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Efficacy and safety of arachidonic acid for treatment of school-age children in Schistosoma mansoni high-endemicity regions.

Barakat R, Abou El-Ela NE, Sharaf S, El Sagheer O, Selim S, Tallima H, Bruins MJ, Hadley KB, El Ridi R - Am. J. Trop. Med. Hyg. (2015)

Bottom Line: Arachidonic acid (ARA), an omega-6 fatty acid, is a potent schistosomicide that displayed significant and safe therapeutic effects in Schistosoma mansoni-infected schoolchildren in S. mansoni low-prevalence regions.We here report on ARA efficacy and safety in treatment of schoolchildren in S. mansoni high-endemicity areas of Kafr El Sheikh, Egypt.Combination of PZQ and ARA might be useful for treatment of children with schistosomiasis in high-endemicity regions.

View Article: PubMed Central - PubMed

Affiliation: Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt; Parasitology Department, National Liver Institute, Menoufiya University, Shebin El-Kom, Menoufiya, Egypt; Zoology Department, Faculty of Science, Cairo University, Cairo, Egypt; Research and Development Department, DSM Biotechnology Center, Delft, The Netherlands; Human Evidence Department, DSM North America, Columbia, Maryland.

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Study flow chart. Only 268 of 353 positive children were included in the study based on the availability of ARA capsules shipped from DSM in Columbia, MD to Egypt.
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Figure 1: Study flow chart. Only 268 of 353 positive children were included in the study based on the availability of ARA capsules shipped from DSM in Columbia, MD to Egypt.

Mentions: The study was carried out between October of 2012 and May of 2013, and it was conducted in two phases. Phase I was screening. All of the 2,947 students (1,549 boys [52%] and 1,398 girls [48%]) in grades III–V from nine primary schools in Motoubis area, Kafr El Sheikh Governorate were included in the screening phase. Only 2,312 children (78%) provided stool samples (1,181 boys [51%] and 1,131 girls [49%]). For each child, two microscopic slides of stool samples on 3 consecutive days were examined for egg counts per gram of stool (epg) by Kato–Katz method as described.23,24 In total, 353 children (15%) were positive (215 boys [61%] and 138 girls [39%]). Only 268 of 353 positive children were included in the study based on the availability of ARA capsules shipped from DSM to Egypt, and they were stratified according to the intensity of infection into light (< 100 epg), moderate (100–400 epg), and heavy (> 400 epg) infection. Of note, 13, 14, and 7 schoolchildren with light, moderate, and heavy S. mansoni infection, respectively (total of 34 of 268 = 13%), additionally suffered light infection with Ascaris lumbricoides and/or Ancylostoma duodenale. Phase II was the randomized clinical trial's Pbo-controlled phase. In total, 268 schoolchildren attending six schools in three villages were randomly assigned to three treatment groups (PZQ + Pbo, ARA, or PZQ + ARA) using computerized random selection. Per stratum, the children were proportionally allocated based on intensity of S. mansoni infection to three treatment groups, where approximately 45% had light infection level and the rest had moderate or heavy infection levels based on egg counts. In total, 160 males and 108 females (9-to 11-year-old children with weight ranges of 20–50 kg) participated in the randomized Pbo-controlled study (Figure 1).


Efficacy and safety of arachidonic acid for treatment of school-age children in Schistosoma mansoni high-endemicity regions.

Barakat R, Abou El-Ela NE, Sharaf S, El Sagheer O, Selim S, Tallima H, Bruins MJ, Hadley KB, El Ridi R - Am. J. Trop. Med. Hyg. (2015)

Study flow chart. Only 268 of 353 positive children were included in the study based on the availability of ARA capsules shipped from DSM in Columbia, MD to Egypt.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385776&req=5

Figure 1: Study flow chart. Only 268 of 353 positive children were included in the study based on the availability of ARA capsules shipped from DSM in Columbia, MD to Egypt.
Mentions: The study was carried out between October of 2012 and May of 2013, and it was conducted in two phases. Phase I was screening. All of the 2,947 students (1,549 boys [52%] and 1,398 girls [48%]) in grades III–V from nine primary schools in Motoubis area, Kafr El Sheikh Governorate were included in the screening phase. Only 2,312 children (78%) provided stool samples (1,181 boys [51%] and 1,131 girls [49%]). For each child, two microscopic slides of stool samples on 3 consecutive days were examined for egg counts per gram of stool (epg) by Kato–Katz method as described.23,24 In total, 353 children (15%) were positive (215 boys [61%] and 138 girls [39%]). Only 268 of 353 positive children were included in the study based on the availability of ARA capsules shipped from DSM to Egypt, and they were stratified according to the intensity of infection into light (< 100 epg), moderate (100–400 epg), and heavy (> 400 epg) infection. Of note, 13, 14, and 7 schoolchildren with light, moderate, and heavy S. mansoni infection, respectively (total of 34 of 268 = 13%), additionally suffered light infection with Ascaris lumbricoides and/or Ancylostoma duodenale. Phase II was the randomized clinical trial's Pbo-controlled phase. In total, 268 schoolchildren attending six schools in three villages were randomly assigned to three treatment groups (PZQ + Pbo, ARA, or PZQ + ARA) using computerized random selection. Per stratum, the children were proportionally allocated based on intensity of S. mansoni infection to three treatment groups, where approximately 45% had light infection level and the rest had moderate or heavy infection levels based on egg counts. In total, 160 males and 108 females (9-to 11-year-old children with weight ranges of 20–50 kg) participated in the randomized Pbo-controlled study (Figure 1).

Bottom Line: Arachidonic acid (ARA), an omega-6 fatty acid, is a potent schistosomicide that displayed significant and safe therapeutic effects in Schistosoma mansoni-infected schoolchildren in S. mansoni low-prevalence regions.We here report on ARA efficacy and safety in treatment of schoolchildren in S. mansoni high-endemicity areas of Kafr El Sheikh, Egypt.Combination of PZQ and ARA might be useful for treatment of children with schistosomiasis in high-endemicity regions.

View Article: PubMed Central - PubMed

Affiliation: Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt; Parasitology Department, National Liver Institute, Menoufiya University, Shebin El-Kom, Menoufiya, Egypt; Zoology Department, Faculty of Science, Cairo University, Cairo, Egypt; Research and Development Department, DSM Biotechnology Center, Delft, The Netherlands; Human Evidence Department, DSM North America, Columbia, Maryland.

Show MeSH
Related in: MedlinePlus