Oral artemether for prevention of Schistosoma mansoni infection: randomised controlled trial

This randomized, double-blind placebo-controlled trial examined the efficacy of oral artemether for the prevention of Schistosoma mansoni infection among 354 children from Cote d'Ivoire. Stool specimens were screened over 4 consecutive days, followed by two mass treatments with praziquantel 4 weeks apart. All S. mansoni negative children were randomly assigned to placebo (n = 151) or artemether (n = 138). An assessment after 24 hours and examination of blood samples after the 3rd week of initial administration was conducted. Findings revealed that administration of oral artemether showed no adverse reaction, with an observation of a relatively lower incidence of S. mansoni infection (31/128 vs. 68/140; relative risk, 0.50; 95% confidence interval, 0.35-0.71; p = 0.00006). In addition, the geometric mean egg output among positive children in the artemether group was significantly lower in placebo treatment (19 vs. 32 eggs/g stool; p = 0.017). Furthermore, there was a significant reduction in the prevalence of Plasmodium falciparum. The study confirmed the safety and prophylactic effect of oral artemether against S. mansoni, and recommends its use as an additional tool for a more effective schistosomiasis control measure.