Schistosomiasis (Bilharzia) Guidelines

Updated: Mar 08, 2023
  • Author: Shadab Hussain Ahmed, MD, FACP, FIDSA, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Guidelines Summary

Praziquantel is effective for schistosomiasis. For S mansoni, S hematobium, and S intercalatum schistosomiasis, praziquantel 40 mg/kg/day is given in 2 divided doses for 1 day. Treatment usually is curative. Urine can be evaluated for test of cure 1-2 months after drug administration. The response may vary depending on organism burden. In cases of lower organism burden, the treatment may be repeated in 2-4 weeks.

For S japonicum and S mekongi schistosomiasis, a higher dose of 60 mg/kg/day in 3 divided doses for 1 day usually is effective.

Praziquantel is pregnancy category B. The WHO supports its use in pregnancy.

Lactation is not considered a contraindication to praziquantel use.

In children younger than 4 years, the benefit versus risk of use has not been determined.

Minimal clinical resistance to praziquantel has been reported. Re-infection occurs rapidly in individuals who remain in endemic areas. [76]

Mass drug administration campaigns against schistosomiasis in Sub-Saharan Africa and Yemen have been successful. The WHO aims to eliminate the disease as a public health issue by 2025. [77]