Therapeutic failure of praziquantel in the treatment of Schistosoma haematobium infection in Brazilians returning from Africa
Mem. Inst. Oswaldo Cruz
;
100(4): 445-449, July 2005. ilus
Artigo
em Inglês
| LILACS
| ID: lil-406003
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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Praziquantel
/
Bexiga Urinária
/
Esquistossomose Urinária
/
Anti-Helmínticos
Limite:
Animais
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Mem. Inst. Oswaldo Cruz
Assunto da revista:
Medicina Tropical
/
Parasitologia
Ano de publicação:
2005
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Fiocruz/BR
/
Hospital Central do Exército/BR
/
Hospital Universitário Clementino Fraga Filho/BR
/
Instituto de Biologia do Exército/BR
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