Efficacy and Safety of Up-Scaled Dosage of 60 Mg/Kg Praziquantel in Control of Schistosoma Mansoni in School Going Children in Kirinyaga County, Kenya

Abstract

Chemotherapy with praziquantel has been the core treatment strategy for schistosomiasis. There has been concerns on tolerance and resistance to praziquantel. Socio-economic activities in Kirinyaga County exposes the community to fresh water snails that harbor the schistosome parasite. Various studies have reported increased prevalence and high infection intensity in the area despite ongoing mass drug administration (MDA) interventions. The study area was in Kirinyaga County, in central Kenya where the prevalence of schistosomiasis in school going children was first determined. A sample size of 190 subjects aged between 4-17 year infected with S. mansoni were randomly allocated in Group A (40 mg/kg) and Group B (60 mg/kg). Stool samples were collected for baseline prevalence, cure rate and egg reduction rate post-treatment. Frequency and severity of adverse events (AE) at 4 and 24 hrs post-treatment were also determined. Peripheral blood was collected for haemoglobin, liver function test and eosinophil levels assays. Prevalence of S. mansoni infection was 52.8%. Cure rates at 21 days post-treatment were 92% for 40 mg/kg while that of 60 mg/kg was at 94% which did not represent any significant difference between the two treatment groups (p˃0.05). Mean hemoglobin levels at 21 days post-treatment were 10.96 g/dl and 11.19 g/dl respectively representing a non-significant difference (p>0.05). Eosinophil levels implied a significant decrease after treatment in both groups although no significant difference was observed between the treatment groups (p>0.05). Adverse events recorded in the 60 mg/kg and 40 mg/kg groups showed that mild abdominal pain was the most frequent AE for the 2 dosages while anoxia was the least occurring at 4 hrs and 24 hrs post-treatment. Both 40 mg/kg and up-scaled 60 mg/kg treatment dosages were proven to offer substantial cure to S. mansoni but the difference in cure rates was found to be insignificant.