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Efficacy and Tolerance of Praziquantel in Patients with Schistosoma Mansoni Infection and Symmers' Fibrosis: a Field Study in the Sudan

Mamoun M. A. Homeida^*, Isam A. el Tom^*, Suad M. Sulaiman, Asim A. Daffalla AND James L. Bennett

^* Department of Medicine, Faculty of Medicine, P.O. Box 102, Khartoum
Bilharzia Research Unit, National Health Laboratories, Khartoum
Institute of Tropical Medicine, National Council for Research, Khartoum, Sudan
Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan

Ultrasonography was used in a village in the Gezira-Managil scheme in the Sudan to identify patients with Symmers' fibrosis. In a random sample from patients with active Schistosoma mansoni infection, 238 patients were found to have no liver involvement while 59 had Symmers' periportal fibrosis. Patients were treated with a single dose of 40 mg/kg body weight of praziquantel. Six months after dosing, 51% and 58% were cured of the infection with 81% and 84% reduction in egg burden in the Symmers' and non-Symmers' patients, respectively. The drug was equally well tolerated by the two groups. It is concluded that patients with Symmers' fibrosis respond to praziquantel and tolerate the drug in a similar manner to patients without Symmers'.

Accepted for publication November 12, 1987.