Efficacy of Praziquantel Treatment for Schistosoma mansoni Infection Among Children in Ethiopia: Systematic Review and Meta-analysis

Background: Schistosomiasis is a chronic neglected tropical disease of poverty caused by blood dwelling trematodes of Schistosoma species. Praziquantel (PZQ) is the current drug of choice for the treatment of human schistosomiasis. The existence of Praziquantel resistance by Schistosoma species is a threat and an alarm for strict monitoring and periodic evaluation of its efficacy. Method: We searched PubMed, PubMed Center, Google Scholar, Web of Science, Google, Science Direct, MEDLINE and proceedings of a professional association to identify studies published in English and assessed the efficacy of Praziquantel against Schistosoma mansoni infection in children. Studies reporting the efficacy of Praziquantel in both adult and children as study participants and studies which investigated the efficacy of Praziquantel combined with other antischistosomal drugs were excluded. Result: Since there was significant heterogeneity, the random effect model was used. A total of 9 papers involving 1,412 participants, that assessed the cure rate and 8 papers that assessed egg reduction rate of Praziquantel were included in the meta-analysis. The pooled cure rate of Praziquantel was 86.65% with 95% CI; 83.4-93.9. There was high heterogeneity (I2=93.4%). Subgroup analysis showed slightly higher Cure rate of Praziquantel in Amhara regional state compared to Oromia regional state (88.58% vs 84.79%). The egg reduction rate was 87.95% and 99.85% using geometric and arithmetic mean of egg count respectively. The prevalence of Schistosoma mansoni decreased from 55.77% to 11.29% after administration of Praziquantel. Conclusion: According to the result of this review, standard dose of Praziquantel was effective against Schistosoma mansoni infection among children in Ethiopia. The cure rate of Praziquantel was slightly higher in Amhara regional state compared to Oromia regional state. The drug showed a great reduction in egg count and intensity of infection.