Assessment of efficacy and safety of praziquantel in the treatment of Schistosoma haematobium in school-aged children, Ogun State, Nigeria

Abstract

Praziquantel (PZQ) remains the drug of choice for treatment of schistosomiasis in infected persons. This study assessed the efficacy and safety of PZQ in school-aged children in four communities’ endemic for schistosomiasis. Urine samples (10 ml) were collected from 300 primary school children aged 5-16 years in Ibaro Oyan, Imala Odo, Apojola and Abule Titun communities located in parts of Ogun State, Nigeria. The urine was examined for the presence of haematuria and ova of S. haematobium. All pupils were also treated with a single dose of PZQ at 40 mg/kg. Urine samples were collected from positive pupils 21 days later to determine the Cure Rate (CR) and Egg Reduction Rate (ERR). Survey forms were also used to collect information on safety of the drug, documenting observed adverse reaction. Results showed that prevalence by haematuria was 147 (69%). Assessing haematuria with ova of S. haematobium revealed that 132 (44%) were positive for haematuria using dip-stick and eggs of S. haematobium simultaneously. Two hundred and nine pupils (69.7%) were infected with S. haematobium with mean egg count of 16.23 eggs/10 ml of urine. Males (73%) were more infected than females (66.7%). The highest prevalence (72.8%) was observed among the age-group 9-12 years and the least prevalence among age-group 5-8 years. The presence of S. haematobium was neither age nor sex dependent (p>0.05). On location and intensity, school children located in Imala Odo Community had the highest prevalence of 89.2%, but pupils in Ibaro had the highest Geometric Mean (GM) of 18.31 eggs/10 ml. At 21 days post-treatment the cure-rate (CR) was 96.1%. The anthelminthic drug Praziquantel efficacy was satisfactory with an Egg Reduction Rate (ERR) of 98.5%. Most of the adverse effects occurred within 4-24 hours after PZQ administration but abdominal pains were the most common adverse visible micro effects complained by the school-children.

Keywords: Efficacy, praziquantel; Schistosoma haematobium; school-aged children; Ogun State; Nigeria