Skip to main content Accessibility help

The effect of single dose versus two doses of praziquantel on Schistosoma haematobium infection and pathology among school-aged children in Mali

  • M. SACKO (a1), P. MAGNUSSEN (a2), M. TRAORÉ (a1) (a3), A. LANDOURÉ (a1), A. DOUCOURÉ (a1), C. M. REIMERT (a2) and B. J. VENNERVALD (a2)...


The aim of this study was to assess the effect of two doses of 40 mg/kg praziquantel with 2 weeks interval versus a standard single dose of 40 mg/kg on cure rates, egg reduction, intensity of infection, and micro-haematuria in Schistosoma haematobium infections. A randomised controlled intervention study was carried out among school-aged children in two different endemic settings with follow-up at 3, 6 and 18 months following drug administration. Differences in cure rates between the two treatment regimens were not significant. However, in high transmission areas, the double treatment regimen was more effective in egg reduction than single treatment regimen and the difference in egg reduction between the two treatments was significant at 3 months (P<0·005), 6 months (P<0·0001) and 18 months (P<0·003) after treatment. There was a significant difference in the effect of the two treatments on prevalence of micro-haematuria at 18-month follow-up in both Koulikoro (P<0·001) and Selingue (P<0·003). The study shows that although no significant difference could be observed in the overall cure-rates between the two treatment regimens, the effect of double treatment was a significant reduction in infection intensity as well as micro-haematuria which may have a great impact in reducing subtle morbidity.


Corresponding author

*Corresponding author: Moussa Sacko, Institut National de Recherche en Santé Publique (INRSP), B.P. 1771, Bamako, Mali. Tel.: +223 222 92 11. Fax: +223 222 92 11. E-mail:


Hide All
Botros, S., Sayed, H., Amer, N., El-Ghannam, M., Bennett, J. L. and Day, T. A. (2005). Current status of sensitivity to praziquantel in a focus of potential drug resistance in Egypt. International Journal for Parasitology 35, 787791.
Danso-Appiah, A. and De Vlas, S. J. (2002). Interpreting low praziquantel cure rates of Schistosoma mansoni infections in Senegal. Trends in Parasitology 18, 125129.
De Clercq, D., Sacko, M., Vercruysse, J., vanden Bussche, V., Landouré, A., Diarra, A., Gryseels, B. and Deelder, A. (1997). Assessment of cure by detection of circulating antigens in serum and urine following schistosomiasis mass treatment in two villages of the Office du Niger, Mali. Acta Tropica 68, 339346.
Chitsulo, L., Engels, D., Montresor, A. and Savioli, L. (2000). The global status of schistosomiasis and its control. Acta Tropica 77, 4151.
Doenhoff, M., Modha, J., Lambertucci, J. R. and McLaren, D. J. (1991). The immune dependence of chemotherapy. Parasitology Today 7, 1618.
Dunne, D. W., Butterworth, A. E., Fulford, A. J., Kariuki, H. C., Langley, J. G., Ouma, J. H., Capron, A., Pierce, R. J. and Sturrock, R. F. (1992). Immunity after treatment of human schistosomiasis: association between IgE antibodies to adult worm antigens and resistance to reinfection. European Journal of Immunology 22, 14831494.
Fitzsimmons, C. M., Joseph, S., Jones, F. M., Reimert, C. M., Hoffmann, K. F., Kazibwe, F., Kimani, G., Mwatha, J. K., Ouma, J. H., Tukahebwa, E. M., Kariuki, H. C., Vennervald, B., Kabatereine, N. B. and Dunne, D. W. (2004). Chemotherapy for schistosomiasis in Ugandan fishermen: treatment can cause a rapid increase in interleukin-5 levels in plasma but decreased levels of eosinophilia and worm-specific immunoglobulin E. Infection and Immunity 72, 40234030.
Giboda, M., Loudova, J., Shonova, O., Bouckova, E., Horacek, J., Numrich, P., Ruppel, A., Vitovec, J., Lukes, S. and Noll, P. (1992). Efficacy of praziquantel treatment of schistosomiasis in a non-endemic country: a follow-up of parasitological, clinical and immunological parameters. Journal of Hygiene, Epidemiology, Microbiology and Immunology 36, 346355.
Gryseels, B., Mbaye, A., De Vlas, S. J., Stelma, F. F., Guisse, F., Van Lieshout, L., Faye, D., Diop, M., Ly, A., Tchuem-Tchuente, L. A., Engels, D. and Polman, K. (2001). Are poor responses to praziquantel for the treatment of Schistosoma mansoni infections in Senegal due to resistance? An overview of the evidence. Tropical Medicine and International Health 6, 864873.
Joseph, S., Jones, F. M., Walter, K., Fulford, A. J., Kimani, G., Mwatha, J. K., Kamau, T., Kariuki, H. C., Kazibwe, F., Tukahebwa, E., Kabatereine, N. B., Ouma, J. H., Vennervald, B. J. and Dunne, D. W. (2004). Increases in human T helper 2 cytokine responses to Schistosoma mansoni worm and worm-tegument antigens are induced by treatment with praziquantel. Journal of Infectious Diseases 190, 835842.
Kabatereine, N. B., Kemijumbi, J., Ouma, J. H., Sturrock, R. F., Butterworth, A. E., Madsen, H., Ornbjerg, N., Dunne, D. W. and Vennnervald, B. J. (2003). Efficacy and side effects of praziquantel treatment in a highly endemic Schistosoma mansoni focus at Lake Albert, Uganda. Transaction of the Royal Society of Tropical Medicine and Hygiene 97, 599603.
Kahama, A. I., Kremsner, P. G., van Dam, G. J. and Deelder, A. M. (1998). The dynamics of a soluble egg antigen of Schistosoma haematobium in relation to egg counts, circulating anodic and cathodic antigens and pathology markers before and after chemotherapy. Transactions of the Royal Society of Tropical Medicine and Hygiene 92, 629633.
Kahama, A. I., Vennervald, B. J., Kombe, Y., Kihara, R. W., Ndzovu, M., Mungai, P. and Ouma, J. H. (1999). Parameters associated with Schistosoma haematobium infection before and after chemotherapy in school children from two villages in the coast province of Kenya. Tropical Medicine and International Health 4, 335340.
King, C. H., Lombardi, G., Lombardi, C., Greenblatt, R., Hodder, S., Kinyanjui, H., Ouma, J., Odiambo, O., Bryan, P. J., Muruka, J., Magak, P., Weinert, D., Mackay, W., Ransohoff, D., Houser, H., Koech, D., Arap Siongok, T. K. and Mahmoud, A. A. F. (1990). Chemotherapy-based control of schistosomiasis haematobia. II. Metrifonate vs. praziquantel in control of intensity and prevalence of infection. American Journal of Tropical Medicine and Hygiene 42, 587595.
Lawn, S. D., Lucas, S. B. and Chiodini, P. L. (2003). Case report: Schistosoma mansoni infection: failure of standard treatment with praziquantel in a returned traveller. Transactions of the Royal Society of Tropical Medicine and Hygiene 97, 100101.
Magnussen, P., Muchiri, E., Mungai, P., Ndzovu, M., Ouma, J. and Tosha, S. (1997). A school-based approach to control of urinary schistosomiasis and intestinal helminths infections in children in Matuga, Kenya: impact of a 2-year chemotherapy program on prevalence and intensity of infections. Tropical Medicine and International Health 2, 825831.
Mott, K. E., Dixon, H., Osei-Tutu, E., England, E. C. and Davis, A. (1985). Effect of praziquantel on haematuria and proteinuria in urinary schistosomiasis. American Journal of Tropical Medicine and Hygiene 34, 11191126.
Muchiri, E. M., Ouma, J. H. and King, C. H. (1996). Dynamics and control of Schistosoma haematobium transmission in Kenya: an overview of the Msambweni Project. American Journal of Tropical Medicine and Hygiene 55, 127134.
Mutapi, F., Mduluza, T. and Roddam, A. W. (2005). Cluster analysis of schistosome-specific antibody responses partitions the population into distinct epidemiological groups. Immunology Letters 96, 231240.
N'Goran, E. K., Gnaka, H. N., Tanner, M. and Utzinger, J. (2003). Efficacy and side-effects of two praziquantel treatments against Schistosoma haematobium infection, among schoolchildren from Cote d'Ivoire. Annals of Tropical Medicine and Parasitology 1, 3751.
N'Goran, E. K., Utzinger, J., N'Guessan, A. N., Muller, I., Zamble, K., Lohourignon, K. L., Traoré, M., Sosthene, B. A., Lengeler, C. and Tanner, M. (2001). Reinfection with Schistosoma haematobium following school-based chemotherapy with praziquantel in four highly endemic villages in Cote d'Ivoire. Tropical Medicine and International Health 6, 817825.
Peters, P. A., Warren, K. S. and Mahmoud, A. A. F. (1976). Rapid, accurate quantification of schistosome eggs via Nuclepore filters. Journal of Parasitology 62, 154155.
Polman, K. (2000). Epidemiological application of circulating antigen detection in schistosomiasis. PhD. Thesis. University of Leiden.
Saathoff, E., Olsen, A., Magnussen, P., Kvalsvig, J. D., Becker, W. and Appleton, C. C. (2004). Patterns of Schistosoma haematobium infection, impact of praziquantel treatment and re-infection after treatment in a cohort of schoolchildren from rural KwaZulu-Natal/South Africa. BMC Infectious Diseases 4, 40.
Sabah, A. A., Fletcher, C., Webbe, G. and Doenhoff, M. J. (1986). Schistosoma mansoni: chemotherapy of infections of different ages. Experimental Parasitology 61, 294303.
Stelma, F., Talla, I., Sow, S., Kongs, A., Niang, M., Ploman, K., Deelder, A. and Gryseels, B. (1995). Efficacy and side effects of Praziquantel in an epidemic focus of Schistosoma mansoni. American Journal of Tropical Medicine and Hygiene 53, 167170.
Tchuem Tchuenté, L. A., Shaw, D. J., Polla, L., Cioli, D. and Vercryusse, J. (2004). Efficacy of praziquantel against Schistosoma haematobium in children. American Journal of Tropical Medicine and Hygiene 71, 778782.
Traoré, M. (1994). A study of the epidemiology of schistosomiasis in Mali: Towards a rationally – based national control program. PhD. Thesis. University of London.
Traoré, M., Traoré, H. A., Kardorff, R., Diarra, A., Landouré, A., Vester, U., Doehring, E. and Bradley, D. J. (1998). The public health significance of urinary schistosomiasis as a cause of morbidity in two districts in Mali. American Journal of Tropical Medicine and Hygiene 59, 407413.
Utzinger, J., N'Goran, E. K., N'Dri, A., Lengeler, C. and Tanner, M. (2000). Efficacy of praziquantel against Schistosoma mansoni with particular consideration for intensity of infection. Tropical Medicine and International Health 5, 771778.
World Health Organization (WHO). (2002): Prevention and control of schistosomiasis and soil-transmitted helminthiasis. World Health Organization Technical Report Series 912, Geneva.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

  • ISSN: 0031-1820
  • EISSN: 1469-8161
  • URL: /core/journals/parasitology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed