article · Bulletin of the National Research Centre/Bulletin of the National Research Center
Co-infection with tuberculosis and schistosomiasis is frequent in sub-Saharan Africa, yet the interaction between treatments is poorly understood. An evaluation of 159 adult patients with tuberculosis co-infected with Schistosoma mansoni assessed the efficacy and safety of a standard single 40 mg/kg dose of praziquantel alongside rifampicin-based tuberculosis therapy. Three weeks following treatment, only 49.0 percent of the 151 assessed patients were cured, and the overall egg reduction rate was 76.4 percent. The cure rate dropped to 13.0 percent among patients with moderate infection intensity. Adverse events occurred in 31.0 percent of participants, primarily manifesting as abdominal pain. High baseline infection intensity and being overweight were linked to cure rates, whilst infection intensity and loose stool consistency correlated with adverse events. These findings reveal reduced treatment efficacy, potentially driven by drug interactions.
Treating parasitic infections alongside tuberculosis is essential in regions where both diseases circulate widely. Demonstrating that standard praziquantel dosing yields poor cure rates in patients taking rifampicin highlights an urgent public health challenge. Understanding these reduced clearance rates allows medical programmes to recognise treatment failures and identify the need for adjusted treatment strategies in co-infected populations.
The abstract does not indicate an application pathway or commercial product, noting that further clinical research with pharmacokinetic tracking and control groups is required.
AI-generated from the published abstract. Always read the original work before citing.
Abstract Background Coinfection with schistosomiasis and tuberculosis (TB) remains common in endemic settings across Sub-Saharan Africa. Despite this coendemicity, studies evaluating the therapeutic efficacy and safety of praziquantel in patients receiving rifampicin-based anti-TB drugs are lacking. We investigated the efficacy and safety of a single 40 mg/kg dose of praziquantel in schistosomiasis–TB coinfected patients undergoing rifampicin-based anti-TB therapy. Methods A prospective efficacy and safety study was conducted among 159 patients with schistosomiasis-TB coinfection treated with single 40 mg/kg dose praziquantel. A pre-tested questionnaire was used to gather both sociodemographic and clinical data. A single stool sample was collected, and duplicate Kato Katz smears prepared for detection of Schistosoma mansoni both at baseline and follow-up. Efficacy of the drug was assessed by both parasitological cure and egg reduction rates (ERR) at 3-week’ post-treatment. Adverse events were assessed within 4 h of drug administration. Results Out of 540 screened TB patients, a total of 159 adult patients with schistosomiasis-TB coinfection were enrolled. Median age was 40 years (Interquartile range (IQR): 35- 46). Out of 151 infected patients who were assessed at follow-up, 74 (49.0%, 95% confidence interval (CI): 40.4, 57.0) were cured (no eggs detected in stool samples at follow-up). The parasitological cure rate was lowest among those with moderate infection intensity 13.0% (three out of 23). The egg reduction rate (ERR) was found to be 76.4%. On multivariable regression analysis, high baseline infection intensity (adjusted prevalence ratio (aPR) = 1.93 95% CI 1.42–2.62; p < 0.001) and being overweight (aPR = 1.77 95% CI 1.09–2.85; p = 0.02) were significant factors associated with cure rate at 3-week’ post-treatment. Of the 155 treated patients who received the drug, 48 (31.0%, 95% CI 23.9–38.1) were observed to present with at least one adverse event, with abdominal pain being the most common (29.7%, 46 out of 155). On multivariable analysis, high baseline infection intensity (aPR = 2.19 95% CI 1.34–3.56; p = 0.002) and changed stool consistency (soft stool aPR = 2.22 95% CI 1.22–4.03; p = 0.009, loose stool aPR = 2.29 95% CI 1.19–4.41; p = 0.01) were significant factors associated with occurrence of adverse events post-treatment. Conclusions This study observed very low parasitological cure and egg reduction rates following single dose of praziquantel treatment in the presence of Rifampicin-based anti-TB regimen. The observed low efficacy may be attributed to the drug-drug interaction. Since the study lacked drug plasma concentration data and comparison group, it only reflects the drug’s effect as observed. Future research with a pharmacokinetic study component and comparison group is needed to gain more evidence on the observed efficacy.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1186/s42269-025-01357-9
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
