Randomized comparison of low-dose versus standard-dose praziquantel therapy in treatment of urinary tract morbidity due to Schistosoma haema tobium infection.

Charles H King Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-4983, USA. chk@po.cwru.edu

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Eric M Muchiri Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-4983, USA. chk@po.cwru.edu

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Peter Mungai Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-4983, USA. chk@po.cwru.edu

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John H Ouma Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-4983, USA. chk@po.cwru.edu

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Hilda Kadzo Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-4983, USA. chk@po.cwru.edu

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Philip Magak Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-4983, USA. chk@po.cwru.edu

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Davy K Koech Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-4983, USA. chk@po.cwru.edu

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DOI:
https://doi.org/10.4269/ajtmh.2002.66.725
Volume/Issue:
Volume 66: Issue 6
Page(s):
725–730
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At present, anthelmintic therapy with praziquantel at a dose of 40 mg/kg of body weight is the recommended treatment for control of urinary tract morbidity caused by Schistosoma haematobium. Although this standard regimen is effective, drug cost may represent a significant barrier to implementation of large-scale schistosomiasis control programs in developing areas. Previous comparison trials have established that low-dose (20-30 mg/kg) praziquantel regimens can effectively suppress the intensity of S. haematobium infection in endemic settings. However, the efficacy of these low-dose regimens in controlling infection-related morbidity has not been determined in a randomized field trial. The present random allocation study examined the relative efficacy of a 20 mg/kg dose versus a 40 mg/kg dose of praziquantel in control of hematuria and bladder and renal abnormalities associated with S. haematobium infection in an endemic area of Coast Province, Kenya. After a nine-month observation period, the results indicated an advantage to the standard 40 mg/kg praziquantel dose in terms of reduction of infection prevalence and hematuria after therapy (P < 0.01 and P < 0.005, respectively). However, the two treatment groups were equally effective in reducing structural urinary tract morbidity detected on ultrasound examination. We conclude that in certain settings, a 20 mg/kg dose of praziquantel may be sufficient in providing control of morbidity due to urinary schistosomiasis in population-based treatment programs.

Author Notes

Published Online:
Jun 2002
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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