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. 2000 Nov-Dec;6(6):585–594. doi: 10.3201/eid0606.000606

Evidence against rapid emergence of praziquantel resistance in Schistosoma haematobium, Kenya.

C H King 1, E M Muchiri 1, J H Ouma 1
PMCID: PMC2640915  PMID: 11076716

Abstract

We examined the long-term efficacy of praziquantel against Schistosoma haematobium, the causative agent of urinary schistosomiasis, during a school-based treatment program in the Msambweni area of Coast Province, Kenya, where the disease is highly endemic. Our results, derived from treating 4,031 of 7,641 children from 1984 to 1993, indicate substantial year-to- year variation in drug efficacy. However, the pattern of this variation was not consistent with primary or progressive emergence of praziquantel resistance. Mathematical modeling indicated that, at current treatment rates, praziquantel resistance will likely take 10 or more years to emerge.

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Selected References

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  1. Bennett J. L., Day T., Liang F. T., Ismail M., Farghaly A. The development of resistance to anthelmintics: a perspective with an emphasis on the antischistosomal drug praziquantel. Exp Parasitol. 1997 Nov;87(3):260–267. doi: 10.1006/expr.1997.4229. [DOI] [PubMed] [Google Scholar]
  2. Boisier P., Ramarokoto C. E., Ravaoalimalala V. E., Rabarijaona L., Serieye J., Roux J., Esterre P. Reversibility of Schistosoma mansoni-associated morbidity after yearly mass praziquantel therapy: ultrasonographic assessment. Trans R Soc Trop Med Hyg. 1998 Jul-Aug;92(4):451–453. doi: 10.1016/s0035-9203(98)91090-2. [DOI] [PubMed] [Google Scholar]
  3. Brindley P. J. Drug resistance to schistosomicides and other anthelmintics of medical significance. Acta Trop. 1994 Mar;56(2-3):213–231. doi: 10.1016/0001-706x(94)90064-7. [DOI] [PubMed] [Google Scholar]
  4. Caporale L. H. Chance favors the prepared genome. Ann N Y Acad Sci. 1999 May 18;870:1–21. doi: 10.1111/j.1749-6632.1999.tb08860.x. [DOI] [PubMed] [Google Scholar]
  5. Chan M. S., Nsowah-Nuamah N. N., Adjei S., Wen S. T., Hall A., Bundy D. A. Predicting the impact of school-based treatment for urinary schistosomiasis given by the Ghana Partnership for Child Development. Trans R Soc Trop Med Hyg. 1998 Jul-Aug;92(4):386–389. doi: 10.1016/s0035-9203(98)91057-4. [DOI] [PubMed] [Google Scholar]
  6. Cioli D., Pica Mattoccia L. Genetic analysis of hycanthone resistance in Schistosoma mansoni. Am J Trop Med Hyg. 1984 Jan;33(1):80–88. doi: 10.4269/ajtmh.1984.33.80. [DOI] [PubMed] [Google Scholar]
  7. Cunha V. M., Noël F. (Ca(2+)-Mg2+)ATPase in Schistosoma mansoni: evidence for heterogeneity and resistance to praziquantel. Mem Inst Oswaldo Cruz. 1998;93 (Suppl 1):181–182. doi: 10.1590/s0074-02761998000700029. [DOI] [PubMed] [Google Scholar]
  8. Davis A., Biles J. E., Ulrich A. M. Initial experiences with praziquantel in the treatment of human infections due to Schistosoma haematobium. Bull World Health Organ. 1979;57(5):773–779. [PMC free article] [PubMed] [Google Scholar]
  9. Davis A., Wegner D. H. Multicentre trials of praziquantel in human schistosomiasis: design and techniques. Bull World Health Organ. 1979;57(5):767–771. [PMC free article] [PubMed] [Google Scholar]
  10. Drake J. W. The distribution of rates of spontaneous mutation over viruses, prokaryotes, and eukaryotes. Ann N Y Acad Sci. 1999 May 18;870:100–107. doi: 10.1111/j.1749-6632.1999.tb08870.x. [DOI] [PubMed] [Google Scholar]
  11. Etard J. F., Borel E., Segala C. Schistosoma haematobium infection in Mauritania: two years of follow-up after a targeted chemotherapy--a life-table approach of the risk of reinfection. Parasitology. 1990 Jun;100(Pt 3):399–406. doi: 10.1017/s0031182000078689. [DOI] [PubMed] [Google Scholar]
  12. Fallon P. G., Doenhoff M. J. Drug-resistant schistosomiasis: resistance to praziquantel and oxamniquine induced in Schistosoma mansoni in mice is drug specific. Am J Trop Med Hyg. 1994 Jul;51(1):83–88. doi: 10.4269/ajtmh.1994.51.83. [DOI] [PubMed] [Google Scholar]
  13. Fallon P. G., Sturrock R. F., Niang A. C., Doenhoff M. J. Short report: diminished susceptibility to praziquantel in a Senegal isolate of Schistosoma mansoni. Am J Trop Med Hyg. 1995 Jul;53(1):61–62. [PubMed] [Google Scholar]
  14. Field D., Magnasco M. O., Moxon E. R., Metzgar D., Tanaka M. M., Wills C., Thaler D. S. Contingency loci, mutator alleles, and their interactions. Synergistic strategies for microbial evolution and adaptation in pathogenesis. Ann N Y Acad Sci. 1999 May 18;870:378–382. doi: 10.1111/j.1749-6632.1999.tb08907.x. [DOI] [PubMed] [Google Scholar]
  15. Guisse F., Polman K., Stelma F. F., Mbaye A., Talla I., Niang M., Deelder A. M., Ndir O., Gryseels B. Therapeutic evaluation of two different dose regimens of praziquantel in a recent Schistosoma mansoni focus in Northern Senegal. Am J Trop Med Hyg. 1997 May;56(5):511–514. doi: 10.4269/ajtmh.1997.56.511. [DOI] [PubMed] [Google Scholar]
  16. Hotez P. J., Zheng F., Long-qi X., Ming-gang C., Shu-hua X., Shu-xian L., Blair D., McManus D. P., Davis G. M. Emerging and reemerging helminthiases and the public health of China. Emerg Infect Dis. 1997 Jul-Sep;3(3):303–310. doi: 10.3201/eid0303.970306. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ismail M., Metwally A., Farghaly A., Bruce J., Tao L. F., Bennett J. L. Characterization of isolates of Schistosoma mansoni from Egyptian villagers that tolerate high doses of praziquantel. Am J Trop Med Hyg. 1996 Aug;55(2):214–218. doi: 10.4269/ajtmh.1996.55.214. [DOI] [PubMed] [Google Scholar]
  18. Jongsuksuntigul P., Imsomboon T. The impact of a decade long opisthorchiasis control program in northeastern Thailand. Southeast Asian J Trop Med Public Health. 1997 Sep;28(3):551–557. [PubMed] [Google Scholar]
  19. King C. H., Lombardi G., Lombardi C., Greenblatt R., Hodder S., Kinyanjui H., Ouma J., Odiambo O., Bryan P. J., Muruka J. Chemotherapy-based control of schistosomiasis haematobia. I. Metrifonate versus praziquantel in control of intensity and prevalence of infection. Am J Trop Med Hyg. 1988 Sep;39(3):295–305. doi: 10.4269/ajtmh.1988.39.295. [DOI] [PubMed] [Google Scholar]
  20. King C. H., Mahmoud A. A. Drugs five years later: praziquantel. Ann Intern Med. 1989 Feb 15;110(4):290–296. doi: 10.7326/0003-4819-110-4-290. [DOI] [PubMed] [Google Scholar]
  21. King C. H., Muchiri E. M., Ouma J. H. Age-targeted chemotherapy for control of urinary schistosomiasis in endemic populations. Mem Inst Oswaldo Cruz. 1992;87 (Suppl 4):203–210. doi: 10.1590/s0074-02761992000800031. [DOI] [PubMed] [Google Scholar]
  22. King C. H., Wiper D. W., 3rd, De Stigter K. V., Peters P. A., Koech D., Ouma J. H., Arap Siongok T. K., Mahmoud A. A. Dose-finding study for praziquantel therapy of Schistosoma haematobium in Coast Province, Kenya. Am J Trop Med Hyg. 1989 May;40(5):507–513. doi: 10.4269/ajtmh.1989.40.507. [DOI] [PubMed] [Google Scholar]
  23. Kusel J., Hagan P. Praziquantel--its use, cost and possible development of resistance. Parasitol Today. 1999 Sep;15(9):352–354. doi: 10.1016/s0169-4758(99)01510-0. [DOI] [PubMed] [Google Scholar]
  24. Laurent C., Lamothe F., Develoux M., Sellin B., Mouchet F. Ultrasonographic assessment of urinary tract lesions due to Schistosoma haematobium in Niger after four consecutive years of treatment with praziquantel. Trop Med Parasitol. 1990 Jun;41(2):139–142. [PubMed] [Google Scholar]
  25. Llayd S., Walters T. M. Worming of dogs in mid-Wales for Echinococcus granulosus. Vet Rec. 1997 May 3;140(18):487–488. [PubMed] [Google Scholar]
  26. McMahon J. E., Kolstrup N. Praziquantel: a new schistosomicide against Schistosoma haematobium. Br Med J. 1979 Dec 1;2(6202):1396–1399. doi: 10.1136/bmj.2.6202.1396. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Mott K. E., Dixon H., Osei-Tutu E., England E. C., Davis A. Effect of praziquantel on hematuria and proteinuria in urinary schistosomiasis. Am J Trop Med Hyg. 1985 Nov;34(6):1119–1126. doi: 10.4269/ajtmh.1985.34.1119. [DOI] [PubMed] [Google Scholar]
  28. Moxon E. R., Rainey P. B., Nowak M. A., Lenski R. E. Adaptive evolution of highly mutable loci in pathogenic bacteria. Curr Biol. 1994 Jan 1;4(1):24–33. doi: 10.1016/s0960-9822(00)00005-1. [DOI] [PubMed] [Google Scholar]
  29. Muchiri E. M., Ouma J. H., King C. H. Dynamics and control of Schistosoma haematobium transmission in Kenya: an overview of the Msambweni Project. Am J Trop Med Hyg. 1996 Nov;55(5 Suppl):127–134. doi: 10.4269/ajtmh.1996.55.127. [DOI] [PubMed] [Google Scholar]
  30. Olds G. R., King C., Hewlett J., Olveda R., Wu G., Ouma J., Peters P., McGarvey S., Odhiambo O., Koech D. Double-blind placebo-controlled study of concurrent administration of albendazole and praziquantel in schoolchildren with schistosomiasis and geohelminths. J Infect Dis. 1999 Apr;179(4):996–1003. doi: 10.1086/314686. [DOI] [PubMed] [Google Scholar]
  31. Olveda R. M., Daniel B. L., Ramirez B. D., Aligui G. D., Acosta L. P., Fevidal P., Tiu E., de Veyra F., Peters P. A., Romulo R. Schistosomiasis japonica in the Philippines: the long-term impact of population-based chemotherapy on infection, transmission, and morbidity. J Infect Dis. 1996 Jul;174(1):163–172. doi: 10.1093/infdis/174.1.163. [DOI] [PubMed] [Google Scholar]
  32. Pereira C., Fallon P. G., Cornette J., Capron A., Doenhoff M. J., Pierce R. J. Alterations in cytochrome-c oxidase expression between praziquantel-resistant and susceptible strains of Schistosoma mansoni. Parasitology. 1998 Jul;117(Pt 1):63–73. doi: 10.1017/s003118209800273x. [DOI] [PubMed] [Google Scholar]
  33. Pugh R. N., Bell D. R., Gilles H. M. Malumfashi Endemic Diseases Research Project, XV. The potential medical importance of bilharzia in northern Nigeria: a suggested rapid, cheap and effective solution for control of Schistosoma haematobium infection. Ann Trop Med Parasitol. 1980 Dec;74(6):597–613. [PubMed] [Google Scholar]
  34. Rainey B. P., Moxon E. R. Microbiology. When being hyper keeps you fit. Science. 2000 May 19;288(5469):1186–1187. doi: 10.1126/science.288.5469.1186. [DOI] [PubMed] [Google Scholar]
  35. Renganathan E., Cioli D. An international initiative on praziquantel use. Parasitol Today. 1998 Oct;14(10):390–391. doi: 10.1016/s0169-4758(98)01310-6. [DOI] [PubMed] [Google Scholar]
  36. Schelling U., Frank W., Will R., Romig T., Lucius R. Chemotherapy with praziquantel has the potential to reduce the prevalence of Echinococcus multilocularis in wild foxes (Vulpes vulpes). Ann Trop Med Parasitol. 1997 Mar;91(2):179–186. doi: 10.1080/00034983.1997.11813128. [DOI] [PubMed] [Google Scholar]
  37. Shaw D. J., Vercruysse J., Picquet M., Sambou B., Ly A. The effect of different treatment regimens on the epidemiology of seasonally transmitted Schistosoma haematobium infections in four villages in the Senegal River Basin, Senegal. Trans R Soc Trop Med Hyg. 1999 Mar-Apr;93(2):142–150. doi: 10.1016/s0035-9203(99)90288-2. [DOI] [PubMed] [Google Scholar]
  38. Stelma F. F., Sall S., Daff B., Sow S., Niang M., Gryseels B. Oxamniquine cures Schistosoma mansoni infection in a focus in which cure rates with praziquantel are unusually low. J Infect Dis. 1997 Jul;176(1):304–307. doi: 10.1086/517273. [DOI] [PubMed] [Google Scholar]
  39. Stelma F. F., Talla I., Sow S., Kongs A., Niang M., Polman K., Deelder A. M., Gryseels B. Efficacy and side effects of praziquantel in an epidemic focus of Schistosoma mansoni. Am J Trop Med Hyg. 1995 Aug;53(2):167–170. doi: 10.4269/ajtmh.1995.53.167. [DOI] [PubMed] [Google Scholar]
  40. Stephenson L. S., Latham M. C., Kinoti S. N., Oduori M. L. Sensitivity and specificity of reagent strips in screening of Kenyan children for Schistosoma haematobium infection. Am J Trop Med Hyg. 1984 Sep;33(5):862–871. doi: 10.4269/ajtmh.1984.33.862. [DOI] [PubMed] [Google Scholar]
  41. Stephenson L. S., Latham M. C., Kurz K. M., Kinoti S. N. Single dose metrifonate or praziquantel treatment in Kenyan children. II. Effects on growth in relation to Schistosoma haematobium and hookworm egg counts. Am J Trop Med Hyg. 1989 Oct;41(4):445–453. doi: 10.4269/ajtmh.1989.41.445. [DOI] [PubMed] [Google Scholar]
  42. Sturrock R. F., Kinyanjui H., Thíongo F. W., Tosha S., Ouma J. H., King C. H., Koech D., Siongok T. K., Mahmoud A. A. Chemotherapy-based control of schistosomiasis haematobia. 3. Snail studies monitoring the effect of chemotherapy on transmission in the Msambweni area, Kenya. Trans R Soc Trop Med Hyg. 1990 Mar-Apr;84(2):257–261. doi: 10.1016/0035-9203(90)90278-m. [DOI] [PubMed] [Google Scholar]
  43. Taylor P., Murare H. M., Manomano K. Efficacy of low doses of praziquantel for Schistosoma mansoni and S. haematobium. J Trop Med Hyg. 1988 Feb;91(1):13–17. [PubMed] [Google Scholar]
  44. Wilkins H. A., Blumenthal U. J., Hagan P., Hayes R. J., Tulloch S. Resistance to reinfection after treatment of urinary schistosomiasis. Trans R Soc Trop Med Hyg. 1987;81(1):29–35. doi: 10.1016/0035-9203(87)90273-2. [DOI] [PubMed] [Google Scholar]
  45. el Malatawy A., el Habashy A., Lechine N., Dixon H., Davis A., Mott K. E. Selective population chemotherapy among schoolchildren in Beheira governorate: the UNICEF/Arab Republic of Egypt/WHO Schistosomiasis Control Project. Bull World Health Organ. 1992;70(1):47–56. [PMC free article] [PubMed] [Google Scholar]

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