PLoS ONE (Oct 2009)

Efficacy of artesunate + sulfamethoxypyrazine/pyrimethamine versus praziquantel in the treatment of Schistosoma haematobium in children.

  • Mahamadou S Sissoko,
  • Abdoulaye Dabo,
  • Hamidou Traoré,
  • Mouctar Diallo,
  • Boubacar Traoré,
  • Drissa Konaté,
  • Boubacar Niaré,
  • Moussa Diakité,
  • Bourama Kamaté,
  • Abdrahamane Traoré,
  • Aboudramane Bathily,
  • Amadou Tapily,
  • Ousmane B Touré,
  • Sarah Cauwenbergh,
  • Herwig F Jansen,
  • Ogobara K Doumbo

DOI
https://doi.org/10.1371/journal.pone.0006732
Journal volume & issue
Vol. 4, no. 10
p. e6732

Abstract

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BACKGROUND:This study was conducted to determine the efficacy of the antimalarial artemisinin-based combination therapy (ACT) artesunate +sulfamethoxypyrazine/pyrimethamine (As+SMP), administered in doses used for malaria, to treat Schistosoma haematobium in school aged children. METHODOLOGY/PRINCIPAL FINDINGS:The study was conducted in Djalakorodji, a peri-urban area of Bamako, Mali, using a double blind setup in which As+SMP was compared with praziquantel (PZQ). Urine samples were examined for Schistosoma haematobium on days -1, 0, 28 and 29. Detection of haematuria, and haematological and biochemical exams were conducted on day 0 and day 28. Clinical exams were performed on days 0, 1, 2, and 28. A total of 800 children were included in the trial. The cure rate obtained without viability testing was 43.9% in the As+SMP group versus 53% in the PZQ group (Chi(2) = 6.44, p = 0.011). Egg reduction rates were 95.6% with PZQ in comparison with 92.8% with As+SMP, p = 0.096. The proportion of participants who experienced adverse events related to the medication was 0.5% (2/400) in As+SMP treated children compared to 2.3% (9/399) in the PZQ group (p = 0.033). Abdominal pain and vomiting were the most frequent adverse events in both treatment arms. All adverse events were categorized as mild. CONCLUSIONS/SIGNIFICANCE:The study demonstrates that PZQ was more effective than As+SMP for treating Schistosoma haematobium. However, the safety and tolerability profile of As+SMP was similar to that seen with PZQ. Our findings suggest that further investigations seem justifiable to determine the dose/efficacy/safety pattern of As+SMP in the treatment of Schistosoma infections. TRIAL REGISTRATION:ClinicalTrials.gov NCT00510159.