REVERSIBILITY OF LOWER REPRODUCTIVE-TRACT ABNORMALITIES IN WOMEN WITHSCHISTOSOMA-HAEMATOBIUM INFECTION AFTER TREATMENT WITH PRAZIQUANTEL -AN INTERIM-REPORT

Little is known whether and to what extent antiparasitic treatment cur es female genital schistosomiasis (FGS). Using a standard protocol, of twenty-one women with FGS nine were re-examined at two to nine weeks after they had been treated with praziquantel at a single dose of 40 m g/kg. Symptoms related to pathology of the urinary tract and to a less er extent of genital pathology subsided in most patients. Schistosoma haematobium ova were no longer detectable in urine of any of the patie nts post-treatment. Efficiency of chemotherapy against adult worms was confirmed by the disappearance of circulating anodic antigen (CAA) in serum. Sandy patches showed resolution in two of four cases after che motherapy. Papillomata due to schistosomiasis alone improved, but pers isted in mixed infection with human papilloma virus (HPV) or when HPV was the only underlying cause. In one patient ulcera could not be rela ted with certainty to schistosomiasis at admission, but resolved after treatment with praziquantel. Leukoplakia (two cases) was not influenc ed by chemotherapy, or even increased during follow-up, regardless of whether ova had been detected or not. Although the follow-up period wa s rather short, time intervals were not standardized, and a relatively small number of patients was investigated, it could be shown that gen ital pathology due to sequestered S. haematobium ova is, at least part ially, reversible already two to nine weeks after killing the adult wo rms by praziquantel. This is paralleled by a normalization of inflamma tory immune responses detectable in histological sections and vaginal lavage.