Reversibility of lower reproductive tract abnormalities in women with Schistosoma haematobium infection after treatment with praziquantel — An interim report

Little is known whether and to what extent antiparasitic treatment cures female genital schistosomiasis (FGS). Using a standard protocol, of twenty-one women with FGS nine were re-examined at two to nine weeks after they had been treated with praziquantel at a single dose of 40 mg/kg. Symptoms relat...

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Published in:	Acta tropica Vol. 62; no. 4; pp. 289 - 301
Main Authors:	Richter, Joachim, Poggensee, Gabriele, Kjetland, Eyrun Floerecke, Helling-Giese, Gertrud, Chitsulo, Lester, Kumwenda, Newton, Gundersen, Svein Gunnar, Deelder, AndréMartien, Reimert, Claus Michael, Haas, Helmut, Krantz, Ingela, Feldmeier, Hermann
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 30-12-1996
Subjects:	Adolescent Adult Animals Antibodies, Helminth - analysis Antigens, Helminth - analysis Antiplatyhelmintic Agents - therapeutic use Biopterins - analogs & derivatives Biopterins - analysis Blood Proteins - analysis Eosinophil Granule Proteins Female Female genital schistosomiasis Follow-Up Studies Genital Diseases, Female - diagnosis Genital Diseases, Female - pathology Genital Diseases, Female - urine Genitalia, Female - pathology Humans Immunoglobulin A - analysis Immunoglobulin E - analysis Immunoglobulin G - analysis Leukoplakia - drug therapy Middle Aged Neopterin Ovum - parasitology Papilloma - pathology Papillomaviridae Papillomavirus Infections - complications Praziquantel - therapeutic use Praziquantel treatment Reversibility of lesions Ribonucleases Schistosoma haematobium Schistosoma haematobium - growth & development Schistosoma haematobium - isolation & purification Schistosomiasis - drug therapy Schistosomiasis - pathology Schistosomiasis - urine Schistosomiasis haematobia - drug therapy Schistosomiasis haematobia - pathology Schistosomiasis haematobia - urine Tumor Virus Infections - complications Urinary Tract - pathology Female genital schistosomiasis Schistosoma haematobium Praziquantel treatment Reversibility of lesions
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Summary:	Little is known whether and to what extent antiparasitic treatment cures female genital schistosomiasis (FGS). Using a standard protocol, of twenty-one women with FGS nine were re-examined at two to nine weeks after they had been treated with praziquantel at a single dose of 40 mg/kg. Symptoms related to pathology of the urinary tract and to a lesser extent of genital pathology subsided in most patients. Schistosoma haematobium ova were no longer detectable in urine of any of the patients post-treatment. Efficiency of chemotherapy against adult worms was confirmed by the disappearance of circulating anodic antigen (CAA) in serum. Sandy patches showed resolution in two of four cases after chemotherapy. Papillomata due to schistosomiasis alone improved, but persisted in mixed infection with human papilloma virus (HPV) or when HPV was the only underlying cause. In one patient ulcera could not be related with certainty to schistosomiasis at admission, but resolved after treatment with praziquantel. Leukoplakia (two cases) was not influenced by chemotherapy, or even increased during follow-up, regardless of whether ova had been detected or not. Although the follow-up period was rather short, time intervals were not standardized, and a relatively small number of patients was investigated, it could be shown that genital pathology due to sequestered S. haematobium ova is, at least partially, reversible already two to nine weeks after killing the adult worms by praziquantel. This is paralleled by a normalization of inflammatory immune responses detectable in histological sections and vaginal lavage.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0001-706X 1873-6254
DOI:	10.1016/S0001-706X(96)00030-7