Tackling Infections to Benefit Africa Partnership and School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania; Tackling Infections to Benefit Africa Partnership, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom.
Tackling Infections to Benefit Africa Partnership and Department of Paediatrics and Child Health, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania.
Acta Trop. 2024 Aug;256:107232. doi: 10.1016/j.actatropica.2024.107232. Epub 2024 May 9.
The World Health Organization calls for schistosomiasis endemic countries to regularly monitor the efficacy of Praziquantel (PZQ) drug, the only antischistosomal drug used for four decades in Tanzania. In response to that call, the current study investigated the efficacy of single dose of PZQ against Schistosoma haematobium during the high transmission season and further assessed, the sensitivity and specificity of urine reagent strips before and after treatment. The study recruited a total of 2,498 -children aged (4 -17 years old) who provided a single urine sample that was visually examined for macro-haematuria, then using urine dipstick and urine filtration technique for microhaematuria and the presence of S. haematobium eggs. The baseline prevalence of S. haematobium eggs positive based on urine filtration test was 29.2 % (95 %CI:27.5-31.0) and that of microhaematuria was 43.1 % (95 %CI:41.1-45.0). Of the infected participants, 40.9 % (95 %CI:37.4-44.6) had a heavy intensity of infection and the geometrical mean intensity (GMI) of infection was 33.7 eggs/10mls of urine. A single dose of PZQ reduced the prevalence of infection to 16.2 %, the GMI of infection to 18.8eggs/10mls of urine and that of microhaematuria to 27.9 %. Cure rate and egg reduction rates (ERR) were 83.8 % and 44.3 % respectively. At baseline, the sensitivity and specificity of the urine reagent strips were 59.7 % and 93.8 %, whereas at post-treatment they were 16.7 % and 93.6 %. When PZQ drug is administered during the high transmission season, its efficacy in term of ERR is poor. The urine reagent strips had low sensitivity but high specificity at pre-and-post PZQ treatment.
世界卫生组织呼吁血吸虫病流行国家定期监测吡喹酮(PZQ)药物的疗效,这是一种在坦桑尼亚使用了四十年的唯一抗血吸虫病药物。为响应这一号召,本研究调查了在高传播季节单次使用 PZQ 治疗埃及血吸虫病的疗效,并进一步评估了治疗前后尿液试剂条的敏感性和特异性。该研究共招募了 2498 名 4-17 岁的儿童,他们提供了一份单次尿液样本,肉眼检查血尿,然后使用尿液试纸和尿液过滤技术检查镜下血尿和埃及血吸虫卵的存在。基于尿液过滤试验的基线埃及血吸虫卵阳性率为 29.2%(95%CI:27.5-31.0),镜下血尿率为 43.1%(95%CI:41.1-45.0)。在感染参与者中,40.9%(95%CI:37.4-44.6)的感染程度较重,感染的几何平均强度(GMI)为 33.7 个/10ml 尿液。单次 PZQ 剂量将感染率降低至 16.2%,感染 GMI 降低至 18.8 个/10ml 尿液,镜下血尿率降低至 27.9%。治愈率和虫卵减少率(ERR)分别为 83.8%和 44.3%。基线时,尿液试剂条的敏感性和特异性分别为 59.7%和 93.8%,而治疗后分别为 16.7%和 93.6%。当在高传播季节使用 PZQ 药物时,其 ERR 疗效较差。尿液试剂条在 PZQ 治疗前后具有低敏感性但高特异性。