Dose-Finding Study for Praziquantel Therapy of Schistosoma Haematobium in Coast Province, Kenya

C. H. King Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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D. W. Wiper III Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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K. V. De Stigter Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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P. A. S. Peters Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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D. Koech Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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J. H. Ouma Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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T. K. Arap Siongok Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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A. A. F. Mahmoud Case Western Reserve University and University Hospitals, Cleveland, Ohio; and Kenya Medical Research Institute and Ministry of Health, Nairobi, Kenya

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To assess the efficacy of low dose praziquantel regimens in comparison with standard 40 mg/kg dosing in the treatment of urinary schistosomiasis, a random allocation dose-finding trial was performed in children and adults from a Schistosoma haematobium endemic region in Coast Province, Kenya. Following an initial screening, 280 individuals with ≥50 eggs/10 ml urine were randomly assigned to receive either 10, 20, 30, or 40 mg/kg of the drug in a single oral dose. Two to three months later, cure rates of 26%, 68%, 78%, and 84% were found for the 10, 20, 30, and 40 mg/kg doses, respectively. The results of 10 mg/kg oral dosing were significantly worse than for all other doses in terms of cure rate and of post-treatment prevalence of morbidity. The 40 mg/kg dosing resulted in a significantly higher cure rate than the 20 mg/kg doses; nevertheless, there was no significant difference between 20 mg/kg and 40 mg/kg doses in terms of mean post-treatment intensity of infection or post-treatment prevalence of hematuria or proteinuria. For large-scale control programs, oral 20 mg/kg praziquantel therapy for urinary schistosomiasis may prove as effective as the standard oral 40 mg/kg dosing for control of infection-associated morbidity and reduction of parasite transmission.

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