Abstract

The aim of the study was to assess the effect of praziquantel (PZQ) treatment on hematuria, proteinuria and the status of eGFR following treatment in school children infected with S. mansoni. A cohort study among 6 - 13 years old children was conducted in the Lake Zone region of Tanzania to assess S. mansoni infection using a circulating cathodic antigen (CCA), Kato Kartz while urine dipstick to screen for urine protein levels and red blood cells. A blood sample was taken for every child to determine creatinine levels and later a status of estimated glomerular filtration rate (eGFR). The prevalence of S. mansoni infection was 64%, 46%, and 24% at baseline, 6 months, and 1 year respectively using CCA test. There was a 62.5% reduction in S. mansoni infection from baseline (p < 0.001). By KK test the reduction at 6-month interval was 18%. The prevalence of eGFR < 90 ml/min/1.73 m2 was zero at six months. There was a 50% reduction in proteinuria and hematuria after 1 year (p < 0.003). Persistent proteinuria was associated with red blood cells in urine (OR = 3.5, 95% CI 1.21 - 10.0, p < 0.020). This study demonstrates that PZQ leads to significant reductions of S. mansoni using CCA test, reductions in proteinuria, and hematuria in school children in Tanzania. There was complete remission in eGFR < 90 ml/min/1.73 m2 from 3.9% to 0% at 6 months. This suggests that praziquantel is effective, but there is still a need for integrated strategies to minimize reinfections.