Authors

M Fukushige¹; F Mutapi²; M E Woolhouse¹;  ¹ Centre for Immunity, Infection and Evolution, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh;  ² Institute of Immunology and Infection Research, Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh

Discussion

The antihelminthic drug praziquantel has been used as the drug of choice for treating schistosome infection for more than 30 years. Although there are multiple epidemiological studies that have reported low praziquantel cure rates, there is no convincing evidence of the development of schistosome resistance to praziquantel. Here, a meta-analysis was conducted to identify the factors that influence the cure rate of praziquantel treatment by taking into consideration differences in host characteristics and drug dose.
The analyses showed that, although there was a considerable variability in cure rates, there has been no clear cure rate reduction over the study period (articles published 1981-2014). In addition, analyses revealed that the cure rate increases with praziquantel dose (10-60 mg/kg body weight), and varies with schistosome species (S. mansoni vs. S. haematobium), and the age of the participants (children: 0-19 years old vs. adults: ≥20 years old). The current WHO recommended treatment dose (40 mg/kg body weight) achieved average cure rates that ranged from 69% to 83%, depending on schistosome parasite species and the age participants. Despite concerns about possible resistance against praziquantel treatment, these results suggest that praziquantel remains effective