Suivi échographique prolongé d'enfants infestés par Schistosoma haematobium après traitement par praziquantel

Abstract

During a Schistosoma haematobium morbidity control program in Niger, we conducted a survey to describe the resolution of lesions after treatment with praziquantel, to determine reinfection rates and to define retreatment schedules. 114 schoolchildren (7-15 years old) living in an hyperendemic village underwent 10 successive examinations over 34 months following an initial evaluation and the administration of 40 mg/kg of praziquantel. All children, whether apparently infected with S. haematobium or not, were treated. Egg output, microhaematuria, visual aspect of urine and abnormalities of the urinary tract by ultrasound were assessed. The initial prevalence of infection was 74.5%. Reinfection began 5 months after treatment and the final prevalence was 47.1%. Bladder abnormalities decreased rapidly, but incompletely, probably due to reinfestation (initial prevalence: 89.5%). Their prevalence increased 8 months after treatment to 72.4% at month 34. Dilatations of the upper urinary tract regressed more slowly but constantly until the end of the study (initial prevalence: 43%; 4.6% at month 34). Three years after treatment, despite reinfection, the general morbidity level (prevalence and severity of lesions) was lower than at baseline in our cohort, which would suggest the advantage of a long interval between mass treatments in the epidemiological context of our survey.