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

Joachim Richter, Gabriele Poggensee, Eyrun Floerecke Kjetland, Gertrud Helling-Giese, Lester Chitsulo, Newton Kumwenda, Svein Gunnar Gundersen, André Martien Deelder, Claus Michael Reimert, Helmut Haas, Ingela Krantz, Hermann Feldmeier

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)289-301
Number of pages13
JournalActa Tropica
Volume62
Issue number4
DOIs
StatePublished - Dec 30 1996
Externally publishedYes

Fingerprint

Schistosoma haematobium
praziquantel
Praziquantel
schistosomiasis
Schistosomiasis
Papillomaviridae
papilloma
ova
drug therapy
Ovum
female genitalia
Pathology
Infection
Drug Therapy
infection
genitalia
Vaginal Douching
circulating antigens
Leukoplakia
Antiparasitic Agents

Keywords

  • female genital schistosomiasis
  • praziquantel treatment
  • reversibility of lesions
  • Schistosoma haematobium

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

Reversibility of lower reproductive tract abnormalities in women with Schistosoma haematobium infection after treatment with praziquantel - An interim report. / Richter, Joachim; Poggensee, Gabriele; Kjetland, Eyrun Floerecke; Helling-Giese, Gertrud; Chitsulo, Lester; Kumwenda, Newton; Gundersen, Svein Gunnar; Deelder, André Martien; Reimert, Claus Michael; Haas, Helmut; Krantz, Ingela; Feldmeier, Hermann.

In: Acta Tropica, Vol. 62, No. 4, 30.12.1996, p. 289-301.

Research output: Contribution to journalArticle

Richter, J, Poggensee, G, Kjetland, EF, Helling-Giese, G, Chitsulo, L, Kumwenda, N, Gundersen, SG, Deelder, AM, Reimert, CM, Haas, H, Krantz, I & Feldmeier, H 1996, 'Reversibility of lower reproductive tract abnormalities in women with Schistosoma haematobium infection after treatment with praziquantel - An interim report', Acta Tropica, vol. 62, no. 4, pp. 289-301. https://doi.org/10.1016/S0001-706X(96)00030-7
Richter, Joachim ; Poggensee, Gabriele ; Kjetland, Eyrun Floerecke ; Helling-Giese, Gertrud ; Chitsulo, Lester ; Kumwenda, Newton ; Gundersen, Svein Gunnar ; Deelder, André Martien ; Reimert, Claus Michael ; Haas, Helmut ; Krantz, Ingela ; Feldmeier, Hermann. / Reversibility of lower reproductive tract abnormalities in women with Schistosoma haematobium infection after treatment with praziquantel - An interim report. In: Acta Tropica. 1996 ; Vol. 62, No. 4. pp. 289-301.
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abstract = "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.",
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