ArticlesOral artemether for prevention of Schistosoma mansoni infection: randomised controlled trial
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Background
Chemotherapy with praziquantel is the current strategy of choice to control schistosomiasis. However, in view of concern about praziquantel tolerance or resistance, new drugs are needed. Artemether, a derivative of the antimalarial drug artemisinin, kills immature schistosomes of Schistosoma japonicum, and reduces the incidence of infection in field trials. Laboratory studies have also showed activity by this drug against S mansoni. We report a randomised double-blind placebo-controlled
Area and population
The trial was done between November, 1998, and July, 1999, in the village of Fagnampleu, in the region of Man in western Côte d'Ivoire. This village, with a population of about 2000, lies on a tarmac road 20 km east of Man, the region's main town. There are two distinct seasons, with rains between April and September; and the mean annual rainfall is 1600 mm.23
The Man region is a highly endemic focus of S mansoni with an infection prevalence of 54% among schoolchildren.24 There has been no
Screening and treatment
349 of the 354 children enrolled in the school provided at least three stool specimens at the baseline survey for Kato-Katz thick smears (figure 2). 28 children were excluded: (15 missed the second treatment with praziquantel, and 13 provided fewer than three stool specimens before the first artemether treatment) and 321 children were randomly assigned to the artemether (n=157) or placebo (n=164). 32 who remained S mansoni positive (19 artemether, 13 placebo) and five who left the area and
Discussion
The study showed that oral artemether is safe and has a clear prophylactic effect against S mansoni. The incidence of S mansoni infection was 50% lower in those children who received artemether rather than placebo. The intensity of infection among the positive children was also reduced significantly. These results are based on repeated stool analyses with at least three consecutive Kato-Katz smears. Our preceding work in the same area showed that such a procedure gives a reliable measure with a
References (29)
- et al.
Schistosomiasis vaccines: research to development
Parasitol Today
(1998) Schistosomiasis: forty years' war on the worm
Parasitol Today
(1998)- et al.
Use of praziquantel against schistosomiasis: a review of current status
Int J Antimicrob Agents
(1994) Chemotherapy of schistosomiasis: an update
Parasitol Today
(1998)- et al.
Praziquantel—its use, cost and possible development of resistance
Parasitol Today
(1999) Reinfection after treatment of schistosomiasis infections
Parasitol Today
(1989)- et al.
The prophylactic effect of artemether against Schistosoma japonicum infections
Parasitol Today
(2000) - et al.
Schistosoma mansoni: chemotherapy of infections of different ages
Exp Parasitol
(1986) - et al.
Underestimation of Schistosoma mansoni prevalences
Parasitol Today
(1992) - et al.
Atlas of the global distribution of schistosomiasis
(1987)
Dose-finding study for praziquantel therapy of Schistosoma haematobium in Coast province, Kenya
Am J Trop Med Hyg
Efficacy and side effects of praziquantel in an epidemic focus of Schistosoma mansoni
Am J Trop Med Hyg
Therapeutic evaluation of two different dose regimens of praziquantel in a recent Schistosoma mansoni focus in northern Senegal
Am J Trop Med Hyg
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