Summary
We have carried out an open clinical study in Somalia to evaluate the efficacy and safety of a simplified dosage schedule of metrifonate in the treatment of Schistosoma haematobium infection. The doses used were:
-
I.
10 mg · kg−1 once daily for 3 days
-
II.
5 mg · kg−1 thrice daily for one day
-
III.
7.5 mg · kg−1 thrice daily for one day.
We screened a total of 550 subjects in four villages for egg excretion in urine, and selected patients with more than 200 eggs per 10 ml of urine. In the initial phase of the study eight patients were assigned to each of the three dose schedules. In an extended study 38 additional patients were treated with regimen II which gave the best outcome in the initial study.
Dosage Schedules I and III turned out to be toxic, and none of the patients was treated with all three doses. Adverse effects, such as abdominal colic, nausea, salivation, dizziness, and headache, were seen in almost all the patients in those two groups. Two patients from Group I reported that they fainted within 2 h after the second dose. None of the patients in Group II reported adverse effects.
After 4–6 weeks follow-up, egg reduction was 96–100% for Groups I and II and the cure rate was around 60%.
This study has shown that a shorter course of treatment with metrifonate might be equally effective and safer than the recommended dosage schedule with three doses of 7.5–10 mg · kg−1 fortnightly.
Similar content being viewed by others
References
Iarotski LS, Davis A (1981) The Schistosomiasis problem in the world: Results of a WHO questionnaire survey. Bull WHO 59: 115–127
Kloetzel K (1967) A rationale for the treatment of Schistosomiasis monsoni even when re-infection is expected. Trans R Soc Trop Med Hyg 61: 609–610
Uptham S (1982) Assignment report: WHO-assisted schistosomiasis control project. Somali Democratic Republic. July 22–Aug 21
Nordgren L, Bengtsson E, Holmstedt B, Pettersson MB (1981) Levels of metrifonate and dichlorvos in plasma and erythrocytes during treatment of Schistosomiasis with Bilarcil. Acta Pharmacol Toxicol 49 [Suppl 5]: 79–86
Davis A, Baily DR (1969) Metrifonate in urinary schistosomiasis. Bull WHO 41: 209–224
Snellen MW (1981) Therapeutic properties of metrifonate. Acta Pharmacol Toxicol 49 [Suppl 5]: 114–117
Tswana SA, Mason PR (1985) Eighteen-month follow up on the treatment of urinary Schistosomiasis with a single dose of metrifonate. Am J Trop Med Hyg 34: 746–749
Arap Siongok TK, Ouman JH, Houser BH, Warren KS (1978) Quantification of infection with Schistosoma haematobium in relation to epidemiology and selective population chemotherapy. 11. Mass treatment with a single dose of metrifonate. J Infect Dis 138: 856–858
Pugh RN, Teesdale CH (1983) Single dose oral treatment in urinary Schistosomiasis, a double blind trial. Br Med J 286: 429–432
World Health Organization (1984) Epidemiological surveillance of communicable diseases in Somali Democratic Republic. National morbidity survey 1980/1982. EM/EPID/78, EM/CD/31
Koura M, Uptham ES, Awad AH, Ahmed MD (1981) Prevalence ofSchistosoma haematobium in the Koryoole and Merca districts of the Somali Democratic Republic. Ann Trop Med Parasitol 75: 53–61
Peters PA, Warren KS, Mahamoud AAF (1976) Rapid, accurate quantification ofSchistosoma eggs via nucleopore filters. J Parasitol 62: 154–155
Peters PA, Mahamoud AAF, Warren KS, Ouma JH, Arap Siongok TK (1976) Field studies of a rapid, accurate means of quantifyingSchistosoma haematobium eggs in urine samples. Bull WHO 54: 159–162
Daniel WW (1978) Applied nonparametric statistics. Houghton Mifflin, Boston
Jewsbury JM, Cooke MJ, Webber MC (1977) Field trial of metrifonate in the treatment and prevention of schistosomiasis infection in man. Ann Trop Med Parasitol 71: 67–83
Reddy S, Oomen JMV, Bell DR (1975) Metrifonate in urinary schistosomiasis. A field trial in northern Nigeria. Ann Trop Med Parasitol 69: 73–76
Farid Z, Bassily S, Kilpatrick ME, Watten RH, Trabolsi B (1981) Urinary schistosomiasis in Egyptian farmers treated with metrifonate (Bilarcil). Ann Trop Med Parasitol 75: 459–461
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Aden-Abdi, Y., Gustafsson, L.L. & Elmi, S.A. A simplified dosage schedule of metrifonate in the treatment ofSchistosoma haematobium infection in Somalia. Eur J Clin Pharmacol 32, 437–441 (1987). https://doi.org/10.1007/BF00637666
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00637666