Safety and efficacy of praziquantel syrup (Epiquantel®) against Schistosoma haematobium and Schistosoma mansoni in preschool-aged children in Niger

被引:24
作者
Garba, Amadou [1 ,2 ,3 ]
Lamine, Mariama S. [1 ]
Djibo, Ali [4 ]
Tahirou, Almoustapha [4 ]
Aouami, Mahamadou Aboubacar [4 ]
Alfari, Aichatou [5 ]
Phillips, Anna E. [6 ]
Fenwick, Alan [6 ]
Utzinger, Juerg [2 ,3 ]
机构
[1] Reseau Int Schistosomoses Environm Amenagement &, Niamey, Niger
[2] Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, CH-4002 Basel, Switzerland
[3] Univ Basel, CH-4003 Basel, Switzerland
[4] Univ Abdou Moumouni Dioffo, Fac Sci Sante, Niamey, Niger
[5] Programme Natl Lutte Bilharziose & Geohelminthes, Niamey, Niger
[6] Univ London Imperial Coll Sci Technol & Med, Schistosomiasis Control Initiat, London W2 1PG, England
关键词
Praziquantel; Syrup formulation; Safety; Efficacy; Preschool-aged children; Schistosomiasis; Schistosoma haematobium; Schistosoma mansoni; Niger; INTESTINAL SCHISTOSOMIASIS; URINARY SCHISTOSOMIASIS; AFRICAN INFANTS; S; MANSONI; INFECTION; TRIAL;
D O I
10.1016/j.actatropica.2012.12.003
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
Given the characteristic age-prevalence curve of Schistosoma infection, preventive chemotherapy with praziquantel is primarily targeted at school-aged children, whilst, in highly endemic areas, other high-risk groups might be included for regular treatment. Nevertheless, schistosomiasis can affect children well before they reach school-age, but this population group is usually excluded from preventive chemotherapy. We assessed the safety and efficacy of praziquantel syrup (Epiquantel (R)) in preschool-aged children in three villages of Niger. Children aged <= 72 months provided multiple urine and stool samples that were microscopically examined using standard protocols. Schistosoma-positive children were treated with praziquantel syrup at a dose of 40 mg/kg after a meal of millet porridge. Children remained under medical supervision for 4 hand adverse events were recorded. Additionally, a questionnaire was administrated to the mothers/guardians 24 h post-treatment for further probing of adverse events. Treatment efficacy was evaluated 3 and 6 weeks post-treatment using multiple stool and urine samples. A third of the 243 treated children reported adverse events within 4 h, whilst a further 6.2% reported adverse events upon probing 24 h post-treatment. Abdominal pain, bloody diarrhoea and sleepiness were the most common adverse events, but these were transient and self-limiting. Praziquantel syrup showed moderate-to-high efficacy against Schistosoma haematobium with egg reduction rates of 69.4% and 71.2% 3 and 6 weeks post-treatment and cure rates of 85.7% (95% confidence interval (CI) 79.7-90.5%) and 94.9% (95% CI 90.5-97.6%), respectively. Considerably lower cure and egg reduction rates were observed against Schistosoma mansoni (e.g. cure rate at 6-week post-treatment follow-up was only 50.6% (95% CI 39.9-61.2%). Concluding, praziquantel syrup is well tolerated in preschool-aged children with moderate-to-high efficacy against S. haematobium, but considerably lower efficacy against S. mansoni in Niger. A larger study is warranted to investigate the observed differences in species-specific susceptibilities and to assess operational issues and community-effectiveness. (C) 2012 Elsevier B.V. All rights reserved.
引用
收藏
页码:318 / 325
页数:8
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