世界卫生组织呼吁血吸虫病流行国家定期监测吡喹酮(PZQ)药物的疗效,在坦桑尼亚使用了四十年的唯一的抗血吸虫药物。为了响应这个号召,本研究调查了单剂量PZQ在高传播季节对血吸虫的疗效,并进一步评估,治疗前后尿试纸的敏感性和特异性。该研究共招募了2,498名年龄(4-17岁)的儿童,他们提供了一次尿液样本,并进行了肉眼检查,然后使用尿液试纸和尿液过滤技术进行微血尿和血吸虫卵的存在。基于尿液滤过试验的血杆菌卵阳性的基线患病率为29.2%(95CI:27.5-31.0),微血尿的基线患病率为43.1%(95CI:41.1-45.0)。在受感染的参与者中,40.9%(95CI:37.4-44.6)的感染强度很大,感染的几何平均强度(GMI)为33.7个鸡蛋/10毫升尿液。单剂量PZQ将感染率降低到16.2%,感染的GMI为18.8卵/10毫升尿液,微血尿的GMI为27.9%。治愈率和减蛋率(ERR)分别为83.8%和44.3%。在基线,尿试条的敏感性和特异性分别为59.7%和93.8%,而在治疗后,它们分别为16.7%和93.6%。当PZQ药物在高传播季节服用时,其在ERR方面的疗效较差。在PZQ治疗前后,尿液试剂条的敏感性低,但特异性高。
The World Health Organization calls for schistosomiasis endemic countries to regularly monitor the efficacy of Praziquantel (PZQ) drug, the only antischistosomal drug used for four decades in Tanzania. In response to that call, the current study investigated the efficacy of single dose of PZQ against Schistosoma haematobium during the high transmission season and further assessed, the sensitivity and specificity of urine reagent strips before and after treatment. The study recruited a total of 2,498 -children aged (4 -17 years old) who provided a single urine sample that was visually examined for macro-haematuria, then using urine dipstick and urine filtration technique for microhaematuria and the presence of S. haematobium eggs. The baseline prevalence of S. haematobium eggs positive based on urine filtration test was 29.2 % (95 %CI:27.5-31.0) and that of microhaematuria was 43.1 % (95 %CI:41.1-45.0). Of the infected participants, 40.9 % (95 %CI:37.4-44.6) had a heavy intensity of infection and the geometrical mean intensity (GMI) of infection was 33.7 eggs/10mls of urine. A single dose of PZQ reduced the prevalence of infection to 16.2 %, the GMI of infection to 18.8eggs/10mls of urine and that of microhaematuria to 27.9 %. Cure rate and egg reduction rates (ERR) were 83.8 % and 44.3 % respectively. At baseline, the sensitivity and specificity of the urine reagent strips were 59.7 % and 93.8 %, whereas at post-treatment they were 16.7 % and 93.6 %. When PZQ drug is administered during the high transmission season, its efficacy in term of ERR is poor. The urine reagent strips had low sensitivity but high specificity at pre-and-post PZQ treatment.