Volume 83, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Although great reductions in human schistosomiasis have been observed after praziquantel (PZQ) mass drug administration (MDA), some individuals remain infected after multiple treatments. Many MDA programs now require monitoring for drug efficacy as a key component. No molecular tools for PZQ resistance currently exist and investigations into the dose of PZQ required to kill 50% of adult worms (ED) present ethical, logistical, and temporal restraints. We, therefore, assessed the feasibility and accuracy of a rapid, inexpensive PZQ test in the laboratory and directly in the field in Uganda under MDA in conjunction with highly detailed infection intensity, clearance, and reinfection data. This test strongly differentiated between subsequently cleared and uncleared infections as well as differences between parasite populations pre- and post-PZQ treatments, advocating its use for on-the-spot monitoring of PZQ efficacy in natural foci. After only a few treatments, uncleared parasites were identified to be phenotypically different from drug-sensitive parasites, emphasizing the urgent need for monitoring of these repeatedly PZQ-treated populations.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Colley DG, LoVerde PT, Savioli L, , 2001. Infectious disease. Medical helminthology in the 21st century. Science 293: 14371438.[Crossref] [Google Scholar]
  2. Kabatereine NB, Brooker S, Koukounari A, Kazibwe F, Tukahebwa EM, Fleming FM, Zhang Y, Webster JP, Stothard JR, Fenwick A, , 2007. Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren. Bull World Health Organ 85: 9199.[Crossref] [Google Scholar]
  3. Zhang Y, Koukounari A, Kabatereine N, Fleming F, Kazibwe F, Tukahebwa E, Stothard JR, Webster JP, Fenwick A, , 2007. Parasitological impact of two-year preventive chemotherapy on schistosomiasis and soil-transmitted helminthiasis in Uganda. BMC Med 5: 27.[Crossref] [Google Scholar]
  4. Fleming FM, Fenwick A, Tukahebwa EM, Lubanga RG, Namwangye H, Zaramba S, Kabatereine NB, , 2009. Process evaluation of schistosomiasis control in Uganda, 2003 to 2006: perceptions, attitudes and constraints of a national programme. Parasitology 136: 17591769.[Crossref] [Google Scholar]
  5. Ismail M, Botros S, Metwally A, William S, Farghally A, Tao LF, Day TA, Bennett JL, , 1999. Resistance to praziquantel: direct evidence from Schistosoma mansoni isolated from Egyptian villagers. Am J Trop Med Hyg 60: 932935. [Google Scholar]
  6. Botros S, Sayed H, Amer N, El-Ghannam M, Bennett JL, Day TA, , 2005. Current status of sensitivity to praziquantel in a focus of potential drug resistance in Egypt. Int J Parasitol 35: 787791.[Crossref] [Google Scholar]
  7. Dan-Dan L, Guang-Han H, Shao-Ji Z, , 2005. Optimal combined approaches of field intervention for schistosomiasis control in China. Acta Trop 96: 242247.[Crossref] [Google Scholar]
  8. Yi Y, Xing-Jian X, Hui-Fen D, Ming-Sen J, Hui-Guo Z, , 2005. Transmission control of schistosomiasis japonica: implications and evaluation of different snail control interventions. Acta Trop 96: 191197.[Crossref] [Google Scholar]
  9. Norton AJ, Gower CM, Lamberton PHL, Webster BL, Lwambo NJS, Blair L, Fenwick A, Webster JP, , 2010. Genetic consequences of mass human chemotherapy for Schistosoma mansoni: population structure pre- and post-praziquantel treatment in Tanzania. Am J Trop Med Hyg 83: 951957.[Crossref] [Google Scholar]
  10. Gower CM, Webster JP, , 2004. Fitness of indirectly transmitted pathogens: restraint and constraint. Evolution 58: 11781184.[Crossref] [Google Scholar]
  11. Gower CM, Webster JP, , 2005. Intraspecific competition and the evolution of virulence in a parasitic trematode. Evolution 59: 544553.[Crossref] [Google Scholar]
  12. Davies CM, Fairbrother E, Webster JP, , 2002. Mixed strain schistosome infections of snails and the evolution of parasite virulence. Parasitol 124: 3138.[Crossref] [Google Scholar]
  13. Webster JP, Davies CM, , 2001. Coevolution and compatibility in the snail-schistosome system. Parasitology 123: S41S56.[Crossref] [Google Scholar]
  14. Woolhouse ME, Webster JP, Domingo E, Charlesworth B, Levin BR, , 2002. Biological and biomedical implications of the co-evolution of pathogens and their hosts. Nat Genet 32: 569577.[Crossref] [Google Scholar]
  15. Webster JP, Shrivastava J, Johnson PJ, Blair L, , 2007. Is host-schistosome coevolution going anywhere? BMC Evol Biol 7: 91.[Crossref] [Google Scholar]
  16. Fallon PG, Doenhoff MJ, , 1994. Drug-resistant schistosomiasis: resistance to praziquantel and oxamniquine induced in Schistosoma mansoni in mice is drug specific. Am J Trop Med Hyg 51: 8388. [Google Scholar]
  17. Cioli D, Botros SS, Wheatcroft-Francklow K, Mbaye A, Southgate V, Tchuem Tchuente LA, Pica-Mattoccia L, Troiani AR, El-Din SH, Sabra AN, Albin J, Engels D, Doenhoff MJ, , 2004. Determination of ED50 values for praziquantel in praziquantel-resistant and -susceptible Schistosoma mansoni isolates. Int J Parasitol 34: 979987.[Crossref] [Google Scholar]
  18. William S, Botros S, Ismail M, Farghally A, Day TA, Bennett JL, , 2001. Praziquantel-induced tegumental damage in vitro is diminished in schistosomes derived from praziquantel-resistant infections. Parasitology 122: 6366.[Crossref] [Google Scholar]
  19. Xiao SH, Keiser J, Chollet J, Utzinger J, Dong Y, Endriss Y, Vennerstrom JL, Tanner M, , 2007. In vitro and in vivo activities of synthetic trioxolanes against major human schistosome species. Antimicrob Agents Chemother 51: 14401445.[Crossref] [Google Scholar]
  20. Xiao S-H, Mei J-Y, Jiao P-Y, , 2009. The in vitro effect of mefloquine and praziquantel against juvenile and adult Schistosoma japonicum . Parasitol Res 106: 237246.[Crossref] [Google Scholar]
  21. Gower CM, Shrivastava J, Lamberton PHL, Rollinson D, Webster BL, Emery A, Kabatereine NB, Webster JP, , 2007. Development and application of an ethically and epidemiologically advantageous assay for the multi-locus microsatellite analysis of Schistosoma mansoni . Parasitology 134: 523536.[Crossref] [Google Scholar]
  22. Botros S, Bennett JL, , 2007. Praziquantel resistance. Expert Opin Drug Discov 2: S35S40.[Crossref] [Google Scholar]
  23. Coles GC, , 1979. The effect of praziquantel on Schistosoma mansoni . J Helminthol 53: 3133.[Crossref] [Google Scholar]
  24. Liang YS, Coles GC, Doenhoff MJ, Southgate VR, , 2001. In vitro responses of praziquantel-resistant and -susceptible Schistosoma mansoni to praziquantel. Int J Parasitol 31: 12271235.[Crossref] [Google Scholar]
  25. Liang YS, Dai JR, Ning A, Yu DB, Xu XJ, Zhu YC, Coles GC, , 2001. Susceptibility of Schistosoma japonicum to praziquantel in China. Trop Med Int Health 6: 707714.[Crossref] [Google Scholar]
  26. Doenhoff MJ, Hagan P, Cioli D, Southgate V, Pica-Mattoccia L, Botros S, Coles G, Tchuem Tchuenté LA, Mbaye A, Engels D, , 2009. Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs. Parasitology 136: 18251835.[Crossref] [Google Scholar]
  27. Kenworthy JD, Ye P, Wu GC, Yu H, Shi YJ, Li H, Coles GC, , 2003. Field evaluation of a test for praziquantel resistance in Schistosoma sp. Vet Parasitol 113: 8387.[Crossref] [Google Scholar]
  28. Ismail M, Metwally A, Farghaly A, Bruce J, Tao LF, Bennett JL, , 1996. Characterization of isolates of Schistosoma mansoni from Egyptian villagers that tolerate high doses of praziquantel. Am J Trop Med Hyg 55: 214218. [Google Scholar]
  29. Katz N, Chaves A, Pellegrino J, , 1972. A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni . Rev Inst Med Trop Sao Paulo 14: 397400. [Google Scholar]
  30. Pica-Mattoccia L, Doenhoff MJ, Valle C, Basso A, Troiani AR, Liberti P, Festucci A, Guidi A, Cioli D, , 2009. Genetic analysis of decreased praziquantel sensitivity in a laboratory strain of Schistosoma mansoni . Acta Trop 111: 8285.[Crossref] [Google Scholar]
  31. Shaw MK, , 1990. Schistosoma mansoni: stage-dependent damage after in vivo treatment with praziquantel. Parasitology 100: 6572.[Crossref] [Google Scholar]
  32. Liang YS, Wang W, Dai JR, Li HJ, Tao YH, Zhang JF, Li W, Zhu YC, Coles GC, Doenhoff MJ, , 2010. Susceptibility to praziquantel of male and female cercariae of praziquantel-resistant and susceptible isolates of Schistosoma mansoni . J Helminthol 84: 202207.[Crossref] [Google Scholar]
  33. Liang YS, Coles GC, Dai JR, Zhu YC, Doenhoff MJ, , 2002. Adult worm tegumental damage and egg-granulomas in praziquantel-resistant and -susceptible Schistosoma mansoni treated in vivo . J Helminthol 76: 327333.[Crossref] [Google Scholar]
  34. Giboda M, Smith JM, , 1994. Schistosoma mansoni eggs as a target for praziquantel: efficacy of oral application in mice. J Trop Med Hyg 97: 98102. [Google Scholar]
  35. Xavier AM, Magalhães JA, Cunha Gdos S, Silva AC, Tavares DA, Sarro-Silva Mde F, de Moraes Neto AH, , 2010. Morphological tegument alterations of adult Schistosoma mansoni, harbored in non anti-helminthic treated, high-immune-tolerogenic and low-inflammatory mice. Acta Trop 116: 9599.[Crossref] [Google Scholar]
  36. Sabra AN, Botros SS, , 2008. Response of Schistosoma mansoni isolates having different drug sensitivity to praziquantel over several life cycle passages with and without therapeutic pressure. J Parasitol 94: 537541.[Crossref] [Google Scholar]
  37. Botros SS, Hammam OA, El-Lakkany NM, El-Din SH, Ebeid FA, , 2008. Schistosoma haematobium (Egyptian strain): rate of development and effect of praziquantel treatment. J Parasitol 94: 386394.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 20 Jul 2010
  • Accepted : 16 Aug 2010
  • Published online : 06 Dec 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error