{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:14:11Z","timestamp":1790075651513,"version":"4.0.1"},"reference-count":42,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T00:00:00Z","timestamp":1581292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: schistosomiasis is a neglected tropical disease caused by helminths of the genus Schistosoma. The disease has a worldwide distribution, with more cases occurring in Africa. Urogenital schistosomiasis caused by S. haematobium with its associated morbidity is prevalent in many areas of Ghana. Praziquantel is still the recommended drug of choice for schistosomiasis treatment, although a number of studies have reported sub-therapeutic effects and associated treatment failure. The current study, therefore, assessed whether persistent schistosomiasis, with its associated morbidity among children living in endemic areas within the Greater Accra Region of Ghana, is as a result of reinfection or suspected praziquantel resistance. Methodology: this was a longitudinal study involving a baseline and follow-up sampling after praziquantel treatment. Urine samples were collected from school children (whose parents had also consented) for the detection of S. haematobium ova using a sedimentation technique. The morbidity parameters were examined with urine chemistry strips, as well as microscopy. Viability was assessed using a modified hatchability technique, vital staining (0.4% trypan blue and 1% neutral red) and fluorescent (Hoechst 33258) microscopy. Infected individuals were treated with a single dose of praziquantel (40mg\/kg). Resampling to determine reinfection was done sixth months post-treatment, after evidence of total egg clearance. For possible resistance assessment, egg counts and viability testing were conducted on the positive samples at the baseline, as well as weekly post-treatment follow-ups for 12 weeks. Results: out of the 420 school children sampled, 77 were initially positive but, after the sixth month sampling for reinfection assessment, eight out of the initial positives were infected again, giving a reinfection percentage of 10.4%. No suspected praziquantel resistance was recorded in the 21 positives detected out of the 360 sampled for suspected resistance assessment. The egg reduction rate increased weekly in the follow-up samples with a gradual reduction in the egg count. The study also recorded a gradual decrease in the percentage of live eggs after the first week; with all viability testing methods used complimenting each other. The morbidity parameters (proteinuria, haematuria and pyuria) changed between the baseline and post-treatment samples, eventually reducing to zero. Conclusions: the outcome of this study suggests that the persistent schistosomiasis, with its associated morbidity observed in these endemic communities, is not likely to be as a result of praziquantel resistance, but reinfection. Even though there was no suspected resistance observed in the study, there remains the need to continuously intensify the monitoring of praziquantel in other endemic communities.<\/jats:p>","DOI":"10.3390\/medsci8010010","type":"journal-article","created":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T09:25:21Z","timestamp":1581413121000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Persistent Urogenital Schistosomiasis and Its Associated Morbidity in Endemic Communities within Southern Ghana: Suspected Praziquantel Resistance or Reinfection?"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3344-4869","authenticated-orcid":false,"given":"Patience B.","family":"Tetteh-Quarcoo","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter O.","family":"Forson","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth K.","family":"Amponsah","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, School of Pharmacy, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ahenkorah","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Japheth A.","family":"Opintan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6612-0476","authenticated-orcid":false,"given":"Janet E. Y.","family":"Ocloo","sequence":"additional","affiliation":[{"name":"Department of Pathology, Korle-Bu Teaching Hospital, Korle-Bu, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther N.","family":"Okine","sequence":"additional","affiliation":[{"name":"Central Laboratory Services, Korle-Bu Teaching Hospital, Korle-Bu, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3643-4217","authenticated-orcid":false,"given":"Robert","family":"Aryee","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"},{"name":"Department of Physiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Afutu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham K.","family":"Anang","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick F.","family":"Ayeh-Kumi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/S0140-6736(06)69440-3","article-title":"Human Schistosomiasis","volume":"368","author":"Gryseels","year":"2006","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1172\/JCI34261","article-title":"Helminth infections: The great neglected tropical diseases","volume":"118","author":"Hotez","year":"2008","journal-title":"J. Clin. Invest."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.trstmh.2008.12.012","article-title":"Improving control of African schistosomiasis: Towards effective use of rapid diagnostic tests within an appropriate disease surveillance model","volume":"103","author":"Stothard","year":"2009","journal-title":"Trans. R Soc. Trop. Med. Hyg."},{"key":"ref_4","unstructured":"Roberts, L., and Janovy, J. (2000). Foundations of Parasitology, McGraw Hill Companies Incorporated. [6th ed.]. Available online: https:\/\/azdoc.tips\/documents\/foundations-of-parasitology-2-5c15f885b25cf."},{"key":"ref_5","unstructured":"Jordan, P., Webbe, G., and Sturrock, R. (2019, September 24). Human schistosomiasis. Wallingford, England. CAB. Available online: https:\/\/academic.oup.com\/trstmh\/article-abstract\/88\/6\/716\/1917879?redirectedFrom=fulltext."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1128\/CMR.12.1.97","article-title":"Relationship between schistosomiasis and bladder cancer","volume":"12","author":"Mostafa","year":"1999","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_7","unstructured":"World Health Organization (2012). Schistosomiasis: Population requiring preventive chemotherapy and number of people treated in 2010. Wkly. Epidemiol. Rec, 87, 37\u201344."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S1995-7645(13)60188-1","article-title":"Prevalence, intensity of infection and risk factors of urinary schistosomiasis in pre-school and school aged children in Guma Local Government Area, Nigeria","volume":"7","author":"Amuta","year":"2014","journal-title":"Asian Pac. J. Trop. Med."},{"key":"ref_9","unstructured":"World Health Organization (2019, September 14). The Control of Schistosomiasis. Second Report of the WHO Expert Committee, Technical Report Series no. 830. Geneva. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/37115."},{"key":"ref_10","unstructured":"World Health Organization (2019, October 18). Preventive chemotherapy in human helminthiasis. Available online: https:\/\/www.paho.org\/hq\/index.php?option=com_docman&view=list&slug=guidelines-3954&Itemid=270&lang=en."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.ijpara.2006.02.002","article-title":"Voltage-gated calcium channel subunits from Platyhelminthes: Potential role in Praziquantel action","volume":"36","author":"Jeziorski","year":"2006","journal-title":"Int. J. Parasitol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1590\/S0074-02762010000400040","article-title":"Specific Schistosomiasis treatment as a strategy for disease control","volume":"105","author":"Coura","year":"2010","journal-title":"Mem. Inst. Oswaldo Cruz Rio de Janeiro"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"342","DOI":"10.4269\/ajtmh.2006.74.342","article-title":"Failure of Standard Treatment with Praziquantel in Two Returned Travelers with Schistosoma haematobium Infection","volume":"74","author":"Alonso","year":"2006","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1590\/S0074-02762005000400018","article-title":"Therapeutic failure of Praziquantel in the treatment of Schistosoma haematobium infection in Brazilians returning from Africa","volume":"100","author":"Thiengo","year":"2005","journal-title":"Mem. do Inst. Oswaldo Cruz."},{"key":"ref_15","first-page":"173","article-title":"Reinfection Pattern and Predictors of Urinary Schistosomiasis among School Pupils from a Southwestern Village in Nigeria","volume":"1","author":"Oniya","year":"2006","journal-title":"Int. J. Trop. Dis. Health"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ezeh, O.K., Agho, K.E., Dibley, M.J., Hall, J., and Page, A.N. (2015). Determinants of neonatal mortality in Nigeria: Evidence from the 2008 demographic and health survey. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-521"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.actatropica.2012.09.010","article-title":"Praziquantel treatment of School children from single and mixed infection foci of intestinal and urogenital schistosomiasis along the Senegal River Basin: Monitoring treatment success and re-infection patterns","volume":"128","author":"Webster","year":"2013","journal-title":"Acta Tropica"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1080\/00034983.1989.11812373","article-title":"Effect of Praziquantel on the eggs of Schistosoma mansoni, with a note on the implications for managing central nervous system Schistosomiasis","volume":"83","author":"Richards","year":"1989","journal-title":"Ann. Trop. Med. Ph."},{"key":"ref_19","first-page":"271","article-title":"Mechanism of action of Praziquantel on the eggs of Schistosoma japonicum","volume":"53","author":"Matsuda","year":"1983","journal-title":"J. Exp. Med."},{"key":"ref_20","unstructured":"Elfaki, T.E.M., Osman, A., and EL Sayid, M. (2015). The Effect of Treatment on Viability of Eggs among Urinary Schistosomiasis Patients in Al-Shajara Area, Khartoum State-Sudan. Eur. Acad. Res., Vol III."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4236\/ojmm.2013.33023","article-title":"Urinary Schistosomiasis in Children\u2014Still a Concern in Part of the Ghanaian Capital City","volume":"3","author":"Simon","year":"2013","journal-title":"Open J. Med. Microbiol"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1440-1770.1995.tb00023.x","article-title":"Schistosomiasis in the Weija Lake: A case study of the public health importance of man-made lakes","volume":"1","author":"Ampofo","year":"1995","journal-title":"Lake Reserv. Res. Management"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Aboagye, I.F., and Edoh, D. (2009). Investigation of the Risk of Infection of Urinary Schistosomiasis at Mahem and Galilea Communities in the Greater Accra Region of Ghana. WAJAE, 15.","DOI":"10.4314\/wajae.v15i1.49426"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.9734\/IJTDH\/2017\/29532","article-title":"Urinary Schistosomiasis and Its Related Anaemia among Children in a High Risk Community in Ghana","volume":"22","author":"Gadri","year":"2017","journal-title":"Int. J. Trop. Dis. Health"},{"key":"ref_25","first-page":"75","article-title":"The pattern of schistosome egg distribution in a micturition flow","volume":"13","author":"Weber","year":"1969","journal-title":"Cent. Afr. J. Med."},{"key":"ref_26","first-page":"7157","article-title":"Prevalence and temporal distribution of Schistosoma haematobium infections in the Vhembe district, Limpopo Province, South Africa","volume":"42","author":"Samie","year":"2010","journal-title":"Afr. J. Biotechnol."},{"key":"ref_27","first-page":"20","article-title":"Comparison of the miracidium hatching test and modified Kato-Katz method for detecting Schistosoma japonicum in low prevalence areas of China","volume":"45","author":"Zhu","year":"2014","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Forson, P.O., Tetteh-Quarcoo, P.B., Ahenkorah, J., Aryee, R., Okine, E.N., Afutu, E., Djameh, G.I., Agyapong, J., Anang, A.K., and Ayeh-Kumi, P.F. (2019). Ability of Vital and Fluorescent Staining in the Differentiation of Schistosoma haematobium Live and Dead Eggs. Med. Sci. (Basel), 7.","DOI":"10.3390\/medsci7040064"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13071-015-0980-5","article-title":"Efficacy of Praziquantel against urinary schistosomiasis and reinfection in Senegalese school children where there is a single well-defined transmission period","volume":"8","author":"Senghor","year":"2015","journal-title":"Parasit Vectors"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s40249-017-0293-3","article-title":"Efficacy of Praziquantel on Schistosoma haematobium and reinfection rates among school-going children in the Ndumo area of uMkhanyakude district, KwaZulu-Natal, South Africa","volume":"6","author":"Kabuyaya","year":"2017","journal-title":"Infect. Dis. Poverty"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Woldegerima, E., Bayih, A.G., Tegegne, Y., Aemero, M., and Zeleke, A.J. (2019). Prevalence and Reinfection Rates of Schistosoma mansoni and Praziquantel Efficacy against the Parasite among Primary School Children in Sanja Town, Northwest Ethiopia. J. Parasitol. Res., 8.","DOI":"10.1155\/2019\/3697216"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"585","DOI":"10.3201\/eid0606.000606","article-title":"Evidence against rapid emergence of Praziquantel resistance in Schistosoma haematobium, Kenya","volume":"6","author":"King","year":"2000","journal-title":"Emerg. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/1756-3305-5-108","article-title":"Schistosoma haematobium infections among school children in Central Sudan one year after treatment with praziquantel","volume":"5","author":"Ahmed","year":"2012","journal-title":"Parasit Vectors."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.trstmh.2008.03.010","article-title":"Efficacy and side effects of Praziquantel treatment against Schistosoma haematobium infection among primary school children in Zimbabwe","volume":"102","author":"Midzi","year":"2008","journal-title":"Trans. R Soc. Trop. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1046\/j.1365-3156.2001.00785.x","article-title":"Reinfection with Schistosoma haematobium following school-based chemotherapy with Praziquantel in four highly endemic villages in Co\u00e3te d\u2019Ivoire","volume":"6","author":"Utzinger","year":"2001","journal-title":"Trop. Med. Int. Health"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Saathoff, E., Olsen, A., Magnussen, P., Kvalsvig, J.D., Becker, W., and Appleton, C.C. (2004). Patterns of Schistosoma haematobium infection, impact of Praziquantel treatment and re-infection after treatment in a cohort of schoolchildren from rural KwaZulu-Natal\/South Africa. BMC Infect. Dis., 4.","DOI":"10.1186\/1471-2334-4-40"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/2049-9957-3-30","article-title":"Efficacy of Praziquantel in the treatment of Schistosoma haematobium infection among school-age children in rural communities of Abeokuta, Nigeria","volume":"3","author":"Ojurongbe","year":"2014","journal-title":"Infect. Dis. Poverty"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/0035-9203(80)90091-7","article-title":"Hybrids between Schistosoma haematobium and Schistosoma mattheei and their identification by isoelectric focusing of enzymes","volume":"14","author":"Wright","year":"1980","journal-title":"Trans. R Soc. Trop. Med. Hyg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1186\/1756-3305-5-298","article-title":"Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with Praziquantel in school-aged children","volume":"5","author":"Stete","year":"2012","journal-title":"Parasit Vectors"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1186\/1756-0500-6-392","article-title":"Efficacy of Praziquantel against Schistosoma haematobium in Dulshatalo village, western Ethiopia","volume":"6","author":"Mekonnen","year":"2013","journal-title":"BMC Res. Notes"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Wami, W.M., Nausch, N., Midzi, N., Gwisai, R., Mduluza, T., Woolhouse, M.E.J., and Mutapi, F. (2016). Comparative Assessment of Health Benefits of Praziquantel Treatment of Urogenital Schistosomiasis in Preschool and Primary School-Aged Children. Biomed. Res. Int., 2016, Article ID 9162631.","DOI":"10.1155\/2016\/9162631"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1046\/j.1365-3156.1999.00408.x","article-title":"Parameters associated with Schistosoma haematobium infection before and after chemotherapy in school children from two villages in the Coast province of Kenya","volume":"4","author":"Kahama","year":"1999","journal-title":"Trop. Med. Int. Health."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/8\/1\/10\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T08:56:25Z","timestamp":1760172985000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/8\/1\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,10]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,3]]}},"alternative-id":["medsci8010010"],"URL":"https:\/\/doi.org\/10.3390\/medsci8010010","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,10]]}}}