Document Detail


The contribution of host-related factors to low cure rates of praziquantel for the treatment of Schistosoma mansoni in Senegal.
MedLine Citation:
PMID:  10586908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Surprisingly low cure rates were repeatedly observed after treatment with a standard dosage of praziquantel in a recently established Schistosoma mansoni focus in northern Senegal. In 4 discrete cohorts from the same population, cure rates were 18-36% and egg count reduction rates were 77-88%. Data and material of 920 compliant subjects from all 4 cohorts were further analyzed to identify possible host-related factors associated with low cure rates. The lowest cure rates were found in the highest egg count groups. However, in low and moderate egg count groups, drug efficacy was also below normal values. Cure rates were similar in males and females, showed no seasonal variation, and were independent of previous praziquantel treatment. They were significantly higher in adults than in children, also after allowing for intensity of infection. Individual water contact behavior and specific humoral immune responses were examined in 2 extreme subgroups, either without significant egg count reduction or showing complete parasitologic cure. There was no significant difference in frequency and duration of water contact between those individuals with complete cure and those that showed little effect of praziquantel treatment. Levels of IgG, IgG1, IgG3, IgG4, IgM, and IgE against adult worm antigen were not different between the 2 subgroups. Thus, the abnormally frequent failure of treatment observed in this focus could not be associated with any host-related factor, other than age and pretreatment egg counts.
Authors:
L van Lieshout; F F Stelma; F Guissé; S T Falcao Ferreira; K Polman; G J van Dam; M Diakhate; S Sow; A Deelder; B Gryseels
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  61     ISSN:  0002-9637     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-12-21     Completed Date:  1999-12-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  760-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Parasitology, Leiden University Medical Centre, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Animals
Anthelmintics / pharmacology,  therapeutic use*
Antigens, Helminth / blood
Child
Cohort Studies
Feces / parasitology
Female
Host-Parasite Interactions
Humans
Immunoglobulin Isotypes / blood
Male
Parasite Egg Count
Praziquantel / pharmacology,  therapeutic use*
Retrospective Studies
Schistosoma mansoni / drug effects*,  immunology
Schistosomiasis mansoni / drug therapy*
Senegal
Seroepidemiologic Studies
Sex Factors
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anthelmintics; 0/Antigens, Helminth; 0/Immunoglobulin Isotypes; 55268-74-1/Praziquantel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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