Treatment of pre-school children under 6 years of age for schistosomiasis: safety, efficacy and acceptability of praziquantel
الملخص
Background
The World Health Organization (WHO) recommends praziquantel for the control and treatment of schistosomiasis, with no real alternative. Pre-school children are excluded from population treatment programs mainly due to paucity of safety data on this age group.
Objectives: This study investigated safety, efficacy and acceptability of praziquantel for the treatment of S. haematobium and S. mansoni infections among pre-school children aged <6years. The study also investigated the burden of schistosomiasis in this age group.
Methods: Pre-school children (n=188) from Sudan were included in the study. The children were treated with praziquantel tablets at a single dose of 40 mg/kg body weight. Adverse events were assessed at 24 hours and 7 days later, via questionnaire administration to parents and guardians.
Efficacy of treatment was assessed at 1, 3 and 6 months by examining stool and urine samples for schistosome eggs. Acceptability was determined by the number of children spitting or vomiting during administration of the drug.
Results: The burden of schistosomiasis among pre-school children aged <6 years was high (31.1%), and this was comparable to that observed among school children-aged 6 years (32%). Praziquantel treatment achieved high cure rates (egg negative) for both S. haematobium and S.
mansoni infections when assessed at 1 month after treatment (89.6-92.1%) and remained high for S. haematobium (89.6-100%) up to 6 months. However, cure rate dropped from 90.5% at one month to 58.8% and 69.2% at 3 and 6 months among S. mansoni-treated children. Praziquantel treatment decreased egg counts considerably with post-treatment geometric mean egg reductions rates ranging from 96.4% to 99.4% at 1 month. Acceptability of praziquantel treatment was high, only for one child the dose had to be repeated after initial spitting. Treatment resolved haematuria and improved weight of the children. There were no drug-related adverse events in all the treated children during
follow-up at 24 hours and 7 days.
Conclusions: Praziquantel is safe, effective and acceptable among children aged <6 years. Preschool children represent a high risk group for schistosomiasis and should be included in population treatment programs.
المراجع
1. Savioli L, Renganathan E, Montresor A et al. Control of schistosomiasis-a global picture. Parasitol Today. 1997;13:444-8.
2. Chitsulo L, Engels D, Montresor A et al. The global status of schistosomiasis and its control. Acta Tropica. 2000;77(1):41-51.
3. Hotez PJ, Kamath A. Neglected tropical diseases in sub-Saharan Africa: review of their prevalence, distribution, and disease burden. PLoS neglected tropical diseases. 2009;3(8):e412.
4. World Health Organization. Prevention and control of schistosomiasis and soil-transmitted helminthiasis: report. WHO Techenical Report Series No912, Geneva; 2002 Contract No.: Document Number|.
5. Partnership for Child Development. The cost of large-scale school health programmes which deliver anthelmintics to children in Ghana and Tanzania. Acta Tropica. 1999;73(2):183-204.
6. Awasthi S, Bundy DAP, Savioli L. Helminthic infections. Bmj. 2003;327(7412):431.
7. Zhang Y, Koukounari A, Kabatereine N et al. Parasitological impact of 2-year preventive chemotherapy on schistosomiasis and soiltransmitted helminthiasis in Uganda. BMC medicine. 2007;5(1):27.
8. Webster JP, Koukounari A, Lamberton PHL et al. Evaluation and application of potential schistosome-associated morbidity markers within large-scale mass chemotherapy programmes. Parasitology. 2009;136(13):1789-99.
9. Utzinger J, Raso G, Brooker S et al. Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution. Parasitology. 2009;136(13):1859- 74.
10. Savioli L, Albonico M, Engels D et al. Progress in the prevention and control of schistosomiasis and soil-transmitted helminthiasis. Parasitology International. 2004;53(2):103-13.
11. Koukounari A, Donnelly C, Sacko M et al. The impact of single versus mixed schistosome species infections on liver, spleen and bladder morbidity within Malian children pre-and post-praziquantel treatment. BMC infectious diseases. 2010;10(1):227.
12. Hatz CFR. The use of ultrasound in schistosomiasis. Advances in parasitology. 2001;48:225-84.
13. Doehring-Schwerdtfeger E, Abdel-Rahim IM, Kardorff R et al. Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity twenty-three months after treatment with praziquantel. The American journal of tropical medicine and hygiene. 1992;46(4):409.
14. World Health Organization. The control of schistosomiasis and soil-transmitted helminthiasis: report. WHO Techenical Report series No728, Geneva. World Health Organization; 1985.
15. Magnussen P, Ndawi B, Sheshe AK et al. The impact of a school health programme on the prevalence and morbidity of urinary schistosomiasis in Mwera Division, Pangani District, Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2001;95(1):58-64.
16. Fenwick A, Savioli L, Engels D et al. Drugs for the control of parasitic diseases: current status and development in schistosomiasis. Trends in parasitology. 2003;19(11):509-15.
17. Doenhoff MJ, Cioli D, Utzinger J. Praziquantel: mechanisms of action, resistance and new derivatives for schistosomiasis. Current opinion in infectious diseases. 2008;21(6):659-67.
18. Danso-Appiah A, De Vlas SJ. Interpreting low praziquantel cure rates of Schistosoma mansoni infections in Senegal. Trends in parasitology. 2002;18(3):125-9.
19. Fenwick A. Waterborne infectious diseases— could they be consigned to history? Science. 2006;313(5790):1077-81.
20. Stothard JR, Gabrielli AF. Schistosomiasis in African infants and preschool children: to treat or not to treat? Trends in parasitology. 2007;23(3):83-6.
21. Keiser J, Ingram K, Utzinger J. Antiparasitic drugs for paediatrics: systematic review, formulations, pharmacokinetics, safety, efficacy and implications for control. Parasitology. 2011;138:1620-32.
22. World Health Organization. Preventive chemotherpy in Human Helmenthiasis Coordinated use of Anthelmenthic Drugs in Human Intervention: a Mannual for Health Professionals and Programme Managers. Geneva, World Health Organization; 2006 Contract No.: Document Number|.
23. El Gadal AA. The Blue Nile Health Project: a comprehensive approach to the prevention and control of water associated diseases in irrigated schemes of the Sudan. Journal of Tropical Medicine and Hygiene. 1985;88:57-63.
24. National Ministry of Health. Annual Health Statistical Report. Sudan: National Health Information Centre; 2009 Contract No.: Document Number|.
25. Fenwick A, Cheesmond AK, Amin MA. The role of field irrigation canals in the transmission of Schistosoma mansoni in the Gezira Scheme, Sudan. Bulletin of the World Health Organization. 1981;59(5):777-86.
26. Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo. 1972;14(6):397-400.
27. Ageel ARM, Amin MA. Integration of schistosomiasis control activities into the primary health care system in the Gizan region, Saudi Arabia. Annals of tropical medicine and parasitology. 1997;91(8):907-16.
28. Bosompem KM, Bentum IA, Otchere J et al. Infant schistosomiasis in Ghana: a survey in an irrigation community. Tropical Medicine & International Health. 2004;9(8):917-22.
29. Ekpo UF, Laja-Deile A, Oluwole AS et al. Urinary schistosomiasis among preschool children in a rural community near Abeokuta, Nigeria. Parasites & Vectors. 2010;3(1):58-62.
30. Garba A, Barkiré N, Djibo A et al. Schistosomiasis in infants and preschool-aged children: Infection in a single Schistosoma haematobium and a mixed S. haematobium-S. mansoni foci of Niger. Acta Tropica. 2010;115(3):212-9.
31. Dabo A, Badawi HM, Bary B et al. Urinary schistosomiasis among preschool-aged children in Sahelian rural communities in Mali. Parasites & Vectors. 2011;4:21.
32. Odogwu SE, Ramamurthy NK, Kabatereine NB et al. Schistosoma mansoni in infants (aged< 3 years) along the Ugandan shoreline of Lake Victoria. Annals of tropical medicine and parasitology. 2006;100(4):315-26.
33. Sousa-Figueiredo JC, Pleasant J, Day M et al. Treatment of intestinal schistosomiasis in Ugandan preschool children: best diagnosis, treatment efficacy and side-effects, and an extended praziquantel dosing pole. International Health. 2010;2(2):103-13.
34. Amin MA, Fenwick A, Teesdale CH et al. The assessment of a large snail control programme over three-year period in the Gezira Irrigated Area of the Sudan. Annals of tropical medicine and parasitology. 1982;76(4):415.
35. Jukes MC, Nokes CA, Alcock KJ et al. Heavy schistosomiasis associated with poor short-term memory and slower reaction times in Tanzanian schoolchildren. Trop Med Int Health. 2002;7(2):104-17.
36. Hotez PJ, Brindley PJ, Bethony JM et al. Helminth infections: the great neglected tropical diseases. The Journal of clinical investigation. 2008;118(4):1311-21.
37. Wang L, Utzinger Jr, Zhou X-N. Schistosomiasis control: experiences and lessons from China. The Lancet. 2008;372(9652):1793-5.
38. Danso Appiah A, De Vlas SJ, Bosompem KM et al. Determinants of health seeking behaviour for schistosomiasis related symptoms in the context of integrating schistosomiasis control within the regular health services in Ghana. Tropical Medicine & International Health. 2004;9(7):784- 94.
39. van der Werf MJ, Bosompem KM, de Vlas SJ. Schistosomiasis control in Ghana: case management and means for diagnosis and treatment within the health system. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2003;97(2):146-52.
40. Fenwick A, Webster JP, Bosque-Oliva E et al. The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002– 2008. Parasitology. 2009;136(13):1719-30.
41. Danso-Appiah A, Stolk WA, Bosompem KM et al. Health Seeking Behaviour and Utilization of
42. Health Facilities for Schistosomiasis-Related Symptoms in Ghana. PLoS neglected tropical diseases. 2010;4(11):e867.
43. Stothard JR, Sousa-Figueiredo JC, Betson M et al. Closing the praziquantel treatment gap: new steps in epidemiological monitoring and control of schistosomiasis in African infants and preschoolaged children. Parasitology. 2011;138(12):1593- 606.
44. Sabah AA, Fletcher C, Webbe G et al. Schistosoma mansoni: chemotherapy of infections of different ages. Experimental parasitology. 1986;61(3):294-303.
45. Danso-Appiah A, Utzinger J, Liu J et al. Drugs for treating urinary schistosomiasis. Cochrane Database Syst Rev. 2008;16(3):CD000053.
46. Mutapi F, Rujeni N, Bourke C et al. Schistosoma haematobium Treatment in 1–5 Year Old Children: Safety and Efficacy of the Antihelminthic Drug Praziquantel. PLoS neglected tropical diseases. 2011;5(5):e1143.
47. Cioli D, Pica-Mattoccia L, Archer S. Antischistosomal drugs: past, present... and future? Pharmacology & therapeutics. 1995;68(1):35-85.
48. Utzinger J, Keiser J. Schistosomiasis and soiltransmitted helminthiasis: common drugs for treatment and control. Expert opinion on pharmacotherapy. 2004;5(2):263-85.
2. Chitsulo L, Engels D, Montresor A et al. The global status of schistosomiasis and its control. Acta Tropica. 2000;77(1):41-51.
3. Hotez PJ, Kamath A. Neglected tropical diseases in sub-Saharan Africa: review of their prevalence, distribution, and disease burden. PLoS neglected tropical diseases. 2009;3(8):e412.
4. World Health Organization. Prevention and control of schistosomiasis and soil-transmitted helminthiasis: report. WHO Techenical Report Series No912, Geneva; 2002 Contract No.: Document Number|.
5. Partnership for Child Development. The cost of large-scale school health programmes which deliver anthelmintics to children in Ghana and Tanzania. Acta Tropica. 1999;73(2):183-204.
6. Awasthi S, Bundy DAP, Savioli L. Helminthic infections. Bmj. 2003;327(7412):431.
7. Zhang Y, Koukounari A, Kabatereine N et al. Parasitological impact of 2-year preventive chemotherapy on schistosomiasis and soiltransmitted helminthiasis in Uganda. BMC medicine. 2007;5(1):27.
8. Webster JP, Koukounari A, Lamberton PHL et al. Evaluation and application of potential schistosome-associated morbidity markers within large-scale mass chemotherapy programmes. Parasitology. 2009;136(13):1789-99.
9. Utzinger J, Raso G, Brooker S et al. Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution. Parasitology. 2009;136(13):1859- 74.
10. Savioli L, Albonico M, Engels D et al. Progress in the prevention and control of schistosomiasis and soil-transmitted helminthiasis. Parasitology International. 2004;53(2):103-13.
11. Koukounari A, Donnelly C, Sacko M et al. The impact of single versus mixed schistosome species infections on liver, spleen and bladder morbidity within Malian children pre-and post-praziquantel treatment. BMC infectious diseases. 2010;10(1):227.
12. Hatz CFR. The use of ultrasound in schistosomiasis. Advances in parasitology. 2001;48:225-84.
13. Doehring-Schwerdtfeger E, Abdel-Rahim IM, Kardorff R et al. Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity twenty-three months after treatment with praziquantel. The American journal of tropical medicine and hygiene. 1992;46(4):409.
14. World Health Organization. The control of schistosomiasis and soil-transmitted helminthiasis: report. WHO Techenical Report series No728, Geneva. World Health Organization; 1985.
15. Magnussen P, Ndawi B, Sheshe AK et al. The impact of a school health programme on the prevalence and morbidity of urinary schistosomiasis in Mwera Division, Pangani District, Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2001;95(1):58-64.
16. Fenwick A, Savioli L, Engels D et al. Drugs for the control of parasitic diseases: current status and development in schistosomiasis. Trends in parasitology. 2003;19(11):509-15.
17. Doenhoff MJ, Cioli D, Utzinger J. Praziquantel: mechanisms of action, resistance and new derivatives for schistosomiasis. Current opinion in infectious diseases. 2008;21(6):659-67.
18. Danso-Appiah A, De Vlas SJ. Interpreting low praziquantel cure rates of Schistosoma mansoni infections in Senegal. Trends in parasitology. 2002;18(3):125-9.
19. Fenwick A. Waterborne infectious diseases— could they be consigned to history? Science. 2006;313(5790):1077-81.
20. Stothard JR, Gabrielli AF. Schistosomiasis in African infants and preschool children: to treat or not to treat? Trends in parasitology. 2007;23(3):83-6.
21. Keiser J, Ingram K, Utzinger J. Antiparasitic drugs for paediatrics: systematic review, formulations, pharmacokinetics, safety, efficacy and implications for control. Parasitology. 2011;138:1620-32.
22. World Health Organization. Preventive chemotherpy in Human Helmenthiasis Coordinated use of Anthelmenthic Drugs in Human Intervention: a Mannual for Health Professionals and Programme Managers. Geneva, World Health Organization; 2006 Contract No.: Document Number|.
23. El Gadal AA. The Blue Nile Health Project: a comprehensive approach to the prevention and control of water associated diseases in irrigated schemes of the Sudan. Journal of Tropical Medicine and Hygiene. 1985;88:57-63.
24. National Ministry of Health. Annual Health Statistical Report. Sudan: National Health Information Centre; 2009 Contract No.: Document Number|.
25. Fenwick A, Cheesmond AK, Amin MA. The role of field irrigation canals in the transmission of Schistosoma mansoni in the Gezira Scheme, Sudan. Bulletin of the World Health Organization. 1981;59(5):777-86.
26. Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo. 1972;14(6):397-400.
27. Ageel ARM, Amin MA. Integration of schistosomiasis control activities into the primary health care system in the Gizan region, Saudi Arabia. Annals of tropical medicine and parasitology. 1997;91(8):907-16.
28. Bosompem KM, Bentum IA, Otchere J et al. Infant schistosomiasis in Ghana: a survey in an irrigation community. Tropical Medicine & International Health. 2004;9(8):917-22.
29. Ekpo UF, Laja-Deile A, Oluwole AS et al. Urinary schistosomiasis among preschool children in a rural community near Abeokuta, Nigeria. Parasites & Vectors. 2010;3(1):58-62.
30. Garba A, Barkiré N, Djibo A et al. Schistosomiasis in infants and preschool-aged children: Infection in a single Schistosoma haematobium and a mixed S. haematobium-S. mansoni foci of Niger. Acta Tropica. 2010;115(3):212-9.
31. Dabo A, Badawi HM, Bary B et al. Urinary schistosomiasis among preschool-aged children in Sahelian rural communities in Mali. Parasites & Vectors. 2011;4:21.
32. Odogwu SE, Ramamurthy NK, Kabatereine NB et al. Schistosoma mansoni in infants (aged< 3 years) along the Ugandan shoreline of Lake Victoria. Annals of tropical medicine and parasitology. 2006;100(4):315-26.
33. Sousa-Figueiredo JC, Pleasant J, Day M et al. Treatment of intestinal schistosomiasis in Ugandan preschool children: best diagnosis, treatment efficacy and side-effects, and an extended praziquantel dosing pole. International Health. 2010;2(2):103-13.
34. Amin MA, Fenwick A, Teesdale CH et al. The assessment of a large snail control programme over three-year period in the Gezira Irrigated Area of the Sudan. Annals of tropical medicine and parasitology. 1982;76(4):415.
35. Jukes MC, Nokes CA, Alcock KJ et al. Heavy schistosomiasis associated with poor short-term memory and slower reaction times in Tanzanian schoolchildren. Trop Med Int Health. 2002;7(2):104-17.
36. Hotez PJ, Brindley PJ, Bethony JM et al. Helminth infections: the great neglected tropical diseases. The Journal of clinical investigation. 2008;118(4):1311-21.
37. Wang L, Utzinger Jr, Zhou X-N. Schistosomiasis control: experiences and lessons from China. The Lancet. 2008;372(9652):1793-5.
38. Danso Appiah A, De Vlas SJ, Bosompem KM et al. Determinants of health seeking behaviour for schistosomiasis related symptoms in the context of integrating schistosomiasis control within the regular health services in Ghana. Tropical Medicine & International Health. 2004;9(7):784- 94.
39. van der Werf MJ, Bosompem KM, de Vlas SJ. Schistosomiasis control in Ghana: case management and means for diagnosis and treatment within the health system. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2003;97(2):146-52.
40. Fenwick A, Webster JP, Bosque-Oliva E et al. The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002– 2008. Parasitology. 2009;136(13):1719-30.
41. Danso-Appiah A, Stolk WA, Bosompem KM et al. Health Seeking Behaviour and Utilization of
42. Health Facilities for Schistosomiasis-Related Symptoms in Ghana. PLoS neglected tropical diseases. 2010;4(11):e867.
43. Stothard JR, Sousa-Figueiredo JC, Betson M et al. Closing the praziquantel treatment gap: new steps in epidemiological monitoring and control of schistosomiasis in African infants and preschoolaged children. Parasitology. 2011;138(12):1593- 606.
44. Sabah AA, Fletcher C, Webbe G et al. Schistosoma mansoni: chemotherapy of infections of different ages. Experimental parasitology. 1986;61(3):294-303.
45. Danso-Appiah A, Utzinger J, Liu J et al. Drugs for treating urinary schistosomiasis. Cochrane Database Syst Rev. 2008;16(3):CD000053.
46. Mutapi F, Rujeni N, Bourke C et al. Schistosoma haematobium Treatment in 1–5 Year Old Children: Safety and Efficacy of the Antihelminthic Drug Praziquantel. PLoS neglected tropical diseases. 2011;5(5):e1143.
47. Cioli D, Pica-Mattoccia L, Archer S. Antischistosomal drugs: past, present... and future? Pharmacology & therapeutics. 1995;68(1):35-85.
48. Utzinger J, Keiser J. Schistosomiasis and soiltransmitted helminthiasis: common drugs for treatment and control. Expert opinion on pharmacotherapy. 2004;5(2):263-85.
منشور
2021-08-11
القسم
Original Articles
