Efficacy and safety of praziquantel treatment against Schistosoma mansoni infection among pre-school age children in southern Ethiopia.

IF 3.6 Q1 TROPICAL MEDICINE
Tafese Tadele, Ayalew Astatkie, Birkneh Tilahun Tadesse, Eyasu Makonnen, Eleni Aklillu, Solomon Mequanente Abay
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引用次数: 0

Abstract

Background: Preventive chemotherapy with a single dose of praziquantel given to an all-at-risk population through mass drug administration is the cornerstone intervention to control and eliminate schistosomiasis as a public health problem. This intervention mainly targets school age children, and pre-school age children (pre-SAC) are excluded from receiving preventive chemotherapy, partly due to scarcity of data on praziquantel treatment outcomes.

Methods: We conducted active efficacy and safety surveillance of praziquantel treatment among 240 Schistosoma mansoni-infected pre-SAC who received a single dose of praziquantel (40 mg/kg) in southern Ethiopia. The study outcomes were egg reduction rates (ERR) and cure rates (CRs) four weeks after treatment using the Kato-Katz technique and treatment-associated adverse events (AEs) that occurred within 8 days post-treatment.

Results: The overall ERR was 93.3% (WHO reference threshold ≥ 90%), while the CR was 85.2% (95% CI = 80.0-89.5%). Baseline S. mansoni infection intensity was significantly associated with CRs, 100% among light infected than moderate (83.4%) or heavy (29.4%) infected children. An increase of 100 in baseline S. mansoni egg count per gram of stool resulted in a 26% (95% CI: 17%, 34%) reduction in the odds of cure. The incidence of experiencing at least one type of AE was 23.1% (95% CI: 18.0%, 29.0%). Stomachache, diarrhea, and nausea were the most common AEs. AEs were mild-to-moderate grade and transient. Pre-treatment moderate (ARR = 3.2, 95% CI: 1.69, 6.14) or heavy infection intensity (ARR = 6.5, 95% CI: 3.62, 11.52) was a significant predictor of AEs (p < 0.001). Sex, age, or soil-transmitted helminth coinfections were not significant predictors of CR or AEs.

Conclusions: Single-dose praziquantel is tolerable and effective against S. mansoni infection among pre-SAC, and associated AEs are mostly mild-to-moderate and transient. However, the reduced CR in heavily infected and AEs in one-fourth of S. mansoni-infected pre-SAC underscores the need for safety and efficacy monitoring, especially in moderate-to-high infection settings. Integrating pre-SACs in the national deworming programs is recommended to accelerate the elimination of schistosomiasis as a public health problem.

吡喹酮治疗埃塞俄比亚南部学龄前儿童曼氏血吸虫感染的有效性和安全性。
背景:通过大规模给药,对所有高危人群进行单剂量吡喹酮预防性化疗,是控制和消除血吸虫病这一公共卫生问题的基础性干预措施。这种干预措施主要针对学龄儿童,学龄前儿童(pre-SAC)被排除在预防性化疗之外,部分原因是缺乏吡喹酮治疗结果的数据:我们在埃塞俄比亚南部对240名感染曼氏血吸虫的学龄前儿童进行了吡喹酮治疗的有效性和安全性监测,这些儿童接受了单剂量吡喹酮治疗(40 mg/kg)。研究结果为使用Kato-Katz技术进行治疗四周后的减蛋率(ERR)和治愈率(CRs),以及治疗后8天内发生的与治疗相关的不良事件(AEs):总ERR为93.3%(世界卫生组织参考阈值≥90%),CR为85.2%(95% CI = 80.0-89.5%)。曼氏沙门氏菌基线感染强度与CR显著相关,轻度感染儿童的CR为100%,而中度(83.4%)或重度(29.4%)感染儿童的CR为100%。每克粪便中的曼氏沙门氏菌卵数基线每增加 100 个,治愈几率就会降低 26% (95% CI: 17%, 34%)。至少一种 AE 的发生率为 23.1%(95% CI:18.0%,29.0%)。胃痛、腹泻和恶心是最常见的不良反应。这些不良反应均为轻度至中度,且为一过性。治疗前的中度感染强度(ARR = 3.2,95% CI:1.69, 6.14)或重度感染强度(ARR = 6.5,95% CI:3.62, 11.52)是AEs的重要预测因素(P 结论:单剂量吡喹酮可显著减少AEs的发生:单剂量吡喹酮对SAC前期的曼森氏杆菌感染具有耐受性和有效性,相关的AEs大多为轻度至中度,且为一过性。然而,重度感染者的 CR 值降低以及四分之一感染曼森氏杆菌的前沙士患者出现的 AEs,都强调了对安全性和有效性进行监测的必要性,尤其是在中度至高度感染的情况下。建议将前SAC纳入国家驱虫计划,以加速消除血吸虫病这一公共卫生问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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