Biennial versus annual treatment for schistosomiasis and its impact on liver morbidity. (January 2017)

• Record Type: Journal Article
• Authors: Olveda, David U.; Inobaya, Marianette T.; McManus, Donald P.; Olveda, Remigio M.; Vinluan, Marilyn L.; Ng, Shu-Kay; Harn, Donald A.; Li, Yuesheng; Guevarra, Jerric R.; Lam, Alfred K.; Ross, Allen G.P.
• Is Part Of: International journal of infectious diseases. Volume 54(2017:Jan.)
• Page Start: 145
• Page End: 149
• Publication Date: 2017-01
• Subjects: Schistosomiasis -- Treatment -- Dosage -- Morbidity; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2016.10.001
• Languages: English
• ISSNs: 1201-9712

Abstract

Summary: Objective: This study assessed the impact of annual versus biennial praziquantel treatment regimens on the prevalence, intensity of infection, and liver fibrosis dynamics of Asiatic schistosomiasis (caused by Schistosoma japonicum ) among individuals residing in 18 endemic barangays in Northern Samar, Philippines. Methods: Five hundred and sixty-five subjects who reported symptoms of gastrointestinal illness and/or were believed to have clinical morbidity based on physical examination were selected for cohort follow-up. Results: The mean prevalence of schistosomiasis was 34% and the mean intensity of infection was 123.1 eggs per gram. Moderate to severe hepatic fibrosis (grade II/III) was demonstrated in approximately 25% of the study population. As expected, a greater reduction in both the prevalence and intensity of infection was documented with two treatment rounds versus one. Overall, hepatic fibrosis (grades I–III) regressed in only 24.3% of those who received a single treatment and in only 19.3% of those who received two doses. The prevalence of grade II–III fibrosis at baseline (25.2%) remained unchanged 2 years after treatment. Conclusions: These findings suggest that in order to reverse moderate to severe liver fibrosis due to schistosomiasis and improve clinical outcomes, a higher clinical dosage of praziquantel (i.e., 60–80 mg/kg) may be required over an extended duration.