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Trop Med Int Health ; 26(6): 632-639, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33576107

RESUMO

OBJECTIVE: To assess the status of intestinal schistosomiasis among preschool-aged (PSAC) and school-aged children (SAC) and to compare the efficacy of praziquantel (PZQ) in both groups. METHODS: The study was conducted on 400 children; 103 PSAC and 297 SAC. Diagnosis of Schistosoma mansoni was based on triplicate Kato-Katz thick smears from a single stool sample. To identify the missed cases by Kato-Katz, 120 randomly selected negative cases (38 PSAC and 82 SAC) were screened by real-time PCR. All S. mansoni-positive cases by Kato-Katz were treated by crushed PZQ tablets. Four weeks after treatment, the cure rate was assessed by Kato-Katz smears and real-time PCR. RESULTS: The prevalence of S. mansoni with Kato-Katz was 7.8% among PSAC and 7.4% among SAC. Most of children (63.3%) had light-intensity infection. The cure rate was 100% among PSAC by both techniques, and 91%, and 77.2% among SAC by Kato-Katz and real-time PCR, respectively. In the 120 stool samples screened by real-time PCR, S. mansoni prevalence was 25%; 15.8% and 29.3% were among PSAC and SAC respectively. Treated cases showed a lower range of Ct values than untreated cases. Two melting temperature ranges (Tm = 83-87°C and 89-93°C) were recognised among uncured cases which may point to S. mansoni genetic variability. CONCLUSION: Continuous monitoring and inclusion of PSAC in schistosomiasis control programmes are crucial. Real-time PCR and other molecular tools are recommended for evaluation of the true prevalence, assessment of cure and further studies on genetic diversity.


Assuntos
Anti-Helmínticos/uso terapêutico , Praziquantel/uso terapêutico , Esquistossomose mansoni/diagnóstico , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/prevenção & controle , Animais , Criança , Pré-Escolar , Egito/epidemiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , População Rural , Schistosoma mansoni/efeitos dos fármacos , Resultado do Tratamento
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