Dosage trial of a combination of oxamniquine and praziquantel in the treatment of schistosomiasis in Zimbabwean schoolchildren
Creasey, A.M.; Taylor, P.; Thomas, J.E.
Central African Journal of Medicine 32(7): 165-167
1986
ISSN/ISBN: 0008-9176 PMID: 3107836 Document Number: 281940
59 children from the Raffingora District of Zimbabwe, with mixed Schistosoma mansoni and S. haematobium infections, were treated with a combination of oxamniquine and praziquantel at 3 dose levels: 4 mg/kg plus 8 mg/kg (group 1), 7.5 mg/kg plus 15 mg/kg (group 2) and 10 mg/kg plus 20 mg/kg (group 3). The drugs were given with water and 85 g of white bread. Side-effects following administration were slight: 70% claimed some abdominal discomfort on day of treatment and one child reported feeling dizzy 5 min. after treatment. Raised alkaline phosphatase levels were the only changes observed in urine and blood tests, and it is thought that these may be associated with liver damage by S. mansoni. None of the S. haematobium infection were cured at follow-up one month after treatment but 2 were cured at 6 months (one each from groups 2 and 3). Egg counts at one month were decreased by 69% in group 1 and 93% in group 2 and 3: drug synergism against S. haematobium has not so far been demonstrated and the parasite was probably affected by praziquantel alone. 20 mg/kg praziquantel is half the dose currently used in Zimbabwe to treat mixed infections. Some synergistic effect was noted for S. mansoni. The cure rate at one month was 77 and 89% for groups 2 and 3 and the faecal egg counts had dropped by 94, 96 and 88% for the 3 groups, resp. Following reports of synergism between oxamniquine and praziquantel three dosage levels of this combination drug were tested in the treatment of simultaneous infections of Schistosoma mansoni and S. haematobium among [59] Zimbabwean schoolchildren. Pre- and post-treatment measurement was made of the patients' clinical health, blood count and biochemistry, urinalysis and parasite egg counts in urine and stool. The combination drug proved effective at the higher dosage levels used, it was easy to administer and gave few side-effects. A synergistic effect was noted in the treatment of S. mansoni but not S. haematobium. The combination exhibited no curative advantage over praziquantel alone. At present the combination of oxamniquine and praziquantel does not appear to have a significant role to play in the chemotherapy of schistosomiasis.AS.