Poor patient compliance reduces the efficacy of metrifonate treatment ofSchistosoma haematobium in Somalia
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The degree of compliance during metrifonate therapy ofSchistosoma haematobium infection has been evaluated together with its impact on drug efficacy in two rural villages in Somalia. Drug treatment was offered to all subjects withS. haematobium infection. 243 subjects were screened for the presence of eggs in the urine using a sensitive Nucleopore filtration method and 211 were positive. All infected patients were put on a treatment schedule of 3 doses of metrifonate 7.5 mg/kg at fortnightly intervals. Drug efficacy was evaluated 6, 12 and 32 weeks after treatment.
Only 48% of the patients took all 3 doses, 15% took 2 doses and 37% only took 1 dose. The cure rate was maximal in Week 6 at 60, 44 and 30% in those who took 3, 2 and 1 dose, respectively. Corresponding egg reduction rates were 98, 90 and 84%, respectively. Drug efficacy throughout the follow up period was much greater in patients who complied with all 3 doses.
It is unlikely that the goal of mass treatment programmes for endemic S. haematobium in villages in Africa will be realized due to poor compliance with the current dosage schedule for metrifonate of 3 doses of 7.5 mg/kg at fortnightly intervals.
Key wordsmetrifonate Schistosoma haematobium compliance cure rate egg reduction rate filtration
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- 1.Sackett DL, Hynes B (1976) Compliance with therapeutic regimens. Johns Hopkins University Press, BaltimoreGoogle Scholar
- 2.Gustafsson LL, Beermann B, Aden Abdi Y (eds) (1987) Handbook of drugs for tropical parasitic infections. Taylor and Francis, LondonGoogle Scholar
- 4.Jordan P, Webbe G (eds) (1982) Schistosomiasis: Epidemiology, treatment and control. Heinemann Medical, LondonGoogle Scholar
- 5.World Health Organization (1984) Epidemiological surveillance of communicable diseases in Somali Democratic Republic. National morbidity survey, 1980/1982. EM/EPID/78, EM/CD/31, WHO, GenevaGoogle Scholar
- 8.Daniel WW (1978) Applied nonparametric statistics. Houghton Mifflin, BostonGoogle Scholar
- 11.Matola YG, Malle LN (1985) Factors affecting the compliance of malaria chemosuppression with chloroquine at some maternal and child health clinics in Tanga Region Tanzania. East Afr Med J oct.; 62 (10): 721–725Google Scholar
- 15.Uptham S (1982) Assignment report: WHO assisted Schistosomiasis control project, World Health Organization and Ministry of Health, Mogadisho, Somali Democratic Republic July 22–August 21, 3–5Google Scholar
- 18.Plestina R, Davis A, Bailey DR (1972) Effect of metrifonate on blood cholinesterases in children during the treatment of schistosomiasis. Bull WHO 46: 747–759Google Scholar