Chemotherapy-Based Control of Schistosomiasis Haematobia

II. Metrifonate vs. Praziquantel in Control of Infection-Associated Morbidity

Charles H. King Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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George Lombardi Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Cheryl Lombardi Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Ruth Greenblatt Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Sally Hodder Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Henry Kinyanjui Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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John Ouma Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Omondi Odiambo Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Patrick J. Bryan Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Jagon Muruka Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Phillip Magak Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Dana Weinert Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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David Ransohoff Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Harold Houser Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Davy Koech Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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Timothy K. Arap Siongok Case Western Reserve University and University Hospitals of Cleveland, Kenyatta Hospital, Kenya Medical Research Institute, Ministry of Health, Cleveland, Ohio, Kenya

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

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DOI:
https://doi.org/10.4269/ajtmh.1990.42.587
Volume/Issue:
Volume 42: Issue 6
Page(s):
587–595
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To determine the relative efficacy of metrifonate and praziquantel in controlling urinary tract morbidity due to Schistosoma haematobium infection, a random allocation treatment trial was performed among 1,813 school age S. haematobium-infected children from the Msambweni area of Coast Province, Kenya. Following baseline examination for infection, hematuria, proteinuria, and ultrasonographic urinary tract abnormalities, oral treatment with either metrifonate (10 mg/kg, repeated at 4 month intervals) or praziquantel (1 dose of 40 mg/kg) was given to infected subjects. Prevalence of morbidity was reassessed 12 months later for each treatment group. Results indicated equivalent patient improvement in response to either regimen: prevalence of hematiuria fell from 75% to 17% after either praziquantel or metrifonate therapy. Similarly, prevalence of proteinuria was significantly reduced from 73% to 29% (metrifonate) or 27% (praziquantel) after therapy. Metrifonate and praziquantel caused similar reductions in bladder granulomata and bladder thickening; however, no reduction in hydronephrosis was noted with either drug. Analysis of outcomes in population subgroups defined by age, sex, pretreatment intensity of infection, or severity of pretreatment morbidity showed no consistent advantage for either drug. In this endemic area, both agents provide effective control of morbidity due to urinary schistosomiasis.
Copyright:
Copyright © 1990 by The American Society of Tropical Medicine and Hygiene 1990
Published Online:
Jun 1990
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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