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The acceptability and safety of praziquantel alone and in combination with mebendazole in the treatment of Schistosoma mansoni and soil-transmitted helminthiasis in children aged 1–4 years in Uganda

Published online by Cambridge University Press:  24 February 2011

HARRIET NAMWANJE*
Affiliation:
Vector Control Division, Ministry of Health, P.O. Box 1661, Kampala, Uganda
NARCIS B. KABATEREINE
Affiliation:
Vector Control Division, Ministry of Health, P.O. Box 1661, Kampala, Uganda
ANNETTE OLSEN
Affiliation:
DBL-Centre for Health Research and Development, Faculty of Life Sciences, University of Copenhagen, Thorvaldsensvej 57, DK-1871 Frederiksberg C, Denmark
*
*Corresponding author: Harriet Namwanje, Vector Control Division, Ministry of Health, P.O. Box 1661, Kampala, Uganda, Tel: +256 752 642388 or +256 41 4251927. E-mail: harrietlwanga@ymail.com/harrnam@gmail.com

Summary

Objective. There is limited information on the acceptability and safety of praziquantel for treatment of schistosomiasis in children below the age of four years. In addition, although mebendazole has been extensively used together with praziquantel against infections with schistosomiasis and soil-transmitted helminthiasis (STH) in school-aged children, no specific acceptability or safety studies have been published on this drug combination in younger children. Methods. A randomized clinical trial was conducted to determine the safety of praziquantel alone and in combination with mebendazole in the treatment of Schistosoma mansoni and STH in children aged 1 to 4 years. Results. A total of 596 children from Bwondha fishing community in Mayuge district and Wang-Kado fishing community in Nebbi district were investigated using duplicate Kato-Katz thick smears of two stool samples and 130 (21·8%) were found infected with S. mansoni. Of these, 19·2% (25) had heavy intensity of infections. Of the infected children, 82 were included and randomised into praziquantel (40 mg/kg) + mebendazole (500 mg) or praziquantel (40 mg/kg) alone. Conclusion. Many symptoms were reported before treatment while very few were reported after treatment and all on treatment day. No serious adverse events were reported or observed after treatment. Praziquantel with or without mebendazole was well tolerated in small children in the study area.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

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References

REFERENCES

Berhe, N., Medhin, G., Erko, B., Smith, T., Gedamu, S., Bereded, D., Moore, R., Habte, E., Redda, A., Gebre-Michael, T. and Gundersen, S. G. (2004). Variations in helminth faecal egg counts in Kato–Katz thick smears and their implications in assessing infection status with Schistosoma mansoni. Acta Tropica 92, 205212. doi: 10.1016/j.actatropica.2004.06.011CrossRefGoogle ScholarPubMed
Bosompem, K. M., Bentum, I. A., Otchere, J., Anyan, W. K., Brown, C. A., Osada, Y., Takeo, S., Kojima, S. and Otha, N. (2004). Infant schistosomiasis in Ghana: a survey in an irrigation community. Tropical Medicine and International Health 9, 917–922. doi: 10.1111/j.1365-3156200401282.xCrossRefGoogle Scholar
De Vlas, S. J., Gryseels, B., van Oortmarssen, G. J., Polderman, A. M. and Habbema, J. D. (1993). Validation of a chart to estimate true Schistosoma mansoni prevalences. Parasitology Today 9, 305307.CrossRefGoogle Scholar
Doenhoff, M. J., Hagan, P., Cioli, D., Southgate, V., Pica-Mattoccia, L., Botros, S., Coles, G., Tchuem Tchuenté, L. A., Mbaye, A. and Engels, D. (2009). Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs. Parasitology 136, 18251835. doi:10.1017/S0031182009990493CrossRefGoogle ScholarPubMed
Ekpo, U. F., Laja-Deile, A., Oluwole, A. S., Sam-Wobo, S. O. and Mafiana, C. F. (2010). Urinary schistosomiasis among preschool children in a rural community near Abeokuta, Nigeria. Parasites and Vectors 3, 58. doi: 10.1186/1756-3305-3-58CrossRefGoogle Scholar
Engels, D., Ndoricimpa, J. and Gryseels, B. (1993). Schistosomiasis mansoni in Burundi: progress in its control since 1985. Bulletin of the World Health Organization 71, 207214.Google ScholarPubMed
Fenwick, A., Webster, J. P., Bosgue-Oliva, E., Blair, L., Fleming, F. M., Zhang, Y., Garba, A., Stothard, J. R., Gabrielli, A. F., Clements, A. C., Kabatereine, N. B., Toure, S., Dembele, R., Nyandindi, U., Mwansa, J. and Koukounari, A. (2009). The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002–2008. Parasitology 136, 17191760. doi: 10.1017/S0031182009990400CrossRefGoogle ScholarPubMed
Fleming, F. M., Fenwick, A., Tukahebwa, E. M., Lubanga, R. G., Namwangye, H., Zaramba, S. and Kabatereine, N. B. (2009). Process evaluation of schistosomiasis control in Uganda, 2003 to 2006: perceptions, attitudes and constraints of a national programme. Parasitology 136, 17591769. doi: 10.1017/S0031182009990709CrossRefGoogle ScholarPubMed
Garba, A., Barkiré, N., Djibo, A., Lamine, M. S., Sofo, B., Gouvras, A. N., Bosqué-Oliva, E., Webster, J. P., Stothard, J. R., Utzinger, J. and Fenwick, A. (2010). Schistosomiasis in infants and preschool-aged children: Infection in a single Schistosoma haematobium and a mixed S. haematobium-S. mansoni foci of Niger. Acta Tropica 115, 212219. doi: 10.1016/j.actatropica.2010.03.005CrossRefGoogle Scholar
Gardner, M. J. and Altman, D. G. (1989). Statistics with Confidence. Confidence Intervals and Statistical Guidelines. London. British Medical Journal. The Universities Press.Google Scholar
Hald, A. (1973). Statistiske Metoder. Tabel-og Formelsamling [In Danish]. Copenhagen. Akademisk Forlag.Google Scholar
Homeida, M., Leahy, W., Copeland, S., Ali, M. M. and Harron, D. W. (1994). Pharmacokinetic interaction between praziquantel and albendazole in Sudanese men. Annals of Tropical Medicine and Parasitology 88, 551559.CrossRefGoogle ScholarPubMed
Johansen, M. V., Sacko, M., Vennervald, B. J. and Kabatereine, N. B. (2007). Leave children untreated and sustain inequity! Trends in Parasitology 23, 568569.CrossRefGoogle ScholarPubMed
Kabatereine, N. B., Ariho, C. and Christensen, N. O. (1992). Schistosoma mansoni in Pachwach, Nebbi-District, Uganda, 40 years after Nelson. Tropical Medicine and Parasitology 43, 162166.Google ScholarPubMed
Kabatereine, N. B., Kemijumbi, J., Ouma, J. H., Sturrock, R. F., Butterworth, A. E., Madsen, H., Ornbjerg, N., Dunne, D. W. and Vennnervald, B. J. (2003). Efficacy and side effects of praziquantel treatment in a highly endemic Schistosoma mansoni focus at Lake Albert, Uganda. Transactions of the Royal Society of Tropical Medicine and Hygiene 97, 599603.CrossRefGoogle Scholar
Kabatereine, N. B., Tukahebwa, E. M., Kazibwe, F., Namwangye, H., Zaramba, S., Brooker, S., Stothard, J. R., Kamenka, C., Whawell, S., Webster, J. P. and Fenwick, A. (2006). Progress towards countrywide control of schistosomiasis and soil-transmitted helminthiasis in Uganda. Transactions of the Royal Society of Tropical Medicine and Hygiene 100, 208215. doi:10.1016/j.trstmh. 2005.03.015CrossRefGoogle ScholarPubMed
Keiser, J., N'Guessan, N. A., Adoubryn, K. D., Silué, K. D., Vounatsou, P., Hatz, C., Utzinger, J. and N'Goran, E. K. (2010). Efficacy and safety of mefloquine, artesunate, mefloquine-artesunate, and praziquantel against Schistosoma haematobium: randomized, exploratory open-label trial. Clinical Infectious Diseases 50, 12051213. doi: 10.1086/651682CrossRefGoogle ScholarPubMed
Odogwu, S. E., Ramamurthy, N. K., Kabatereine, N. B., Kazibwe, F., Tukahebwa, E., Webster, J. P., Fenwick, A. and Stothard, J. R. (2006). Schistosoma mansoni in infants (aged <3 years) along the Ugandan shoreline of Lake Victoria<3 years) along the Ugandan shoreline of Lake Victoria. Annals of Tropical Medicine and Parasitology 100, 315326. doi: 10.1179/136485906X105552CrossRefGoogle Scholar
Olsen, A. (2007). Efficacy and safety of drug combinations in the treatment of schistosomiasis, soil-transmitted helminthiasis, lymphatic filariasis and onchocerciasis. Transactions of the Royal Society of Tropical Medicine and Hygiene 101, 747758. doi:10.1016/j.trstmh.2007.03.006CrossRefGoogle ScholarPubMed
Sousa-Figueiredo, J. C., Pleasant, J., Day, M., Betson, M., Rollinson, D., Montresor, A., Kazibwe, F., Kabaterine, N. B. and Stothard, J. R. (2010). Treatment of intestinal schistosomiasis in Ugandan preschool children: best diagnosis, treatment efficacy and side-effects, and an extended praziquantel dosing pole. International Health 2, 103113. doi: 10.1016/j.inhe.2010.02.003CrossRefGoogle Scholar
Stothard, J. R. and Gabrielli, A. F. (2007). Response to Johansen et al.: Leave children untreated and sustain inequity! Trends in Parasitology 23, 569570.CrossRefGoogle Scholar
Stothard, J. R., Pleasant, J., Oguttu, D., Adriko, M., Galimaka, R., Ruggiana, A., Kazibwe, F. and Kabatereine, N. B. (2008). Strongyloides stercoralis: a field-based survey of mothers and their preschool children using ELISA, Baermann and Koga plate methods reveals low endemicity in western Uganda. Journal of Helminthology 82, 263269. doi: 10.1017/S0022149X08971996CrossRefGoogle ScholarPubMed
Stothard, J. R., Sousa-Figuereido, J. C., Betson, M., Adriko, M., Arinaitwe, M., Rowell, C., Besiyge, F. and Kabatereine, N. B. (2011). Schistosoma mansoni infections in young children: When are schistosome antigens in urine, eggs in stool and antibodies to eggs first detectable? PLoS Neglected Tropical Diseases 5(1): e938. doi:10.1371/journal.pntd.0000938CrossRefGoogle ScholarPubMed
World Health Organization (1995). Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products. WHO Technical Report Series No. 850. World Health Organization, Geneva.Google Scholar
World Health Organization (2002). Prevention and Control of Schistosomiasis and Soil-transmitted Helminthiasis. A Report of a WHO Expert Committee. WHO Technical Report Series No. 912. World Health Organization, Geneva.Google Scholar
World Health Organization (2004). Bench Aid for the Diagnosis of Intestinal Parasites. World Health Organization, Geneva.Google Scholar
World Health Organization (2006). Preventive Chemotherapy in Human Helminthiasis. Coordinated use of Anthelminthic Drugs in Human Interventions: A Manual for Health Professionals and Programme Managers. World Health Organization, Geneva.Google Scholar
Woolhouse, M. E., Mutapi, F., Ndhlovu, P. D., Chandiwana, S. K. and Hagan, P. (2000). Exposure, infection and immune responses to Schistosoma haematobium in young children. Parasitology 120, 3744. doi: 10.1017/S0031182099005156CrossRefGoogle ScholarPubMed