Affiliations: National Institutes of Health, University of the
Philippines, Manila, Philippines | Department of Clinical Epidemiology, College of
Medicine, University of the Philippines, Manila, Philippines | Department of Health, Manila, Philippines
Note: [] Correspondence: Vicente Y. Belizario Jr., National Institutes of
Health, University of the Philippines, Pedro Gil St., Ermita, Manila,
Philippines. Tel.: +63 2 5250395; Fax: +63 2 5255885; E-mail:
vbelizar@yahoo.com
Abstract: The aim of this study was to compare the efficacy, safety and
reinfection rates at 6 and 12 months after treatment of schistosomiasis with
praziquantel 60 mg/kg single dose, as compared to the standard 40 mg/kg single
dose regimen. A school-based randomized, double blind, experimental drug trial
was implemented in Bunawan and Trento, in the province of Agusan del Sur,
Philippines. The Kato Katz technique was used for quantitative assessment of
Schistosoma japonicum infection. Follow-up visits were done 21, 180 and 360
days post-treatment. Efficacy, safety and reinfection rates of the two
treatment regimens were compared using Student's t-test, Chi-square/Fisher's
exact test and analysis of variance. There were 102 and 101 patients assigned
to the 40 mg/kg and 60 mg/kg treatment groups, respectively. On day 21
post-treatment, 95% and 98.0% of the patients were cured, with egg
reduction rates were of 99.9% and 99.99%, respectively. Remaining
infections were of light intensity. On days 180 and 360, infection rates
increased, with re-emergence of moderate and heavy intensity infections. On
treatment day, the cumulative prevalence of adverse events in the 60 mg/kg
treatment group was significantly higher than in the 40 mg/kg treatment group
(P=0.002). In conclusion, praziquantel 40 mg/kg and
60 mg/kg single dose therapy had comparable efficacy. A significantly higher
prevalence of adverse events, mostly mild and transient, was observed in the
60 mg/kg regimen. The 40 mg/kg regimen is recommended for the treatment of
schistosomiasis. High reinfection rates suggest the need to re-examine
behavioral and environmental factors in the community.
