September 25, 2016
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Schistosomiasis (cont.)

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What is the treatment for schistosomiasis?

Currently, the drug used in most people is praziquantel (Biltricide); however, it only is effective against adult worms and does not affect eggs or immature worms. Treatment with this drug is simple and its dose is based on the patient's weight with two doses given on one day. However, the drug causes rapid disintegration of the worm which, in turn, allows the human immune system to attack the parasite. This immune response can cause localized reactions, which may increase the patient's symptoms. Corticosteroids are often used to reduce the symptoms of this reaction. Unfortunately, this response limits the use of praziquantel. Praziquantel and oxaminquine or artemether are used by some clinicians early in infections, or to treat individuals infected with both malaria and schistosomes, respectively.

Ocular schistosomiasis should not be treated with this praziquantel. Other organs with heavy parasite infections may not function well and require supportive care until the hyperimmune response abates after drug administration. Other drugs (oxamniquine, metrifonate, artemisinins, and trioxolanes) have been used in some patients but have limited effectiveness. New drugs are in development.

Surgical care may include removal of tumor masses, ligation of esophageal varices, shunt surgeries, and granuloma removal.

When should people with schistosomiasis seek medical care?

People associated with freshwater sources in areas where Schistosoma spp. are endemic should seek medical care if they develop symptoms of acute schistosomiasis (see above, especially for abdominal pain, blood in stools or urine, and fever). Those with diagnosed chronic schistosomiasis should seek medical care if their chronic symptoms increase (especially abdominal pain, shortness of breath, bloody diarrhea or bloody urine, seizures, or mental-status changes). Anyone with undiagnosed schistosomiasis who develops symptoms listed above should seek medical care and inform the caregivers that they have been exposed to freshwater sources in areas where the disease is endemic either as residents of the areas or as a tourist.

Medically Reviewed by a Doctor on 11/23/2015


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