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Efficacy of Mefloquine Intermittent Preventive Treatment in Pregnancy against Schistosoma haematobium Infection in Gabon: A Nested Randomized Controlled Assessor-Blinded Clinical Trial.
MedLine Citation:
PMID:  23175561     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background. Urogenital schistosomiasis is a major public health problem in sub-Saharan Africa and routine programs for screening and treatment of pregnant women are not established. Mefloquine - currently evaluated as a potential alternative to sulfadoxine-pyrimethamine as intermittent preventive treatment (IPTp) against malaria in pregnancy - is known to exhibit activity against Schistosoma haematobium. In this study we evaluated the efficacy of mefloquine IPTp against S. haematobium infection in pregnant women.Methods. Pregnant women with S. haematobium infection presenting at two antenatal health care centres in rural Gabon were invited to participate in this nested randomized controlled, assessor blinded clinical trial comparing sulfadoxine-pyrimethamine with mefloquine IPTp. Study drugs were administered twice during pregnancy with a one month interval after completion of the first trimester.Results. Sixty five pregnant women were included in this study. S. haematobium egg excretion rates showed a median reduction of 98% (70-100%) in the mefloquine group compared to an increase of 20% (-186-75%) in the comparator group. More than 80% of patients showed at least 50% reduction of egg excretion and overall cure rate was 47% (36-70%) 6 weeks after the second administration of mefloquine IPTp.Conclusion. Mefloquine - when used as IPTp for the prevention of malaria - shows promising activity against concomitant S. haematobium infection leading to an important reduction of egg excretion in pregnant women. Provided that further studies confirm these findings, the use of mefloquine may transform future IPTp programs into a two-pronged intervention addressing two of the most virulent parasitic infections in pregnant women in sub-Saharan Africa.Clinical Trials Registration Numbers. NCT01132248, ATMR2010020001429343.
Authors:
Arti Basra; Ghyslain Mombo-Ngoma; Meskure Capan Melser; Daisy Akerey Diop; Heike Würbel; Jean-Rodolphe Mackanga; Moritz Fürstenau; Rella Manego Zoleko; Ayola A Adegnika; Raquel Gonzalez; Clara Menendez; Peter G Kremsner; Michael Ramharter
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-21
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  -     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Center for Medical Research of Lambaréné, Gabon.
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