Purpose

Praziquantel (PZQ) is the preferred drug for schistomiasis treatment because of its safety. As PZQ is used for mass drug administration (MDA) in schistosomiasis endemic areas, the effectiveness of the drug, used solely for decades, should be continuously monitored to detect drug resistance. We aimed to assess the effectiveness of PZQ to cure Schistosoma mansoni infection and to reduce the intensity of infection in an endemic area by estimating the cure rate (CR), egg reduction rate (ERR), and comparing these estimates to the levels recommended by the World Health Organization (WHO).

Methods

A total of 342 children aged 5–15 years living in Kafr-El-Sheikh were screened for S. mansoni infection. Stool samples were examined microscopically using Kato–Katz (KK) technique. Among the screened children, 106 children had S. mansoni ova in stool, 100 of them received the first dose of PZQ (40 mg/kg). Four weeks later, 96 of 100 children received the second dose of PZQ. Stool samples, collected 4 weeks after each dose of PZQ, were examined using KK. The effectiveness of PZQ was assessed based on ERR and CR.

Results

CR after the first dose of PZQ was 66.7%, increased to 79.12% after second dose (X² = 3.05, P = 0.08). Median egg count before treatment was 30.00 (6.00–744), that significantly decreased after two doses of PZQ to 0.00 (0.00–221.33) (Z = 8.29, P = 0.001). Children aged 10–15 years showed higher CR (91.3%) than those aged 5–9 years (OR = 5.25, CI 1.58–17.40).

Conclusions

PZQ is still an effective agent against S. mansoni in endemic areas, achieving a high CR and ERR with predominantly low intensity of infection. Age is a main predictor of response to PZQ.

中文翻译：

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吡喹酮在埃及流行地区长期使用后的效果评估。

目的

吡喹酮（PZQ）因其安全性而成为治疗血吸虫病的首选药物。由于 PZQ 用于血吸虫病流行地区的大规模给药 (MDA)，因此应持续监测仅使用数十年的药物的有效性，以检测耐药性。我们旨在通过估计治愈率 (CR)、产卵减少率 (ERR) 并将这些估计值与推荐的水平进行比较，来评估 PZQ 在治愈曼氏血吸虫感染和降低流行地区感染强度方面的有效性。世界卫生组织 (WHO)。

方法

共有 342 名居住在 Kafr-El-Sheikh 的 5-15 岁儿童接受了曼氏链球菌感染筛查。使用 Kato-Katz (KK) 技术对粪便样本进行显微镜检查。在接受筛查的儿童中，106 名儿童的粪便中含有曼氏链球菌卵，其中 100 名接受了第一剂 PZQ（40 毫克/千克）。四个星期后，100 名儿童中有 96 人接受了第二剂 PZQ。在每次服用 PZQ 后 4 周收集的粪便样本使用 KK 进行检查。根据 ERR 和 CR 评估 PZQ 的有效性。

结果

吡喹酮的第一剂量后CR为66.7％，经过第二剂量提高到79.12％（X ²  = 3.05，P  = 0.08）。治疗前卵数中位数为 30.00 (6.00–744)，两剂 PZQ 后显着降低至 0.00 (0.00–221.33) ( Z  = 8.29, P  = 0.001)。10-15 岁儿童的 CR（91.3%）高于 5-9 岁儿童（OR = 5.25，CI 1.58-17.40）。

结论

在流行地区，PZQ 仍然是抗曼氏链球菌的有效药物，可实现高 CR 和 ERR，主要是低感染强度。年龄是对 PZQ 反应的主要预测因素。