Comparative Assessment of Health Benefits of Praziquantel Treatment of Urogenital Schistosomiasis in Preschool and Primary School-Aged Children

Schistosomiasis is a major public health problem in Africa. However, it is only recently that the burden of schistosomiasis has become recognised as a significant component impacting on the health, wellbeing and development of infants and preschool children (aged ≤5 years). A longitudinal study was conducted in Zimbabwean children to determine the effect of single praziquantel treatment on Schistosoma haematobium-related morbidity markers: microhaematuria, proteinuria, and albuminuria. Changes in these indicators were compared in 1–5 years versus 6–10 years old to determine if treatment outcomes differed by age-group. Praziquantel was efficacious at reducing infection 12 weeks post-treatment: cure rate=94.6%; (95% CI: 87.9–97.7%). Infection rates remained lower 12 months post-treatment compared to baseline in both age-groups. Among children who received praziquantel, the odds of presenting with two markers of morbidity 12 weeks post-treatment were significantly lower compared to baseline; proteinuria: odds ratio, OR=0.54; (95% CI: 0.31–0.95), and albuminuria: OR=0.05; (95% CI: 0.02–0.14). Levels of microhaematuria significantly reduced 12 months post-treatment, and the effect of praziquantel did not differ between the two age-groups: OR=0.97; (95% CI: 0.50–1.87). Praziquantel treatment has health benefits in preschool-aged children exposed to S. haematobium and the efficacy of praziquantel on infection and morbidity is not age-dependent.