A comparative study on the efficacy of praziquantel and albendazole in the treatment of urinary schistosomiasis in Adim, Cross River State, Nigeria

Background: Praziquantel (PZQ) is the current drug of choice for the treatment of urinary schistosomiasis in endemic areas. It is very efficacious, although the potential for the development of resistance has been reported in some endemic areas among human subjects and in animal studies. Its' limitation include high cost and administration of multiple numbers of tablets. Albendazole (ALB) is used in the treatment of intestinal helminths infection. It is a broad-spectrum single-dose antihelminthic with an excellent cure rate and safety criteria. Currently, it is not routinely used for the treatment of urinary schistosomiasis. Methods: Urine samples collected from 596 pupils aged between 2 and 16 years were processed and examined for the presence of ova of Schistosoma haematobium using a standard filtration technique. A total of 100 infected subjects were treated with a standard dose of PZQ (40 mg/kg body weight), while another group of 96 infected subjects were treated with ALB (400 mg for individuals above 3 years). A post-treatment study was conducted 1 month after treatment to assess their cure rate. Results: The prevalence of S. haematobium infection in the study area was 32.8% (196/596). More males were infected (44.2%) (122/276) than females (23.1%) (74/320). The difference in the prevalence rate of infection by gender was statistically significant (X-2=15.7>3.841, p<0.05). The highest prevalence of infection was observed among subjects aged 14-16 years (42.1%) (32/76), while those aged 5-7 years had the least prevalence (23.7%) (38/160). There was no statistically significant difference in the prevalence of urinary schistosomiasis by age of the subjects (X-2=5.99<9.5, p>0.05). PZQ gave a higher cure rate of 78.0% (78/100) compared with ALB (68.7%) (66/96). There was no statistically significant difference in the cure rate obtained with both drugs (X-2=0.355>0.282, p>0.05). The intensity of egg excretion was greatly reduced in subjects who were not cured by the two drugs. Conclusion: The findings of this study suggest the use of ALB for the treatment of urinary schistosomiasis. We recommend further assessment of the efficacy of the drug in an area with higher morbidity of urinary schistosomiasis than the present study area.