Definition
Bilharzia, known to most as schistosomiasis, is a parasitosis like teniasis, triggered by flatworms belonging to the genus Schistosoma; in schistosomiasis, the parasites reach the bloodstream, causing damage to the affected site (eg intestine, rectum, spleen, liver, lung, etc.). Schistosomiasis ranks second among the most widespread parasites in the tropics (the primacy goes to malaria).
Causes
The species most involved in schistosomiasis are Schistosoma mansoni, Schistosoma haematobium, Schistosoma japonicum: we are talking about flat worms that infect humans by ingestion or contact with contaminated water. The intermediate host is represented by particular molluscs in which the Schistosoma larvae replicate; the latter are therefore released into the water, infecting it.
Symptoms
The clinical-symptomatological picture that distinguishes schistosomiasis depends on the infecting species; acute schistosomiasis begins with fever, anorexia, headache, cough, liver / splenomegaly, and enlarged lymph nodes.
The intestinal variant is marked by mostly intestinal symptoms, such as diarrhea with possible bleeding, intestinal ulcers and intestinal polyps. Schistosomiasis of the urinary tract, on the other hand, manifests itself with pain during urination, hematuria and frequent urination. Finally, the cutaneous form of the disease begins with skin rash, itching and dermatitis.
Schistosomiasis Information - Drugs for the Treatment of Schistosomiasis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Schistosomiasis - Drugs to Treat Schistosomiasis.
Medicines
Schistosomiasis must be treated from the very first symptoms, to avoid the development of its complications, such as renal failure, increased risk of kidney cancer, liver fibrosis, cirrhosis, bleeding of esophageal varices and portal hypertension. Although less fatal than malaria. , schistosomiasis must in any case be diagnosed, therefore treated, promptly: for the diagnosis it is necessary to search for Schistosoma eggs in the faeces and / or urine; alternatively, it is possible to undergo antibody tests starting from the patient's blood samples. The biopsy is reserved only for those severe cases, in which schistosomiasis causes complications affecting internal organs.
The drug of excellence used for the treatment of schistosomiasis is praziquantel, also used in therapy for the treatment of teniasis.
In the past, other drugs were also used (eg lucanthone, niridazole, oxamnichina and sodium stibocaptate), currently little used due to their lower efficacy than praziquantel.
Corticosteroid treatment is conceivable only in the case of complications to the contral nervous system.
The following are the classes of drugs most used in the therapy for schistosomiasis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
- Praziquantel (eg Droncit, Tremazol): it is one of the most widely used anthelmintic drugs for the treatment of schistosomiasis; the active principle acts by increasing the membrane permeability of the parasite, causing its paralysis. The drug is initially taken at a dose of 20mg / kg; after 4-6 hours, repeat the same administration. For schistosomiasis caused by S. japonicum, it is recommended to administer the drug at higher doses (60 mg / kg, in triple doses over 24 hours). For the treatment of schistosomiasis in children, the recommended dose suggests taking 70 mg / kg orally. first day (equally divided into three doses) After 30 days from the end of the treatment, it is possible to follow another therapy cycle.
- Oxamnichina (eg. Vansil): the drug is effective only against infections sustained by S. mansoni. Indicatively, take the drug at a dose of 15 mg / kg, in a single administration. In some areas, where the disease is endemic, higher doses (30 mg / kg) are recommended.
- Metrifonate (eg Neguvon): second choice drug for the treatment of schistosomiasis; it is used, in particular, for the regression of chronic complications caused by the disease. Administer the drug in three doses, at intervals of 14 days from each other. It appears that the drug under investigation is even more effective than Praziquantel; despite this, Metrifonate is less used in therapy due to its high cost. For the posology: consult your doctor.
It is recommended that the patient undergo clinical checks after 3 and 6 months from the end of therapy, to check for the possible presence of other live Schistosoma eggs; in this case, a further course of therapy is recommended which, in all likelihood, will lead to complete remission from schistosomiasis.
