Interventions for treating schistosomiasis mansoni

Saconato H, Atallah ÁN

Published Online:

January 21, 2009

Schistosoma mansoni is a parasite that infects the intestine, liver and spleen and can be fatal. People become infected when they come in contact with contaminated water. The review found that the drugs oxamniquine and praziquantel are both effective for curing the infection. Evidence from one trial shows that zinc supplements do not help to prevent re-infection. A small number of patients given oxamniquine have suffered seizures which could mean that this drug is less safe.

Abstract (click to read)

Background:

Schistosoma mansoni is a parasite carried by freshwater snails. S. mansoni infects the intestine, liver and spleen and can be fatal.

Objectives:

To assess the effects of oxamniquine and praziquantel for treating S. mansoni infection.

Search strategy:

We searched the Cochrane Infectious Diseases Group specialized trials register (September 2005), CENTRAL (The Cochrane Library Issue 3, 2005), MEDLINE (1966 to September 2005), EMBASE (1980 to September 2005), LILACS (September 2005), and reference lists of articles. The Revista da Sociedade Brasileira de Medicina Tropical and Brazilian Tropical Medicine Congress abstracts were hand searched

Selection criteria:

Randomised and quasi-randomised trials comparing oxamniquine and/or praziquantel with placebo for the treatment of S. mansoni.

Data collection and analysis:

Two reviewers independently assessed trial quality and extracted data.

Main results:

Thirteen trials met the inclusion criteria. Oxamniquine and praziquantel are effective in curing S. mansoni infection when compared to placebo. In Africa, 15 mg/kg oxamniquine is less effective than 40 mg/kg praziquantel in people older than 14 years (OR 0.23, 95% CI 0.09 to 0.60), but no difference was shown using 30 mg/kg oxamniquine (OR 2.88, 95% CI 0.69 to 11.96). In Brazil, 15 to 19 mg/kg oxamniquine is as effective as 50 to 70 mg/kg praziquantel in people older than 14 years (OR 0.61, 95% CI 0.26 to 1.46). Both drugs appear safe. No difference in reinfection rate between zinc supplementation and placebo has been shown.

Authors' conclusions:

Oxamniquine and praziquantel both appear to be effective for treatment of S. mansoni, although lower doses of oxamniquine (less than 30 mg/kg) may not be as effective in some areas.

This record should be cited as:

Saconato H, Atallah ÁN. Interventions for treating schistosomiasis mansoni. Cochrane Database of Systematic Reviews 1999, Issue 3. Art. No.: CD000528. DOI: 10.1002/14651858.CD000528

Assessed as up to date:

September 7, 2005

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Infectious Diseases Group

PEARLS - Practical Evidence About Real Life Situations (click to read)

Clinical question:

How effective is Chinese herbal medicine (CHM) for primary dysmenorrhoea (PD)?

Bottom line:

Compared to placebo, no treatment, conventional medicine such as non-steroidal antiinflammatory drugs (NSAIDs) and the oral contraceptive (OC), acupuncture and heat compression, CHM reduced menstrual pain in the treatment of PD. It also improved overall symptoms and reduced the use of additional medication.

Caveat:

These findings should be interpreted with caution due to the generally low methodological quality of the studies. There was no accurate description of the herbal preparations. The practice of Chinese medicine uses clusters of related symptoms to determine appropriate treatment and there are five or six different patterns of Chinese diagnostics which may correspond to the Western concept of PD.

Context:

Dysmenorrhoea is a common complaint. NSAIDS and the OC have been used successfully but more women are looking for non-drug therapies. CHM has been used for centuries in China, and is commonly used in public hospitals in China for the treatment of PD.

Cochrane Systematic Review:

Zhu X et al. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Review 2007, Issue 4. Art No : CD005288.DOI : 10.1002/14651858. CD0005288.pub 2. The review contains 39 trials involving 3,475 participants, 36 of the trials were conducted in mainland China, one in Taiwan, one in Japan and one in The Netherlands.

Authored by:

Brian R McAvoy

Cochrane Primary Health Care Field

Health topics:

Infectious disease > Neglected tropical diseases > Schistosomiasis

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Interventions for treating schistosomiasis mansoni

More like this

Copyright © 2011 - The Cochrane Collaboration