Center for International Health Research at Rhode Island Hospital, 55 Claverick Street, Suite 101, Providence, RI 02903, United States of America (USA).
Department of Immunology, Research Institute for Tropical Medicine, Manila, Philippines.
Bull World Health Organ. 2018 Jan 1;96(1):59-65. doi: 10.2471/BLT.17.198879. Epub 2017 Nov 27.
In 2014, an estimated 40 million women of reproductive age were infected with and/or . In both 2003 and 2006, the World Health Organization (WHO) recommended that all schistosome-infected pregnant and breastfeeding women be offered treatment, with praziquantel, either individually or during treatment campaigns. In 2006, WHO also stated the need for randomized controlled trials to assess the safety and efficacy of such treatment. Some countries have yet to follow the recommendation on treatment and many programme managers and pregnant women in other countries remain reluctant to follow the recommended approach. Since 2006, two randomized controlled trials on the use of praziquantel during pregnancy have been conducted: one against in Uganda and the other against in the Philippines. In these trials, praziquantel treatment of pregnant women had no significant effect on birth weight, appeared safe and caused minimal side-effects that were similar to those seen in treated non-pregnant subjects. Having summarized the encouraging data, on efficacy, pharmacokinetics and safety, from these two trials and reviewed the safety data from non-interventional human studies, we recommend that all countries include pregnant women in praziquantel treatment campaigns. We identify the barriers to the treatment of pregnant women, in countries that already include such women in individual treatments and mass drug administration campaigns, and discuss ways to address these barriers.
2014 年，估计有 4000 万育龄期妇女感染了 和/或 。2003 年和 2006 年，世界卫生组织（WHO）建议对所有感染血吸虫的孕妇和哺乳期妇女进行治疗，单独使用或在治疗活动期间使用吡喹酮。2006 年，世界卫生组织还表示需要进行随机对照试验，以评估这种治疗的安全性和疗效。一些国家尚未遵守治疗建议，许多国家的方案管理人员和孕妇仍然不愿意采用建议的方法。自 2006 年以来，已经进行了两项关于孕妇使用吡喹酮的随机对照试验：一项是在乌干达针对 ，另一项是在菲律宾针对 。在这些试验中，吡喹酮治疗孕妇对出生体重没有显著影响，似乎是安全的，引起的副作用极小，与接受治疗的非孕妇相似。在总结了这两项试验在疗效、药代动力学和安全性方面令人鼓舞的数据，并审查了非干预性人体研究的安全性数据后，我们建议所有国家将孕妇纳入吡喹酮治疗活动。我们确定了在已经将孕妇纳入个体治疗和大规模药物治疗活动的国家中治疗孕妇的障碍，并讨论了如何解决这些障碍。
