press CODEN: PARAA doi: 10.1017/S0031182009005939 Language of Original Document: English
Uncontrolled Keywords: systematic review meta-analysis praziquantel metrifonate artemisinin
Subjects: WA Public Health > WA 20.5 Research (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 810 Schistosomiasis
QV Pharmacology > QV 4 General works
QV Pharmacology > QV 38 Drug action.
Digital Object Identifer (DOI):
Depositing User: Faye Moody
Date Deposited: 29 Mar 2010 15:36
Last Modified: 06 Sep 2019 10:14


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