Safety and efficacy of praziquantel syrup (Epiquantel^?) against Schistosoma haematobium and Schistosoma mansoni in preschool-aged children in Niger

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• 作者：Amadou Garba ; Mariama S. Lamine ; Ali Djibo ; Almoustapha Tahirou ; Mahamadou Aboubacar Aouami ; Aichatou Alfari ; Anna E. Phillips ; Alan Fenwick ; J¨¹rg Utzinger
• 关键词：Praziquantel ; Syrup formulation ; Safety ; Efficacy ; Preschool-aged children ; Schistosomiasis ; Schistosoma haematobium ; Schistosoma mansoni ; Niger
• 刊名：Acta Tropica
• 出版年：2013
• 出版时间：November, 2013
• 年：2013
• 卷：128
• 期：2
• 页码：318-325
• 全文大小：706 K

文摘

Given the characteristic age-prevalence curve of Schistosoma infection, preventive chemotherapy with praziquantel is primarily targeted at school-aged children, whilst, in highly endemic areas, other high-risk groups might be included for regular treatment. Nevertheless, schistosomiasis can affect children well before they reach school-age, but this population group is usually excluded from preventive chemotherapy. We assessed the safety and efficacy of praziquantel syrup (Epiquantel^?) in preschool-aged children in three villages of Niger. Children aged ¡Ü72 months provided multiple urine and stool samples that were microscopically examined using standard protocols. Schistosoma-positive children were treated with praziquantel syrup at a dose of 40 mg/kg after a meal of millet porridge. Children remained under medical supervision for 4 h and adverse events were recorded. Additionally, a questionnaire was administrated to the mothers/guardians 24 h post-treatment for further probing of adverse events. Treatment efficacy was evaluated 3 and 6 weeks post-treatment using multiple stool and urine samples. A third of the 243 treated children reported adverse events within 4 h, whilst a further 6.2 % reported adverse events upon probing 24 h post-treatment. Abdominal pain, bloody diarrhoea and sleepiness were the most common adverse events, but these were transient and self-limiting. Praziquantel syrup showed moderate-to-high efficacy against Schistosoma haematobium with egg reduction rates of 69.4 % and 71.2 % 3 and 6 weeks post-treatment and cure rates of 85.7 % (95 % confidence interval (CI) 79.7-90.5 % ) and 94.9 % (95 % CI 90.5-97.6 % ), respectively. Considerably lower cure and egg reduction rates were observed against Schistosoma mansoni (e.g. cure rate at 6-week post-treatment follow-up was only 50.6 % (95 % CI 39.9-61.2 % ). Concluding, praziquantel syrup is well tolerated in preschool-aged children with moderate-to-high efficacy against S. haematobium, but considerably lower efficacy against S. mansoni in Niger. A larger study is warranted to investigate the observed differences in species-specific susceptibilities and to assess operational issues and community-effectiveness.