Practical dosing of praziquantel for schistosomiasis in preschool-aged children.
OBJECTIVE
Schistosomiasis is known to occur in preschool-aged children, but achieving accurate dosing of praziquantel in its current form is challenging. While waiting for a paediatric formulation, there is a need to develop a means for using the available products to treat this age group. Current 600-mg tablets are differently scored to give units of 150 mg (a quarter of a tablet) or 300 mg (half a tablet).


METHODS
We examined several dosing schemes to dose accurately (40-60 mg/kg) children aged 3-72 months (weight range 4-25 kg, based on available weight-for-age growth references from sub-Saharan Africa and Brazil, n = 106,230).


RESULTS
Adequate dosing can be achieved with formulations that can be split into four 150 mg quarters for children weighing 5 kg or more, and with tablets than can be split into two 300 mg halves for children weighing 10 kg or more. Giving ½ tablet for 5-7 kg; ¾ tablet for 8-10 kg; 1 tablet for 11-15 kg; 1 ½ tablet for 16-21 kg; and two tablets for 22-25 kg will have 100% of subjects correctly dosed within the target 40-60 mg/kg range.


CONCLUSIONS
Formulations that can be divided into four parts (to give 150 mg increments) are preferred for children weighing less than 11 kg; the same dosing can be applied with 600 mf praziquantel formulations that can be divided into four quarters or two halves from 11 kg body weight.
UNICEF/UNDP/World Bank/WHO Special Programme for Research & Training in Tropical Diseases (TDR), Geneva, Switzerland.
Piero L
PL
Olliaro
Methodology and Statistics Unit, Centre de Recherche Public - Santé (CRP-Santé), Strassen, Luxembourg.
Michel
M
Vaillant
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Daniel J
DJ
Hayes
Department of Control of Neglected Tropical Diseases, World Health Organization (WHO), Geneva, Switzerland.
Antonio
A
Montresor
Department of Control of Neglected Tropical Diseases, World Health Organization (WHO), Geneva, Switzerland.
Lester
L
Chitsulo
D017954:Africa South of the Sahara; D000871:Anthelmintics / Q000008:administration & dosage* / Q000627:therapeutic use; D001835:Body Weight / Q000502:physiology; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011223:Praziquantel / Q000008:administration & dosage* / Q000627:therapeutic use; D012552:Schistosomiasis / Q000188:drug therapy*; D016896:Treatment Outcome
D000871:Anthelmintics; D011223:Praziquantel
dosage; praziquantel; schistosomiasis