Treatment of pre-school children under 6 years of age for schistosomiasis: safety, efficacy and acceptability of praziquantel
The World Health Organization (WHO) recommends praziquantel for the control and treatment of schistosomiasis, with no real alternative. Pre-school children are excluded from population treatment programs mainly due to paucity of safety data on this age group.
Objectives: This study investigated safety, efficacy and acceptability of praziquantel for the treatment of S. haematobium and S. mansoni infections among pre-school children aged <6years. The study also investigated the burden of schistosomiasis in this age group.
Methods: Pre-school children (n=188) from Sudan were included in the study. The children were treated with praziquantel tablets at a single dose of 40 mg/kg body weight. Adverse events were assessed at 24 hours and 7 days later, via questionnaire administration to parents and guardians.
Efficacy of treatment was assessed at 1, 3 and 6 months by examining stool and urine samples for schistosome eggs. Acceptability was determined by the number of children spitting or vomiting during administration of the drug.
Results: The burden of schistosomiasis among pre-school children aged <6 years was high (31.1%), and this was comparable to that observed among school children-aged 6 years (32%). Praziquantel treatment achieved high cure rates (egg negative) for both S. haematobium and S.
mansoni infections when assessed at 1 month after treatment (89.6-92.1%) and remained high for S. haematobium (89.6-100%) up to 6 months. However, cure rate dropped from 90.5% at one month to 58.8% and 69.2% at 3 and 6 months among S. mansoni-treated children. Praziquantel treatment decreased egg counts considerably with post-treatment geometric mean egg reductions rates ranging from 96.4% to 99.4% at 1 month. Acceptability of praziquantel treatment was high, only for one child the dose had to be repeated after initial spitting. Treatment resolved haematuria and improved weight of the children. There were no drug-related adverse events in all the treated children during
follow-up at 24 hours and 7 days.
Conclusions: Praziquantel is safe, effective and acceptable among children aged <6 years. Preschool children represent a high risk group for schistosomiasis and should be included in population treatment programs.
Keywords:Schistosomiasis,Praziquantel, Safety,Young Children.
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