TY - JOUR
T1 - Reversibility of lower reproductive tract abnormalities in women with Schistosoma haematobium infection after treatment with praziquantel - An interim report
AU - Richter, Joachim
AU - Poggensee, Gabriele
AU - Kjetland, Eyrun Floerecke
AU - Helling-Giese, Gertrud
AU - Chitsulo, Lester
AU - Kumwenda, Newton
AU - Gundersen, Svein Gunnar
AU - Deelder, André Martien
AU - Reimert, Claus Michael
AU - Haas, Helmut
AU - Krantz, Ingela
AU - Feldmeier, Hermann
N1 - Funding Information:
The study was supported by grants of the Schistosomiasis and other Trematodes Infections Unit of the WHO, of the Director's Initiative Fund of the UNDP/WB/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and of the Danish Research Council. It was also supported by the Kongregation der Franziskanerinnen, Salzkotten, Germany, and from the Research Forum and the Department of Infectious Diseases, Ullevaal Hospital, and Norwegian Lions International. The authors whish to thank to Dr. K.E. Mott and Dr. N.R. Bergquist for encouraging the study, without their active support this study would not have been feasible. We are indebted to Dr. V. van Oosterzee and Dr. E.F. van de Velde of Mangochi Hospital, Ms. C. MacDonald, Guelph Nutrition Project, to Ms. R. Maziyaya, Mrs. Ph. Nyalugwe, Mr. D.N. Kalua, Mrs. T. Cullinan and Professor W. Cullinan. Leisegang Feinmechanik-Optik GmbH & Co. provided an excellent photocolposcope.
PY - 1996/12/30
Y1 - 1996/12/30
N2 - 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.
AB - 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.
KW - Schistosoma haematobium
KW - female genital schistosomiasis
KW - praziquantel treatment
KW - reversibility of lesions
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U2 - 10.1016/S0001-706X(96)00030-7
DO - 10.1016/S0001-706X(96)00030-7
M3 - Article
C2 - 9028413
AN - SCOPUS:0030607736
SN - 0001-706X
VL - 62
SP - 289
EP - 301
JO - Acta Tropica
JF - Acta Tropica
IS - 4
ER -