RESUMO
The long-term effect of single-dose praziquantel on morbidity and mortality from Schistosoma mansoni was investigated in surveys in 1987 and 1994 in central Sudan. Prevalence of infection dropped from 53% to 34%, and intensity of infection (> or = 400 eggs/g of faeces) from 31% to 18%. There was a reduction in hepatomegaly and hepatosplenomegaly, although splenomegaly alone was unchanged. Prevalence of periportal fibrosis decreased from 14% to 10%. Endoscopic investigation of patients with fibrosis showed a reduction in oesophageal varices from 47% to 30%. Mortality due to bleeding varices was high (community-wide, up to 11/100 infected patients with bleeding). Thus praziquantel mass treatment can be spaced to a much longer period, reducing the expense of treatment, delivery and distribution.
Assuntos
Anti-Helmínticos/uso terapêutico , Doenças Endêmicas/prevenção & controle , Doenças Endêmicas/estatística & dados numéricos , Praziquantel/uso terapêutico , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Anti-Helmínticos/farmacologia , Causas de Morte , Criança , Pré-Escolar , Varizes Esofágicas e Gástricas/parasitologia , Hepatomegalia/parasitologia , Humanos , Incidência , Lactente , Cirrose Hepática/parasitologia , Pessoa de Meia-Idade , Morbidade , Contagem de Ovos de Parasitas , Vigilância da População , Praziquantel/farmacologia , Prevalência , Esquistossomose mansoni/complicações , Esquistossomose mansoni/diagnóstico , Índice de Gravidade de Doença , Esplenomegalia/parasitologia , Sudão/epidemiologiaRESUMO
Ultrasonography was used in a village in the Gezira-Managil scheme in the Sudan to identify patients with Symmers' fibrosis. In a random sample from patients with active Schistosoma mansoni infection, 238 patients were found to have no liver involvement while 59 had Symmers' periportal fibrosis. Patients were treated with a single dose of 40 mg/kg body weight of praziquantel. Six months after dosing, 51% and 58% were cured of the infection with 81% and 84% reduction in egg burden in the Symmers' and non-Symmers' patients, respectively. The drug was equally well tolerated by the two groups. It is concluded that patients with Symmers' fibrosis respond to praziquantel and tolerate the drug in a similar manner to patients without Symmers'.
