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 and Ogobara K Doumbo

PLOS ONE, 2009, vol. 4, issue 10, 1-8

Abstract: 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 (Chi2 = 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

Date: 2009
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0006732

DOI: 10.1371/journal.pone.0006732

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