Praziquantel is frequently and widely used in Asia to treat liver fluke infections which can have very serious long-term effects if untreated.
The best is the supervised administration of the drug, usually infected patients whether with schistosomiasis or liver flukes received low education or may be asymptomatic so their motivation to take the drug is not appropriate. SO it is recommended that the patient take the drug in front of one of the dealing physician or nurse
Mostaf/Fadwa,
Thank you for your replies. Perhaps I should have explained. I am planning a research study in rural areas of Northeast Thailand where opisthorchiasis is endemic with frequently high prevalence rates due to the culturally and strongly ingrained habit of eating infected raw, undercooked or inadequately fermented cyprinid fish. The infection rates in this region continue to remain high after many years of a national control programme, which includes heath education programmes and praziquantel (single dose after a meal) as the standard treatment for infected or likely infected villagers. While I am very much aware that supervised administration is most important, this very rarely seems to happen, and one of the purposes of the research project is to assess the size of the problem this may be creating. After being given the drug to take after their next meal, villagers may be followed up by health volunteers to ask whether they took the drug , but I strongly suspect the validity of the feedback they receive. Before and after tests on fetal samples is one approach, but the standard test is the single Kato-katz thick smear technique which has low sensitivity. Hence, my search for an inexpensive and easily measured test for taking praziquantel.
Compliance assessment is a problem. If we ask for the smell and side effect of praziquantel in addition to quantitative measurement of ova this could solve part of the problem. Vomiting or diarrhea could decrease the efficacy of the drug. Later comparing the drug efficacy in patients with and without side effects could clarify compliance.
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