Post-treatment assessment of praziquantel efficacy among school-age children infected with schistosomiasis in Ipogun area of Ondo State, Nigeria

Abstract

Schistosomiasis, a major public health challenge is caused by trematodes of the genus Schistosoma whose intermediate host is snails. Sub-Saharan African (SSA) carried 85% of the global burden of this infection principally amongst school age children. Similarly, Nigeria bears the highest weight of this highly preventable infection in SSA. Preventive chemotherapy (PC) with 40-60 mg\kg praziquantel (PZQ) annually is the focal control strategy in endemic areas. Despite more than two decades of PZQ usage in Nigeria, the disease is still prevalent in affected communities. Thus, the study sought to assess the current post-treatment efficacy of PZQ use for urinary schistosomiasis among primary school age children of Ipogun village. Urine reagent strip (Haemastix)^® was initially used to screen pupils for haematuria, while Kato-Katz and urine filtration were employed to confirm the presence of schistosome ova in the faeces and urine of the study population pre- and post-treatment. A total of 202 children were screened, out of which 117 (57.9%) were positive for microhaematuria and 91 (45.0%) had ova of Schistosoma haematobium in their urine. The 14 and 21 day post-treatment assessment revealed 73.6% and 23.1% of the initially infected children to still be with infection respectively. Additionally, there was a statistical significant (P=0.02) in the reduction of egg count twenty-one days post-treatment. Though the efficacy of the drug as observed in the egg reduction rate in the study area can be classified as satisfactory, continuous monitoring of schistosome response should not cease if the global target of eliminating morbidity due to schistosomiasis by year 2020 is to be achieved.

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Keywords: preventive chemotherapy, egg reduction rate, elimination, morbidity, microhaematuria