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Therapeutic failure of praziquantel in the treatment of Schistosoma haematobium infection in Brazilians returning from Africa
Silva, Iran Mendonça da; Thiengo, Roberto; Conceição, Maria José; Rey, Luis; Lenzi, Henrique Leonel; Pereira Filho, Edson; Ribeiro, Paulo César.
Affiliation
  • Silva, Iran Mendonça da; Instituto de Biologia do Exército. Divisão de Ensino e Pesquisa. Subdivisão de Pesquisa. Seção de Vigilância Epidemiológica. Rio de Janeiro. BR
  • Thiengo, Roberto; Hospital Central do Exército. Serviço de Urologia. Rio de Janeiro. BR
  • Conceição, Maria José; Fiocruz. Instituto Oswaldo Cruz. Departamento de Patologia. Rio de Janeiro. BR
  • Rey, Luis; Fiocruz. Instituto Oswaldo Cruz. Departamento de Medicina Tropical. Laboratório de Biologia e Controle de Esquistossomose. Rio de Janeiro. BR
  • Lenzi, Henrique Leonel; Hospital Universitário Clementino Fraga Filho. Rio de Janeiro. BR
  • Pereira Filho, Edson; Instituto de Biologia do Exército. Divisão de Ensino e Pesquisa. Subdivisão de Pesquisa. Seção de Vigilância Epidemiológica. Rio de Janeiro. BR
  • Ribeiro, Paulo César; Instituto de Biologia do Exército. Divisão de Ensino e Pesquisa. Subdivisão de Pesquisa. Seção de Vigilância Epidemiológica. Rio de Janeiro. BR
Mem. Inst. Oswaldo Cruz ; 100(4): 445-449, July 2005. ilus
Article in En | LILACS | ID: lil-406003
Responsible library: BR1.1
RESUMO
Several cases of therapeutic failure of praziquantel used for the treatment of urinary schistosomiasis have been reported. Alternative drugs, like niridazol and metrifonate, have shown a lower therapeutic effect and more side effects than praziquantel. Twenty-six Brazilian military men (median age of 29 years) with a positive urine parasitological exam who were part of a United Nation peace mission in Mozambique in 1994 were treated with 40 mg/kg body weight praziquantel, single dose. They swimmed in Licungo river (Mocuba city, Mozambique) during the weekends. After this, they presented haematuria, dysuria, polakiuria, and lumbar pain. Control cystoscopy examinations carried out between 6 and 24 months after each treatment (including two additional treatments at a minimum interval of 6 months) revealed the presence of viable eggs. Granulomas in the vesical submucosa were observed in 46.2 percent (12/26) of the individuals. A vesical biopsy confirmed the presence of granulomas in all of these patients and the presence of viable eggs in 34.3 percent (9/26) of individuals who no longer excreted eggs in urine. The eggs filled with miracidia showed characteristics of viability. Histopathological examination using different strains demonstrated therapeutic failure and the need for repeated treatment. In this study, we demonstrated a low efficacy of praziquantel in the treatment of schistosomiasis haematobia, and the necessity of the urinary bladder biopsy as criterion of cure.
Subject(s)
Full text: 1 Index: LILACS Main subject: Praziquantel / Urinary Bladder / Schistosomiasis haematobia / Anthelmintics Limits: Animals / Humans / Male Country/Region as subject: America do sul / Brasil Language: En Journal: Mem. Inst. Oswaldo Cruz Journal subject: MEDICINA TROPICAL / PARASITOLOGIA Year: 2005 Type: Article
Full text: 1 Index: LILACS Main subject: Praziquantel / Urinary Bladder / Schistosomiasis haematobia / Anthelmintics Limits: Animals / Humans / Male Country/Region as subject: America do sul / Brasil Language: En Journal: Mem. Inst. Oswaldo Cruz Journal subject: MEDICINA TROPICAL / PARASITOLOGIA Year: 2005 Type: Article