Interventions for treating schistosomiasis haematobium.

BACKGROUND

Schistosomiasis is a parasite that is carried by freshwater snails. There are two common forms, urinary schistosomiasis (which is considered in this review) and intestinal schistosomiasis.

OBJECTIVES

The objective of this review was to assess the effects of drugs for treatment of Schistosomiasis haematobium.

SEARCH STRATEGY

The Cochrane Infectious Diseases Group trials register, Medline and reference lists of articles were searched. The WHO Division of Control of Tropical Diseases was contacted.

SELECTION CRITERIA

Randomised trials of metrifonate or praziquantel or other drugs for treating Schistosomiasis haematobium.

DATA COLLECTION AND ANALYSIS

One reviewer assessed trial quality and extracted data, and this was checked by a review editor.

MAIN RESULTS

Five trials, all from Africa, were included. The quality of the trials was variable. There were no good randomised controlled trials of praziquantel single dose treatment versus current standard treatment with metrifonate of three doses of 10 milligrams per kilogram at two weekly intervals. Praziquantel at doses of 40 milligram per kilogram was more effective than single dose metrifonate 10 milligrams per kilogram (odds ratio 6.94, 95% confidence interval 4.85 to 9.92). In one trial of metrifonate compared with praziquantel, there was no difference demonstrated in a range of clinical outcomes including cessation of haematuria and proteinuria. Both drugs improved nutritional status and physical fitness.

REVIEWER'S CONCLUSIONS: Praziquantel (single dose) appears to be more effective than metrifonate (split dose) in terms of parasitological cure of Schistosomiasis haematobium, but the reinfection rate is high with both drugs.