Schistosomiasis: Health Significance Of Its Diagnosis, Treatment And Prophylaxis
How To Diagnose And Treat Schistosomiasis
Diagnosis And treatment Of Schistosomiasis
Schistosomiasis is diagnosed by demonstrating the eggs in appropriate specimens or in tissue biopsy. Investigation for S. hematobium includes plain x-ray of abdomen for bladder clacification, excretory urograms and cystoscopy with biopsy, especially when there are no eggs or miracidia in urine. Rectal biopsy, sigmoidoscopy, barium enema and colonoscopy with biopsy are necessary to diagnose S. mansoni and S. japonicum. Serological tests are available for diagnosis.
Treatment: It should be the aim to start treatment early since at this stage, lesions are reversible. Schistosoma hematobium is most susceptible and S. japonicum is more resistant to drug therapy.
Niridazole: This is a nitrothiazole derivative useful in urinary and intestinal schistosomiasis. Recommended dose is 15 to 25 mg/Kg/daily in two or three divided doses orally for 6 to 7 days. Side effects include neuropsychiatric manifestations including convulsions in patients with CNS disease, persistent vomiting and sometimes marked abdominal pain.
Oxamniquine: This is a quinolone derivative specific for S. mansoni infection. It is given orally in a dose of 20 to 30 mg/Kg/day for 3 days. Fever and eosinophilia may develop 2 to 3 days after completing treatment.
Metriphonate: This is an organophosphorous compound specific for only S. hematobium. It is given orally in a dose of 10 mg/Kg every 2 weeks for a total of 3 doses.
Praziquantel: This is given as a single oral dose of 30 to 45 mg/Kg and the drug is effective in all types of infections. Cure rates of 72 to 95% have been reported and aide effects are few, spasmodic abdominal pain being the most common. Being very effective and easy to administer, this drug is gaining importance to eradicate infection from endemic areas.
Hycanthone: This is a thioxanthone preparation that is administered as a single intramuscular injection. The dose is 1.5 to 3 mg/Kg up to a maximum adult dose of 200 mg. This drug is indicated for treatment of S. hematobium and S. mansoni. Liver function tests are done usually before giving the injection.
In resistant cases, the time honoued drug, sodium antimonyl tartarate, may be required. It is given as a 0.5% intravenous solution starting with 30 mg and increasing the doses to a total of 2g over a period of 3 to 6 weeks.
Proper Environmental Sanitation In Developing Regions
Prophylaxis Of Schistosomiasis
Preventive measures should aim at:
- Proper environmental sanitation and health education
- Mass therapy with oral drugs to reduce the worm load
- Destruction of snails by proper control of water and use of molluscides and
- Avoidance of infection by wearing protective clothing
© 2014 Funom Theophilus Makama