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Research article
Samuel Nkansah Darko
Kumasi Centre for Collaborative Research in Tropical Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0750-4311
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Praziquantel (PZQ) is the standard treatment for Schistosomiasis in sub-Saharan Africa. However, there is evidence suggesting praziquantel treatment failure in Schistosome infections with associated potential renal impairment. The objective of this study was to determine the effect of three monthly doses of 60 mg/kg/day PZQ on schistosome egg count, liver and renal function during the treatment of urinary schistosomiasis in Ghana.
Methods: A nested case-control study was designed from a cohort screened for schistosomiasis; 28 schistosomiasis positive cases by microscopy matched with 53 healthy controls by age and gender. The study population was urban dwellers from the Asokwa sub-metropolitan area, Kumasi in Ghana. Participants were within the age range of 6 to 30 years. We assessed Schistosoma haematobium egg counts in urine and its associated impact on liver and renal function at baseline, treatment and post-treatment phases using serum.
Results: Of the 28 cases and 53 controls, 78.6% and (81.1% were males respectively. Globulin levels before treatment was higher in cases [36.7 (32.8, 40.1) vrs 30.5 (22.4, 33.8), p=0.005] at pre-treatment but not at post-treatment [35.8 (31.2, 39.1) vrs 37.4 (29.7, 43.0), p= 0.767]. Estimated cure rate was 42.9%, 46.4% and 96.4% after first, second and third dose respectively. Schistosome egg counts dropped significantly (p= 0.001) from before second dose to post-treatment. Similarly, levels of alanine aminotransferase (p=0.001), aspartate aminotransferase (p=0.028) and gamma glutamyl transferase (p=0.001) significantly declined towards post-treatment. Estimated glomerular filtration rate significantly improved from before second dose to post-treatment using both the Chronic Kidney Disease Epidemiology Program (p=0.001) and 4-variable Modification of Diet in Renal Disease (p=0.002) equations.
Conclusion: Treatment of urinary Schistosoma hematobium infections with a repeated high monthly dose of 60 mg/kg of praziquantel for 3 months is safe and effective.
Keywords
praziquantel, Schistosomiasis, resistance, renal, urinary
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On 26 Apr, 2020
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On 25 Apr, 2020
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Editorial decision: Minor revision
On 23 Apr, 2020
Review #3 received
Received 03 Apr, 2020
Reviewer #3 agreed
On 20 Mar, 2020
Review #1 received
Received 19 Mar, 2020
Review #2 received
Received 19 Mar, 2020
Reviewer #1 agreed
On 18 Mar, 2020
Reviewer #2 agreed
On 18 Mar, 2020
Editor assigned
On 17 Mar, 2020
Reviewers invited
Invitations sent on 17 Mar, 2020
Submission checks complete
On 16 Mar, 2020
Editor invited
On 16 Mar, 2020
No comments provided
Editorial decision: Major revision
On 24 Feb, 2020
Review #4 received
Received 17 Feb, 2020
Review #5 received
Received 17 Feb, 2020
Reviewer #5 agreed
On 04 Feb, 2020
Review #3 received
Received 25 Jan, 2020
Reviewer #4 agreed
On 06 Jan, 2020
Review #2 received
Received 03 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
Reviewer #2 agreed
On 03 Jan, 2020
Reviewer #3 agreed
On 03 Jan, 2020
Review #1 received
Received 03 Jan, 2020
Submission checks complete
On 24 Dec, 2019
Editor invited
On 23 Dec, 2019
Editor assigned
On 10 Dec, 2019
First submitted
On 09 Dec, 2019
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This preprint is under consideration at BMC Infectious Diseases. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Samuel Nkansah Darko
Kumasi Centre for Collaborative Research in Tropical Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0750-4311
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 11 May, 2020
No community comments so far
Editor assigned
On 26 Apr, 2020
Submission checks complete
On 25 Apr, 2020
Editor invited
On 25 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 23 Apr, 2020
Review #3 received
Received 03 Apr, 2020
Reviewer #3 agreed
On 20 Mar, 2020
Review #1 received
Received 19 Mar, 2020
Review #2 received
Received 19 Mar, 2020
Reviewer #1 agreed
On 18 Mar, 2020
Reviewer #2 agreed
On 18 Mar, 2020
Editor assigned
On 17 Mar, 2020
Reviewers invited
Invitations sent on 17 Mar, 2020
Submission checks complete
On 16 Mar, 2020
Editor invited
On 16 Mar, 2020
No comments provided
Editorial decision: Major revision
On 24 Feb, 2020
Review #4 received
Received 17 Feb, 2020
Review #5 received
Received 17 Feb, 2020
Reviewer #5 agreed
On 04 Feb, 2020
Review #3 received
Received 25 Jan, 2020
Reviewer #4 agreed
On 06 Jan, 2020
Review #2 received
Received 03 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
Reviewer #2 agreed
On 03 Jan, 2020
Reviewer #3 agreed
On 03 Jan, 2020
Review #1 received
Received 03 Jan, 2020
Submission checks complete
On 24 Dec, 2019
Editor invited
On 23 Dec, 2019
Editor assigned
On 10 Dec, 2019
First submitted
On 09 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Praziquantel (PZQ) is the standard treatment for Schistosomiasis in sub-Saharan Africa. However, there is evidence suggesting praziquantel treatment failure in Schistosome infections with associated potential renal impairment. The objective of this study was to determine the effect of three monthly doses of 60 mg/kg/day PZQ on schistosome egg count, liver and renal function during the treatment of urinary schistosomiasis in Ghana.
Methods: A nested case-control study was designed from a cohort screened for schistosomiasis; 28 schistosomiasis positive cases by microscopy matched with 53 healthy controls by age and gender. The study population was urban dwellers from the Asokwa sub-metropolitan area, Kumasi in Ghana. Participants were within the age range of 6 to 30 years. We assessed Schistosoma haematobium egg counts in urine and its associated impact on liver and renal function at baseline, treatment and post-treatment phases using serum.
Results: Of the 28 cases and 53 controls, 78.6% and (81.1% were males respectively. Globulin levels before treatment was higher in cases [36.7 (32.8, 40.1) vrs 30.5 (22.4, 33.8), p=0.005] at pre-treatment but not at post-treatment [35.8 (31.2, 39.1) vrs 37.4 (29.7, 43.0), p= 0.767]. Estimated cure rate was 42.9%, 46.4% and 96.4% after first, second and third dose respectively. Schistosome egg counts dropped significantly (p= 0.001) from before second dose to post-treatment. Similarly, levels of alanine aminotransferase (p=0.001), aspartate aminotransferase (p=0.028) and gamma glutamyl transferase (p=0.001) significantly declined towards post-treatment. Estimated glomerular filtration rate significantly improved from before second dose to post-treatment using both the Chronic Kidney Disease Epidemiology Program (p=0.001) and 4-variable Modification of Diet in Renal Disease (p=0.002) equations.
Conclusion: Treatment of urinary Schistosoma hematobium infections with a repeated high monthly dose of 60 mg/kg of praziquantel for 3 months is safe and effective.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
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