国外吡喹酮防治血吸虫病的进展

吡喹酮是一种对人体5种主要血吸虫病(曼氏、埃及、湄公、间插与日本血吸虫病)都非常有效的药物。全球已对1亿多例血吸虫感染者及有疫水接触史的可能感染者用吡喹酮进行了治疗,积累了极为丰富的经验。该文概述自吡喹酮问世以来国外用吡喹酮治疗几种血吸虫病的效果、副反应及吡喹酮在几个主要流行国家(埃及、巴西、老挝、印度尼西亚、菲律宾)防治规划中的应用。

Progress of praziquantel in the treatment of schistosomiasis in foreign countries: a review

Since late 1970s, praziquantel has been well developed in the treatment of schistosome infections both at home and abroad. In this paper, the author presents a comprehensive review on praziquantel for the treatment of schistosomiasis in foreign countries. Praziquantel has been used for treatment of five major schistosome infections: i.e., Schistosoma haematobium, S. mansoni, S. intercalatum, S. mekongi and S. japonicum with good effect. The dose-schedules used in different schistosome infections were similar,mainly,40mg/kg body weight, single dose, or 60 mg/kg divided into two doses given in one day. The side effects owing to treatment of the chemical were also similar and were presented. Up till now, the drug has been used in more than 100 million people for treatment of schistosome infection and mass chemotherapy in highly endemic population without preliminary screening. No single death has been identified during and shortly after the treatment among very large population. As a whole, it is the drug of choice in the treatment of major schistosome infections with mild side effects, excellent therapeutic efficacy and easiness for administration. It is also effective to late stage schistosomiasis with hepatic fibrosis induced by S. mansoni infection or obstructive uropathy induced by S. haematobium. The drug is a very useful weapon for morbidity control and has sped up the control work. Praziquantel is not only used for individual treatment, but also used for mass treatment to reduce the prevalence and morbidity in whole population in heavily endemic areas. The strategy of chemotherapy is slight different used in the control programme in different endemic countries, i.e., Egypt, Brazil, Indonesia, Laos, etc., and is also reviewed herein. WHO morbidity control strategy using praziquantel for schistosomiasis in the endemic community is also introduced.