Kabuyaya Muhubiri, Chimbari Moses John, Manyangadze Tawanda, Mukaratirwa Samson
Discipline of Public Health Medicine, Howard College, University of KwaZulu-Natal, Durban, P.O Box, 4041, South Africa.
College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Infect Dis Poverty. 2017 Apr 7;6(1):83. doi: 10.1186/s40249-017-0293-3.
Despite its low cure rates and possible resistance, praziquantel (PZQ) is the only drug available for schistosomiasis treatment. Hence, monitoring its efficacy is crucial. This study assessed the efficacy of PZQ, determined re-infection and incidence rates of Schistosoma haematobium infection among school-going children in the Ndumo area, KwaZulu-Natal.
A cohort of 320 school-going children (10 - 15 years) in 10 primary schools was screened for S. haematobium infection using the filtration technique. Infected children were treated at different times and hence were divided into two sub-cohorts; A1 and A2. Non-infected children constituted the sub-cohort B. Children who continued excreting viable eggs 4 weeks post-treatment received a second dose of PZQ. Re-infection rates were determined in sub-cohort A1 and A2 at 28 and 20 weeks post-treatment, respectively. Cure rates (CR) and egg reduction rates (ERR) were calculated. Incidence rate was assessed 28 weeks post baseline survey using children that were negative for schistosome eggs at that survey. Analysis of data was done using the Chi square and the Wilcoxon rank test. A 95% confidence interval with a P-value < 0.05 determined significance.
At baseline, 120 (37.5%) of the 320 study participants were found infected with Schistosoma haematobium. Heavy infections accounted for 36.7%. The calculated cure rates were 88.07% and 82.92% for females and males, respectively. Egg Reduction Rates of 80% and 64% for females and males were observed 4 weeks after the initial treatment. After the second treatment, CR was 100% in females and 50% in males with an ERR of 100% in females and 70% in males. At 20 and 28 weeks post treatment, reinfection rates of 8.03% and 8.00% were observed, respectively, giving an overall rate of 8.1%. An incidence rate of 4.1% was observed 28 weeks after the baseline screening.
The study indicated high CR while the ERR was low suggesting a reduced PZQ efficacy. The efficacy improved among females after the second dose. Re-infection rates at 20 and 28 weeks post-treatment were low. The study also indicated a low incidence rate for the 28 weeks period.
尽管吡喹酮（PZQ）治愈率低且可能产生耐药性，但它是目前唯一可用于治疗血吸虫病的药物。因此，监测其疗效至关重要。本研究评估了吡喹酮在夸祖鲁 - 纳塔尔省恩杜莫地区学龄儿童中的疗效，确定了埃及血吸虫感染的再感染率和发病率。
采用过滤技术对10所小学的320名学龄儿童（10 - 15岁）进行埃及血吸虫感染筛查。感染儿童在不同时间接受治疗，因此分为两个亚组：A1和A2。未感染儿童构成亚组B。治疗4周后仍排出活卵的儿童接受第二剂吡喹酮。分别在治疗后28周和20周测定亚组A1和A2的再感染率。计算治愈率（CR）和虫卵减少率（ERR）。在基线调查28周后，使用该调查时血吸虫卵阴性的儿童评估发病率。使用卡方检验和威尔科克森秩和检验进行数据分析。P值<0.05的95%置信区间确定为具有显著性。
基线时，320名研究参与者中有120名（37.5%）被发现感染埃及血吸虫。重度感染占36.7%。计算得出女性和男性的治愈率分别为88.07%和82.92%。初次治疗4周后，女性和男性的虫卵减少率分别为80%和64%。第二次治疗后，女性的治愈率为100%，男性为50%；女性的虫卵减少率为100%，男性为70%。治疗后20周和28周，再感染率分别为8.03%和8.00%，总体再感染率为8.1%。基线筛查28周后观察到的发病率为4.1%。
该研究表明治愈率高，但虫卵减少率低，提示吡喹酮疗效降低。第二次给药后女性的疗效有所改善。治疗后20周和28周的再感染率较低。该研究还表明28周期间的发病率较低。
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