{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T12:49:17Z","timestamp":1786625357306,"version":"build-2736575974"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p><jats:italic>Schistosoma mansoni<\/jats:italic> and <jats:italic>S<\/jats:italic>. <jats:italic>haematobium<\/jats:italic> infections have been public health problems in Ethiopia, <jats:italic>S<\/jats:italic>. <jats:italic>mansoni<\/jats:italic> being more prevalent. To reduce the burden of schistosomiasis, a national school-based prazequantel (PZQ) mass drug administration (MDA) program has been implemented since November 2015. Nevertheless, <jats:italic>S<\/jats:italic>. <jats:italic>mansoni<\/jats:italic> infection is still a major public health problem throughout the country. Reduced efficacy of PZQ is reported by a few studies in Ethiopia, but adequate data in different geographical settings is lacking. Hence, this study aimed to assess the efficacy and safety of PZQ for the treatment of <jats:italic>S<\/jats:italic>. <jats:italic>mansoni<\/jats:italic> infection across different transmission settings in Amhara Regional State, northwest Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A school-based single-arm prospective cohort study was conducted from February to June, 2023 among 130 <jats:italic>S<\/jats:italic>. <jats:italic>mansoni<\/jats:italic>-infected school-aged children (SAC). Forty-two, 37, and 51 <jats:italic>S<\/jats:italic>. <jats:italic>mansoni<\/jats:italic>-infected SAC were recruited from purposely selected schools located in low, moderate, and high transmission districts, respectively. School-aged children who were tested positive both by Kato Katz (KK) using stool samples and by the point of care circulating cathodic antigen (POC-CCA) test using urine samples at baseline were treated with a standard dose of PZQ and followed for 21 days for the occurrence of adverse events. After three weeks post-treatment, stool and urine samples were re-tested using KK and POC-CCA. Then the cure rate (CR), egg reduction rate (ERR), and treatment-associated adverse events were determined. The data were analyzed using SPSS version 21.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Out of the total 130 study participants, 110 completed the follow-up. The CR and ERR of PZQ treatment were 88.2% (95%CI: 82.7\u201393.6) and 93.5% (95%CI: 85.4\u201398.5), respectively, by KK. The CR of PZQ based on the POC-CCA test was 70.9% (95%CI: 62.7\u201379.1) and 75.5% (95%CI: 67.3\u201383.6) depending on whether the interpretation of \u2018trace\u2019 results was made as positive or negative, respectively. After treatment on the 21<jats:sup>st<\/jats:sup> day, 78 and 83 participants tested negative both by KK and POC-CCA, with respective interpretations of \u2018trace\u2019 POC-CCA test results as positive or negative. The CR in low, moderate and high transmission settings was 91.7%, 91.2% and 82.5%, respectively (p = 0.377) when evaluated by KK. The CR among SAC with a light infection at baseline (95.7%) by KK was higher than that of moderate (81.5%) and heavy (64.3%) infections (\u03c7<jats:sup>2<\/jats:sup> = 12.53, p = 0.002). Twenty-six (23.6%) participants manifested at least one adverse event. Eleven (10.0%), eight (7.3%), six (5.5%), and three (2.7%) participants complained about abdominal pain, nausea, headache, and anorexia, respectively. All adverse events were mild, needing no intervention. Occurrence of adverse events was slightly higher in high endemic areas (32.5%) than moderate (23.5%) and low endemic areas (p = 0.279).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>A single dose of 40 mg\/kg PZQ was efficacious and safe for the treatment of <jats:italic>S<\/jats:italic>. <jats:italic>mansoni<\/jats:italic> infection when it was evaluated by the KK test, but a lower efficacy was recorded when it was evaluated by the POC-CCA test. However, the POC-CCA test\u2019s specificity, clearance time of CCA from urine after treatment, and interpretation of weakly reactive (trace) test results need further research.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0298332","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T18:24:40Z","timestamp":1709576680000},"page":"e0298332","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy and safety of prazequantel for the treatment of Schistosoma mansoni infection across different transmission settings in Amhara Regional State, northwest Ethiopia"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3478-4176","authenticated-orcid":true,"given":"Getaneh","family":"Alemu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arancha","family":"Amor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Endalkachew","family":"Nibret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abaineh","family":"Munshea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melaku","family":"Anegagrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"key":"pone.0298332.ref001","unstructured":"WHO. 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