Efficacy of praziquantel against Schistosoma mekongi and Opisthorchis viverrini: a randomized, single-blinded dose-comparison trial
Schistosomiasis and opisthorchiasis are of public health importance in Southeast Asia. Praziquantel (PZQ) is the drug of choice for morbidity control but few dose comparisons have been made. Ninety-three schoolchildren were enrolled in an area of Lao PDR where Schistosoma mekongi and Opisthorchis vi...
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creator | Lovis, Leonore Mak, Tippi K Phongluxa, Khampheng Ayé Soukhathammavong, Phonepasong Vonghachack, Youthanavanh Keiser, Jennifer Vounatsou, Penelope Tanner, Marcel Hatz, Christoph Utzinger, Jürg Odermatt, Peter Akkhavong, Kongsap |
description | Schistosomiasis and opisthorchiasis are of public health importance in Southeast Asia. Praziquantel (PZQ) is the drug of choice for morbidity control but few dose comparisons have been made.
Ninety-three schoolchildren were enrolled in an area of Lao PDR where Schistosoma mekongi and Opisthorchis viverrini coexist for a PZQ dose-comparison trial. Prevalence and intensity of infections were determined by a rigorous diagnostic effort (3 stool specimens, each examined with triplicate Kato-Katz) before and 28-30 days after treatment. Ninety children with full baseline data were randomized to receive PZQ: the 40 mg/kg standard single dose (n = 45) or a 75 mg/kg total dose (50 mg/kg+25 mg/kg, 4 hours apart; n = 45). Adverse events were assessed at 3 and 24 hours posttreatment.
Baseline infection prevalence of S. mekongi and O. viverrini were 87.8% and 98.9%, respectively. S. mekongi cure rates were 75.0% (95% confidence interval (CI): 56.6-88.5%) and 80.8% (95% CI: 60.6-93.4%) for 40 mg/kg and 75 mg/kg PZQ, respectively (P = 0.60). O. viverrini cure rates were significantly different at 71.4% (95% CI: 53.4-84.4%) and 96.6% (95% CI: not defined), respectively (P = 0.009). Egg reduction rates (ERRs) against O. viverrini were very high for both doses (>99%), but slightly lower for S. mekongi at 40 mg/kg (96.4% vs. 98.1%) and not influenced by increasing diagnostic effort. O. viverrini cure rates would have been overestimated and no statistical difference between doses found if efficacy was based on a minimum sampling effort (single Kato-Katz before and after treatment). Adverse events were common (96%), mainly mild with no significant differences between the two treatment groups.
Cure rate from the 75 mg/kg PZQ dose was more efficacious than 40 mg/kg against O. viverrini but not against S. mekongi infections, while ERRs were similar for both doses.
Controlled-Trials.com ISRCTN57714676. |
doi_str_mv | 10.1371/journal.pntd.0001726 |
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Ninety-three schoolchildren were enrolled in an area of Lao PDR where Schistosoma mekongi and Opisthorchis viverrini coexist for a PZQ dose-comparison trial. Prevalence and intensity of infections were determined by a rigorous diagnostic effort (3 stool specimens, each examined with triplicate Kato-Katz) before and 28-30 days after treatment. Ninety children with full baseline data were randomized to receive PZQ: the 40 mg/kg standard single dose (n = 45) or a 75 mg/kg total dose (50 mg/kg+25 mg/kg, 4 hours apart; n = 45). Adverse events were assessed at 3 and 24 hours posttreatment.
Baseline infection prevalence of S. mekongi and O. viverrini were 87.8% and 98.9%, respectively. S. mekongi cure rates were 75.0% (95% confidence interval (CI): 56.6-88.5%) and 80.8% (95% CI: 60.6-93.4%) for 40 mg/kg and 75 mg/kg PZQ, respectively (P = 0.60). O. viverrini cure rates were significantly different at 71.4% (95% CI: 53.4-84.4%) and 96.6% (95% CI: not defined), respectively (P = 0.009). Egg reduction rates (ERRs) against O. viverrini were very high for both doses (>99%), but slightly lower for S. mekongi at 40 mg/kg (96.4% vs. 98.1%) and not influenced by increasing diagnostic effort. O. viverrini cure rates would have been overestimated and no statistical difference between doses found if efficacy was based on a minimum sampling effort (single Kato-Katz before and after treatment). Adverse events were common (96%), mainly mild with no significant differences between the two treatment groups.
Cure rate from the 75 mg/kg PZQ dose was more efficacious than 40 mg/kg against O. viverrini but not against S. mekongi infections, while ERRs were similar for both doses.
Controlled-Trials.com ISRCTN57714676.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0001726</identifier><identifier>PMID: 22848766</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Animals ; Anthelmintics - administration & dosage ; Anthelmintics - pharmacology ; Biology ; Child ; Clinical trials ; Demographic aspects ; Diagnosis ; Dosage and administration ; Drug dosages ; Drug therapy ; Eggs ; Female ; Fluke infections ; Food ; Humans ; Infections ; Laos ; Male ; Medicine ; Methods ; Opisthorchiasis - drug therapy ; Opisthorchis - drug effects ; Praziquantel ; Praziquantel - administration & dosage ; Praziquantel - pharmacology ; Prevalence studies (Epidemiology) ; Public health ; Schistosoma - drug effects ; Schistosomiasis - drug therapy ; Treatment Outcome ; Tropical diseases</subject><ispartof>PLoS neglected tropical diseases, 2012-07, Vol.6 (7), p.e1726-e1726</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Lovis et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Lovis L, Mak TK, Phongluxa K, Ayé Soukhathammavong P, Vonghachack Y, et al. (2012) Efficacy of Praziquantel against Schistosoma mekongi and Opisthorchis viverrini: A Randomized, Single-Blinded Dose-Comparison Trial. PLoS Negl Trop Dis 6(7): e1726. doi:10.1371/journal.pntd.0001726</rights><rights>Lovis et al. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-86e1fad6b2f9f621c1edddb00b29667a170e24a5a20c88cb00c44db6e604cab83</citedby><cites>FETCH-LOGICAL-c624t-86e1fad6b2f9f621c1edddb00b29667a170e24a5a20c88cb00c44db6e604cab83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404075/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404075/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22848766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Sripa, Banchob</contributor><creatorcontrib>Lovis, Leonore</creatorcontrib><creatorcontrib>Mak, Tippi K</creatorcontrib><creatorcontrib>Phongluxa, Khampheng</creatorcontrib><creatorcontrib>Ayé Soukhathammavong, Phonepasong</creatorcontrib><creatorcontrib>Vonghachack, Youthanavanh</creatorcontrib><creatorcontrib>Keiser, Jennifer</creatorcontrib><creatorcontrib>Vounatsou, Penelope</creatorcontrib><creatorcontrib>Tanner, Marcel</creatorcontrib><creatorcontrib>Hatz, Christoph</creatorcontrib><creatorcontrib>Utzinger, Jürg</creatorcontrib><creatorcontrib>Odermatt, Peter</creatorcontrib><creatorcontrib>Akkhavong, Kongsap</creatorcontrib><title>Efficacy of praziquantel against Schistosoma mekongi and Opisthorchis viverrini: a randomized, single-blinded dose-comparison trial</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Schistosomiasis and opisthorchiasis are of public health importance in Southeast Asia. Praziquantel (PZQ) is the drug of choice for morbidity control but few dose comparisons have been made.
Ninety-three schoolchildren were enrolled in an area of Lao PDR where Schistosoma mekongi and Opisthorchis viverrini coexist for a PZQ dose-comparison trial. Prevalence and intensity of infections were determined by a rigorous diagnostic effort (3 stool specimens, each examined with triplicate Kato-Katz) before and 28-30 days after treatment. Ninety children with full baseline data were randomized to receive PZQ: the 40 mg/kg standard single dose (n = 45) or a 75 mg/kg total dose (50 mg/kg+25 mg/kg, 4 hours apart; n = 45). Adverse events were assessed at 3 and 24 hours posttreatment.
Baseline infection prevalence of S. mekongi and O. viverrini were 87.8% and 98.9%, respectively. S. mekongi cure rates were 75.0% (95% confidence interval (CI): 56.6-88.5%) and 80.8% (95% CI: 60.6-93.4%) for 40 mg/kg and 75 mg/kg PZQ, respectively (P = 0.60). O. viverrini cure rates were significantly different at 71.4% (95% CI: 53.4-84.4%) and 96.6% (95% CI: not defined), respectively (P = 0.009). Egg reduction rates (ERRs) against O. viverrini were very high for both doses (>99%), but slightly lower for S. mekongi at 40 mg/kg (96.4% vs. 98.1%) and not influenced by increasing diagnostic effort. O. viverrini cure rates would have been overestimated and no statistical difference between doses found if efficacy was based on a minimum sampling effort (single Kato-Katz before and after treatment). Adverse events were common (96%), mainly mild with no significant differences between the two treatment groups.
Cure rate from the 75 mg/kg PZQ dose was more efficacious than 40 mg/kg against O. viverrini but not against S. mekongi infections, while ERRs were similar for both doses.
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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lovis, Leonore</au><au>Mak, Tippi K</au><au>Phongluxa, Khampheng</au><au>Ayé Soukhathammavong, Phonepasong</au><au>Vonghachack, Youthanavanh</au><au>Keiser, Jennifer</au><au>Vounatsou, Penelope</au><au>Tanner, Marcel</au><au>Hatz, Christoph</au><au>Utzinger, Jürg</au><au>Odermatt, Peter</au><au>Akkhavong, Kongsap</au><au>Sripa, Banchob</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of praziquantel against Schistosoma mekongi and Opisthorchis viverrini: a randomized, single-blinded dose-comparison trial</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>6</volume><issue>7</issue><spage>e1726</spage><epage>e1726</epage><pages>e1726-e1726</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Schistosomiasis and opisthorchiasis are of public health importance in Southeast Asia. Praziquantel (PZQ) is the drug of choice for morbidity control but few dose comparisons have been made.
Ninety-three schoolchildren were enrolled in an area of Lao PDR where Schistosoma mekongi and Opisthorchis viverrini coexist for a PZQ dose-comparison trial. Prevalence and intensity of infections were determined by a rigorous diagnostic effort (3 stool specimens, each examined with triplicate Kato-Katz) before and 28-30 days after treatment. Ninety children with full baseline data were randomized to receive PZQ: the 40 mg/kg standard single dose (n = 45) or a 75 mg/kg total dose (50 mg/kg+25 mg/kg, 4 hours apart; n = 45). Adverse events were assessed at 3 and 24 hours posttreatment.
Baseline infection prevalence of S. mekongi and O. viverrini were 87.8% and 98.9%, respectively. S. mekongi cure rates were 75.0% (95% confidence interval (CI): 56.6-88.5%) and 80.8% (95% CI: 60.6-93.4%) for 40 mg/kg and 75 mg/kg PZQ, respectively (P = 0.60). O. viverrini cure rates were significantly different at 71.4% (95% CI: 53.4-84.4%) and 96.6% (95% CI: not defined), respectively (P = 0.009). Egg reduction rates (ERRs) against O. viverrini were very high for both doses (>99%), but slightly lower for S. mekongi at 40 mg/kg (96.4% vs. 98.1%) and not influenced by increasing diagnostic effort. O. viverrini cure rates would have been overestimated and no statistical difference between doses found if efficacy was based on a minimum sampling effort (single Kato-Katz before and after treatment). Adverse events were common (96%), mainly mild with no significant differences between the two treatment groups.
Cure rate from the 75 mg/kg PZQ dose was more efficacious than 40 mg/kg against O. viverrini but not against S. mekongi infections, while ERRs were similar for both doses.
Controlled-Trials.com ISRCTN57714676.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22848766</pmid><doi>10.1371/journal.pntd.0001726</doi><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1935-2735 |
ispartof | PLoS neglected tropical diseases, 2012-07, Vol.6 (7), p.e1726-e1726 |
issn | 1935-2735 1935-2727 1935-2735 |
language | eng |
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source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
subjects | Adolescent Animals Anthelmintics - administration & dosage Anthelmintics - pharmacology Biology Child Clinical trials Demographic aspects Diagnosis Dosage and administration Drug dosages Drug therapy Eggs Female Fluke infections Food Humans Infections Laos Male Medicine Methods Opisthorchiasis - drug therapy Opisthorchis - drug effects Praziquantel Praziquantel - administration & dosage Praziquantel - pharmacology Prevalence studies (Epidemiology) Public health Schistosoma - drug effects Schistosomiasis - drug therapy Treatment Outcome Tropical diseases |
title | Efficacy of praziquantel against Schistosoma mekongi and Opisthorchis viverrini: a randomized, single-blinded dose-comparison trial |
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