Re-infection rates and the therapeutic efficacy of Praziquantel against schistosoma mansoni among Selected primary school children in jimma town, Southwest ethiopia

Abstract

Background: Schistosomiasis is among neglected tropical parasitic diseases thatresult in major public health problem in the majority of developing tropical and sub-tropical countries including Ethiopia.Praziquantel (PZQ) is a first line drug of choice for the treatment of schistosomiasis even if low cure rate has been reported in different corner of the world. The re-infection rate of the parasite is common in areas where there is a water source containing infective larval forms (cercariae) of the parasite released by infected freshwater snails. Therefore, assessing the re-infection rate and determining the efficacy of PZQ in the study area is very crucial. Objective: To assess the re-infection rate and therapeutic efficacy Praziquantel against S. mansoni infection among selected primary school children in Jimma Town. Method: A school-based follow-up study was conducted from June 2021 to February 2022 among selected schools, Hamile 19, Seto Yido, Tuluma keneni, Abdi Gudina and Jimma primary schools in Jimma town, Southwest Ethiopia. Stool specimens were examined using single Kato-Katz thick smear method. School children who were tested positive for Schistosoma mansoni were involved in the drug efficacy and re-infection rate of the parasites and treated with 40 mg/kg of PZQ (BERMOXEL ®) . Cure and egg reduction rates were evaluated three weeks after treatment. The re-infection rate of those who were cured was evaluated after six months’ post treatment period. Data was analyzed using Statistical Package for Social Science (SPSS) version 25. Bivariate and Multivariable analysis was done and variable with a p-value ≤ 0.05 was considered as statistically significant. Results: A total of 521school children participated in the study. At baseline, the overall prevalence of S. mansoni infection was 117(22.5%). Among positive for the infection, 92 were assessed for praziquantel efficacy study and three weeks of post treatment with 40mg/kg of praziquantel the children were re-examined. The egg reduction rate and cure rate of praziquantel among the study participant were 99.3% and 97.8% respectively(ERR=99.3 & CR=97.8) After six months of praziquantel treatment, 79 school children were traced for stool examination and 6.33% were re-infected by S. mansoni. The odds 0f S .mansoni infection was significant among males (AOR= 3.3; 95% CI= 2.0-5.3, P<0.01) and study participant who had the habit of crossing water bodies with barefoot (AOR=2.3; 95%CI=1.5-5; p<0.01) Conclusion and Recommendation: The infection of S. mansoni is moderate relative to the WHO guideline and Re-infection rate of S. mansoni was low among five primary schools of Jimma town. Efficacy of praziquantel was satisfactory against S. mansoni. Being male & crossing River on bare foot were significantly associated with S.mansoni infection. Scheduled health education should be given to reduce the prevalence and transmission