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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As part of a programme of multicentre trials of the tolerance and therapeutic effect of praziquantel, clinical trials were carried out in Brazil in patients with active Schistosoma mansoni infections, each of whom had a minimum geometric mean egg output of 100 eggs per gram of faeces calculated from multiple pretreatment stool examinations.The first stage was a double-blind assessment of tolerance and efficacy of oral doses of 1 x 20, 2 x 20, or 3 x 20 mg of praziquantel per kg of body weight. Subsequently, single-blind trials explored the effects of 3 x 20 mg/kg at 4-hourly intervals, and a single dose of 50 mg/kg.Side effects increased in frequency as dosage increased. Nausea, epigastric pain, headache, dizziness, and drowsiness were all noted but their severity was mild or moderate and they disappeared in 48 hours. In general, monitoring laboratory tests showed little change.Following a stringent parasitological follow-up, 96% of 28 patients followed at 1 year after treatment with either 3 x 20 mg/kg or 1 x 50 mg/kg were cured. Praziquantel seems to be a very promising drug against S. mansoni and further clinical trials should be strongly encouraged.
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PMID:Preliminary trials with praziquantel in human infections due to Schistosoma mansoni. 39 54

In Peri-Peri (Minas Gerais), an area endemic for Schistosoma mansoni, 591 inhabitants were examined. A coprological survey showed a prevalence of infection of 43.7%. After clinical examination 220 patients were distributed into three groups for treatment with oxamniquine; in Group 1, 19 children (2 to 15 years) were treated with a single oral dose of drug suspension around 20 mg/kg body weight; in Group 2, 47 children were treated orally with two 10 mg/kg doses with a 6- to 8-hour interval between them; in Group 3, 154 adults were treated with a single dose of about 15 mg/kg (capsules). The most frequent side effects were dizziness, drowsiness, and headache. No statistical difference in frequency of side effects was observed between Groups 1 and 2. Nevertheless, after treatment 32% of the patients in Group 1 complained of dizziness and 13% of headache, whereas in Group 2 the frequencies of these symptoms were 2% and 0%, respectively. Adults (Group 3) had a higher frequency of side effects, their chief complaints being dizziness and drowsiness. In Groups 1, 2, and 3, respectively, 73.7%, 62.2%, and 82.4% of the patients were cured. Statistical analysis did not show any difference in cure rates between children in Groups 1 and 2; however a significance was found when compared with the cure rate observed in adults, showing the drug to be more active in the latter group. In 61.8% of the 40 patients not cured a decrease of over 90% in the number of S. mansoni eggs/g feces was observed. From the data above oxamniquine seems to be an effective schistosomicidal drug suitable for use in endemic areas, although further studies are still needed.
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PMID:Field trials with oxamniquine in a Schistosomiasis mansoni-endemic area. 84 45

A 34-year-old male developed acute Katayama fever with fever, diarrhoea, joint pains, headache, urticarial rash and eosinophilia 18 days after falling into and spending 15 min in the water during water-skiing in the outlet of the Volta river. Low anti-schistosomal antibody titres were found by the immunofluorescence assay after 4 weeks, and the first Schistosoma mansoni eggs were found in faeces after 6 weeks. Both symptoms and eosinophilia increased the first days after treatment with oxamniquine, after which he improved gradually. Examination of frozen sera by the newly developed Magnetic Beads Antigen Capture-EIA (MBAC-EIA) later demonstrated a peak in schistosomal circulating anodic antigen (CAA) levels of diagnostic significance already 4 weeks after he was infected.
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PMID:Early detection of circulating anodic antigen (CAA) in a case of acute schistosomiasis mansoni with Katayama fever. 141 23

Two of three members (a 29-year-old man [case 1] and a 26-year-old woman [case 2]) of a tourist party to the tropics (Mali) developed a high fever (less than or equal to 40 degrees C), headache, cough, weight loss (less than or equal to 5 kg) and tiredness 3-4 weeks after returning to Germany. In case 1, acute schistosomiasis was tentatively diagnosed as the cause because he reported an attack of dermatitis after exposure to fresh water in an endemic schistosomiasis region and had marked eosinophilia (2118/microliters; 28%) on admission. Serological tests were positive (ELISA with adult antigen, O.D. 0.65 [normal less than 0.15]; with egg antigen O.D. 1.73 [normal less than 0.30], antibody titre in the immunofluorescence test 1:320 [normal less than 1:80]) supported the diagnosis and it was confirmed by demonstrating the parasite, Schistosoma mansoni, in stool but not urine. Findings in case 2 were similar. The third member of the group [case 3], a 58-year-old woman, was symptom-free, but tests revealed schistosomiasis. All three patients were treated with a single dose of Praziquantel (40 mg/kg). A second course of praziquantel (single dose of 40 mg/kg as well as 20 mg/kg three times daily for 3 days) became necessary in case 1, while in case 3 a further single dose of 40 mg/kg was given to ensure a parasite-free state. A follow-up scheme is suggested: clinical examination with white cell and differential counts 1, 3, 6 and 12 months after treatment; three stool and/or urine examinations 3, 6 and 12 months after treatment.
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PMID:[Acute schistosomiasis in travellers to the tropics]. 160 Aug 68

A study of morbidity and side effects of treatment with praziquantel in relation to intensity of infection with Schistosoma mansoni was conducted in 406 infected individuals from a newly-settled village in Metekel, north-western Ethiopia. Each subject was submitted to a standardized medical history and abdominal palpation. The frequencies of hepatomegaly and splenomegaly were low, 2% and 3%, respectively. A positive association was found between egg load and a history of blood in the stool. Interviews on side effects were conducted on the day following treatment with praziquantel (40 mg/kg body weight). Positive correlations with egg load were found for several side effects, including abdominal pain, diarrhoea, headache, back pain, and vomiting. Unusual side effects involving swelling of various parts of the body confirm 2 previous reports from a different region in Ethiopia and should be investigated further.
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PMID:Schistosoma mansoni infection in a new settlement in Metekel district, north-western Ethiopia: morbidity and side effects of treatment with praziquantel in relation to intensity of infection. 251 35

Clinical features in 173 white expatriates returning to Britain with the sole diagnosis of schistosomiasis were compared with those in non-infected control subjects, matched for age and sex, returning from similar endemic areas. Infection was, with one exception, acquired in Africa. Schistosoma mansoni was found in 135 patients, S haematobium in 29, and mixed infection in 9. 79% of patients with S haematobium had symptoms, compared with 47% of patients with S mansoni. Tiredness, headache, and gastrointestinal disturbance were no more frequent in symptomatic patients than in control subjects. In over 50% of patients with schistosomiasis the diagnosis was established from snips of rectal mucosa, and this raises the question of how best to look for infection in those who have been exposed. Urine examination and schistosomal serology appear to be the best screening methods; patients with haematuria or seropositivity should be investigated further.
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PMID:Schistosomiasis in expatriates returning to Britain from the tropics: a controlled study. 286 26

A double-blind placebo-controlled study of the concurrent administration of albendazole and praziquantel was conducted in>1500 children with high prevalences of geohelminths and schistosomiasis. The study sites were in China and the Philippines, including 2 strains of Schistosoma japonicum, and 2 different regions of Kenya, 1 each with endemic Schistosoma mansoni or Schistosoma haematobium. Neither medication affected the cure rate of the other. There was no difference between the side effect rate from albendazole or the double placebo. Praziquantel-treated children had more nausea, abdominal pain, and headache but these side effects were statistically more common in children with schistosomiasis, suggesting a strong influence of dying parasites. The subjects were followed for 6 months for changes in infection status, growth parameters, hemoglobin, and schistosomiasis morbidity. In all 4 sites, a significant 6-month increase in serum hemoglobin was observed in children who received praziquantel, strongly supporting population-based mass treatment.
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PMID:Double-blind placebo-controlled study of concurrent administration of albendazole and praziquantel in schoolchildren with schistosomiasis and geohelminths. 1006 97

A 26-year-old Brazilian man was admitted to The Toronto Hospital with a headache and visual scintillation. His last travel to Brazil was five years previously. A computed tomography (CT) scan of the head showed an occipital mass with surrounding vasogenic edema. Occipital brain biopsy revealed Schistosoma mansoni eggs. The patient was treated with two doses of praziquantel (20 mg/kg) and dexamethasone (10 mg). His symptoms and occipital mass resolved. Cerebral schistosomiasis is, in part, caused by the host's inflammatory response to Schistosoma. Modes of treatment have included surgical resection, the antiparasitic drugs oxamniquine or praziquantel, and corticosteroids. Corticosteroids may diminish granulomatous inflammation, thereby preventing further tissue destruction, and there is evidence that they also reduce ova deposition. Our review of the literature supports prompt medical therapy in patients with cerebral schistosomiasis. While the minimally or asymptomatic individual may be treated with praziquantel alone, clinicians should consider adjunctive therapy with corticosteroids for patients with prominent neurologic signs or symptoms or mass lesions with evidence of surrounding edema on a CT scan or by magnetic resonance imaging.
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PMID:The role of corticosteroids in the treatment of cerebral schistosomiasis caused by Schistosoma mansoni: case report and discussion. 1043 54

Schistosomiasis is a tropical helminthic infection, observed in travelers as well as local populations. It is most often due to Schistosoma mansoni or Schistosoma haematobium and can be diagnosed at the invasive phase. Migration of the schistosomulae (larvae) in the body leads to acute parasitic toxemia, which includes a hypersensitivity reaction and circulating immune complexes. The invasive stage occurs generally 2 to 6 weeks after the exposure and combines fever, asthenia, faintness and headaches. Other signs include diarrhea, dry cough, dyspnea, urticarial rash, arthralgia, myalgia, and enlargement of liver and spleen. Although rare, neurological and cardiac complications may be fatal. This diagnosis should be considered in travelers returning from the tropics with compatible clinical signs and delayed hypereosinophilia, if they report exposure in an endemic area. It is later confirmed by seroconversion for schistosomiasis and then by observation of schistosome eggs in stool or urine (according to species). The standard treatment of acute schistosomiasis with praziquantel is ineffective and can aggravate clinical outcome during this phase. Corticosteroid treatment is recommended for serious forms with neurological or cardiac manifestations.
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PMID:[Invasive schistosomiases]. 1632 4

The efficacy and safety of oral artesunate+sulfadoxine/pyrimethamine (AS+SP) (4 mg/kg AS for 3 consecutive days+25 mg sulfadoxine on Day 0) in the treatment of Schistosoma mansoni infections were compared with those of praziquantel (PZQ) (40 mg/kg) among infected schoolchildren (46 in each study arm) in eastern Sudan. The cure rate at 28 days was 58.6% in the AS+SP group and 100% in the PZQ group (P<0.001). While drug-related adverse effects (headache, dizziness, nausea and diarrhoea) were not significantly different between the two groups, significantly more children suffered abdominal pain in the PZQ group than in the AS+SP group (P=0.001). Thus, AS+SP has poor efficacy in the treatment of S. mansoni compared with PZQ.
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PMID:Artesunate plus sulfadoxine/pyrimethamine versus praziquantel in the treatment of Schistosoma mansoni in eastern Sudan. 1926 14


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