吡喹酮治疗埃塞俄比亚南部翁多杰内特谢沙凯凯莱小学曼氏血吸虫病学童的疗效及副作用
Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia.
作者信息
Erko Berhanu, Degarege Abraham, Tadesse Konjit, Mathiwos Asnake, Legesse Mengistu
机构信息
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
出版信息
Asian Pac J Trop Biomed. 2012 Mar;2(3):235-9. doi: 10.1016/S2221-1691(12)60049-5.
OBJECTIVE
To evaluate the efficacy and side effects of praziquantel (PZQ) in the treatment of schistosomiasis in Ethiopia.
METHODS
In a cross-sectional study, stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia, in April 2010. Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni (S. mansoni) ova. Children who were found positive for S. mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration. Four weeks post-treatment, stool specimens were collected from the same children and examined following the same procedure as in the pre-treatment. Drug efficacy was determined based on cure and egg reduction rates.
RESULTS
Pre-treatment prevalence of S. mansoni infection was 74.9% with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6% (P<0.000 1, OR: 8.33, CI: 5.3-13.1) and egg reduction rate of 68.2% (P=0.03, F=0.64). The cure rate showed significant association with age (χ(2)=11, P=0.004), the highest rate being observed in the 15-22 age group. 83% of S. mansoni infected children showed various treatment-related symptoms, the most frequent being headache, nausea, and abdominal pain. These symptoms were associated with age (P<0.001) and pre-treatment intensity of infection (P<0.05).
CONCLUSIONS
The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia. Hence, in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated, treatment failure, or reduced susceptibility of the parasite. Treatment-related side effects observed were transient and tolerable.
目的
评估吡喹酮（PZQ）治疗埃塞俄比亚血吸虫病的疗效和副作用。
方法
在一项横断面研究中，2010年4月从埃塞俄比亚南部翁多杰内特的谢沙凯凯莱小学随机选取299名学童采集粪便标本。粪便标本采用改良加藤厚涂片法检查曼氏血吸虫卵。曼氏血吸虫检测呈阳性的儿童口服单剂量40mg/kg体重的PZQ，并在给药24小时后询问与治疗相关的症状。治疗四周后，从同一批儿童采集粪便标本，按照与治疗前相同的程序进行检查。根据治愈率和虫卵减少率确定药物疗效。
结果
治疗前曼氏血吸虫感染率为74.9%，几何平均虫卵计数为268。评估的普通PZQ总体治愈率为73.6%（P<0.0001，OR：8.33，CI：5.3 - 13.1），虫卵减少率为68.2%（P = 0.03，F = 0.64）。治愈率与年龄呈显著相关性（χ(2)=11，P = 0.004），15 - 22岁年龄组的治愈率最高。83%感染曼氏血吸虫的儿童出现了各种与治疗相关的症状，最常见的是头痛、恶心和腹痛。这些症状与年龄（P<0.001）和治疗前感染强度（P<0.05）有关。
结论
目前的观察结果显示，与埃塞俄比亚此前报道的其他品牌PZQ相比，所评估的PZQ治愈率和虫卵减少率相对较低。因此，建议进行深入研究，以明确目前相对较低的治愈率是所评估吡喹酮的实际治愈率、治疗失败还是寄生虫易感性降低。观察到的与治疗相关的副作用是短暂且可耐受的。
Zotero 插件