Schistosomiasis is the third most devastating tropical disease in the world and about the most important of all water impounding diseases in the tropics. In the absence of vaccine for preventing the disease and the widely reported therapeutic failure with praziquantelmonotherapy, identification of drug combinations with high therapeutic efficacy is crucial to protecting vulnerable populations such as ‘Almajiri’ children from the scourge of the disease. A randomized control trial was carried out in February and March 2014 to compare the cure rates of artesunate - praziquantel combination and praziquantelmonotherapy among 70 children diagnosed with urinary schistosomiasis at the ‘Almajiri’ Integrated Model School, Sokoto, Nigeria. Urine samples were collected from the children and examined for ova of Schistosomahaematobium (microscopically by sedimentation technique) one month after drug administration. Mean age of participants was 11.9 + 2.6 years. A significantly higher cure rate was recorded among the group on artesunate - praziquantel combination (85.7%) compared to the group on praziquantelmonotherapy (51.4%), χ2 = 29.109, p = 0.004. Participants on artesunate - praziquantel combination were 5 times more likely to be cured than those on praziquantelmonotherapy (Odds ratio (OR) = 5.426, p = 0.002, 95% Confidence Interval (CI) = 2.697 – 9.349). These findings underscore the need to adopt artesunate - praziquantel combination as the standard treatment for urinary schistosomiasis (instead of the currently used praziquantelmonotherapy) particularly in populations at risk of repeated exposure to infected water, for prompt and effective treatment of those infected, and morbidity reduction in both the individual patients and the community.
Keywords: Comparative cure rates, Artesunate, Praziquantel, Combination, Monotherapy, Urinary schistosomiasis