title: Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia.
abstract: 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.
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
authors.forename: Berhanu
authors.initials: B
authors.lastname: Erko
authors.forename: Abraham
authors.initials: A
authors.lastname: Degarege
authors.forename: Konjit
authors.initials: K
authors.lastname: Tadesse
authors.forename: Asnake
authors.initials: A
authors.lastname: Mathiwos
authors.forename: Mengistu
authors.initials: M
authors.lastname: Legesse
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D011223:Praziquantel / Q000009:adverse effects* / Q000627:therapeutic use*; D015995:Prevalence; D012555:Schistosomiasis mansoni / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D012556:Schistosomicides / Q000009:adverse effects* / Q000627:therapeutic use*; D013334:Students; D055815:Young Adult
chemical_list: D012556:Schistosomicides; D011223:Praziquantel
keywords: Drug efficacy; Efficacy; Egg reduction; Ethiopia; Infection; Parasite; Praziquantel; Prevalence; Schistosoma mansoni; Schistosomiasis; Schoolchildren; Side effect; Susceptibility; Thick smear