Mnkugwe Rajabu Hussein, Minzi Omary S, Kinung'hi Safari M, Kamuhabwa Appolinary A, Aklillu Eleni
Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam 11103, Tanzania.
Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska University Hospital-Huddinge, Karolinska Institutet, 141 86 Stockholm, Sweden.
Pathogens. 2019 Dec 27;9(1):28. doi: 10.3390/pathogens9010028.
Single-dose targeted praziquantel preventive chemotherapy is the WHO-recommended intervention for schistosomiasis control in endemic countries. The objective of this study was to assess the efficacy and safety of single-dose praziquantel among -infected children in north-western Tanzania. A prospective safety and efficacy surveillance study was conducted among 341 school-going children treated with a single-dose praziquantel 40 mg/kg body weight. Socio-demographic, pre-treatment, and post-treatment stool examination and safety data were collected. The primary and secondary outcomes were treatment efficacy (parasitological cure and egg reduction rates at three weeks post-treatment) and treatment-related adverse events, respectively. The overall cure rate and egg reduction rate were 81.2% (76.8-85.3%) and 95.0% (92.7-97.3%), respectively. There was no significant association between cure rate and pre-treatment infection intensity. The incidence of treatment-associated adverse events was 28.5% (23.7-33.3%), with abdominal pain being the most common. Post-treatment abdominal pain and vomiting were significantly associated with pre-treatment infection intensity ( < 0.001) and anemia ( = 0.03), respectively. Praziquantel single-dose is still safe and efficacious against infection. However, the lack of cure in about one-fifth and adverse events in a quarter, of the infected children indicate the need for close praziquantel safety monitoring and treatment optimization research to improve efficacy.
单剂量靶向吡喹酮预防性化疗是世界卫生组织推荐的流行国家控制血吸虫病的干预措施。本研究的目的是评估单剂量吡喹酮在坦桑尼亚西北部感染儿童中的疗效和安全性。对341名接受40mg/kg体重单剂量吡喹酮治疗的学龄儿童进行了一项前瞻性安全性和疗效监测研究。收集了社会人口统计学、治疗前和治疗后粪便检查及安全性数据。主要和次要结局分别为治疗效果(治疗后三周的寄生虫学治愈率和虫卵减少率)和治疗相关不良事件。总体治愈率和虫卵减少率分别为81.2%(76.8 - 85.3%)和95.0%(92.7 - 97.3%)。治愈率与治疗前感染强度之间无显著关联。治疗相关不良事件的发生率为28.5%(23.7 - 33.3%),其中腹痛最为常见。治疗后腹痛和呕吐分别与治疗前感染强度(<0.001)和贫血(=0.03)显著相关。单剂量吡喹酮对感染仍然安全有效。然而,约五分之一的感染儿童未治愈,四分之一的儿童出现不良事件,这表明需要密切监测吡喹酮的安全性并开展治疗优化研究以提高疗效。