Table 2.
Characteristics of included studies about efficacy of treatment for schistosomiasis and strongyloidiasis, 1993–2016.
| Study | Quality | Design | Population | Intervention/Outcomes | Results |
|---|---|---|---|---|---|
| Treatment efficacy of anti-Schistosoma drugs | |||||
| Kramer et al., 2014 [48] | AMSTAR: 11/11 Data in study: GRADE: high-quality evidence |
Systematic review, fixed effects meta-analysis; Embase, MEDLINE (1966 to 2014), LILACS, Cochrane library, Cochrane infectious disease (1980–2014) |
School-aged and young adults: 6–20 years (16 trials); 2–23 years (5 trials); Adults (2 trials). Participants setting: Rural areas in 15 sub-Saharan African countries; an urban setting in Saudi Arabia |
Interventions: drugs used to treat urinary schistosomiasis: praziquantel, metrifonate, artesunate and/or in combination Outcome: parasitological cure or failure at 4 weeks; % egg reduction rate at 4 weeks |
Praziquantel (single dose 40 mg/kg), egg reduction (60%) in urine achieved in 4–8 weeks (38 per 100 (95% CI: 26–54). Treatment failure: RR 0.42, (95% CI: 0.29–0.59), 864 participants, 7 trials Metrifonate (single dose 10 mg/kg) reduced egg excretion only marginally in comparison to placebo (RR 0.63, 95% CI: 0.54 to 0.73) 210 participants, 1 trial, at 8 months |
| Danso-Appiah et al., 2013 [47] | AMSTAR: 11/11 Data in study: GRADE: low- to moderate-quality evidence |
Systematic review and meta-narrative of RCTs, RTCs of anti-Schistosoma drugs | Trials conducted in Africa (n = 36), South America (n = 15; all in Brazil) and the Middle East (n = 1). 52 trials enrolling 10,269 participants in endemic areas |
Intervention: praziquantel 40 mg/kg, oxamniquine 40 mg/kg |
Praziquantel (single dose 40 mg/kg) vs. placebo: reduced parasitological treatment failure at 1 month (69/100; RR = 3.13, 2 trials, 414 participants). Praziquantel (single dose 30 mg/kg): RR = 1.52, 3 trials, 521 participants. Higher doses: no significant difference. Oxamniquine (single dose 40 mg/kg) vs. Placebo: reduced parasitological treatment failure at 3 months in 2 trials (68/100; RR = 8.74). |
| Pérez del Villar et al., 2012 [49] | AMSTAR: 11/11 Data in study: not reported. GRADE: Moderate-quality evidence |
Quantitative systematic review and meta-analysis | Healthy villagers who live in areas in Africa endemic for Sc. haematobium and Sc. mansoni and in China for Sc. Japonicum | Intervention: prophylactic effect of artesunate or artemether vs. placebo against Sc. haematobium, Sc. mansoni and Sc. japonica infections. Outcomes: parasitological cure rate at 3–8 weeks; infection rate at 3–4 weeks after treatment. |
Artesunate treatment (single dose: significantly lower cure rates than with praziquantel. Combined therapy of artesunate plus sulfadoxine-pyrimethamine: significantly less effective than praziquantel treatment Combination of artemisinin derivatives and praziquantel: higher cure rate than praziquantel monotherapy Artesunate or artemether: significantly better than a placebo. |
| Treatment efficacy of drugs for strongyloidiasis | |||||
| Henriquez-Camacho et al., 2016 [52] | AMSTAR: 11/11 GRADE: Moderate-quality evidence |
Systematic review of RCTs, controlled or uncontrolled interventional studies. | Individuals with chronic infections of St. stercoralis; Immuno-competent patients. All ages |
Intervention: ivermectin (single/double dose) vs. albendazole or thiabendazole. Outcome: elimination of infection; parasitological cure (>2 negative stool samples, 5 weeks). |
Ivermectin (single/double dose) vs. albendazole: parasitological cure was higher with ivermectin, 84/100 vs. 48/100 ivermectin (RR = 1.79). Ivermectin vs. thiabendazole: little or no difference in parasitological cure, 74/100 vs. 68/100), but adverse events were less common with ivermectin (RR = 0.31) than albendazole. No serious adverse events or death reported |
AMSTAR: a tool for assessing the methodological quality of systematic reviews; GRADE: Grading of Recommendations, Assessment, Development and Evaluation; LILACS: Latin American Literature in Health Sciences; RCT: randomized clinical trial; RR: Relative Risk.