Biltricide

A urine filtration method was employed to identify S. haematobium eggs [21 (link)]. In brief, 10 mL of urine was vigorously shaken and filtered through a Nytrel filter with a 40 µm mesh size and examined microscopically for the presence of S. haematobium eggs that were counted by experienced laboratory technicians. Stool samples were subjected to the Kato-Katz technique [22 (link)]. Two thick smears from each stool sample were microscopically examined to identify and quantify eggs of S. mansoni and soil-transmitted helminths.
After examination, all schoolchildren were treated with a single 40 mg/kg oral dose of praziquantel (600 mg; Biltricide, Bayer, Leverkusen, Germany) through the "Programme National de Lutte contre les Maladies Tropicales Negligées à Chimioprophylaxie Préventive" (PNLMTN-CP) of Côte d’Ivoire. Children with soil-transmitted helminths were treated with albendazole (400 mg).

At baseline, all included children were given PZQ (600 mg tablets; Biltricide, Bayer, Abidjan, Côte d’Ivoire), according to the calculated dose per kg of bodyweight (40 mg/kg, weight measured by a Seca 877 digital scale). Prior to treatment, breakfast was provided to each child. After sample collection, directly observed treatment was applied by the study physician and was accompanied with water and lunch, provided by the research team. Children allocated to the intense treatment group were re-treated with PZQ at 2, 4, and 6 weeks after the first treatment.
After treatment, children remained under medical supervision for at least 3 hours and adverse events were recorded. If needed, symptomatic treatment for adverse events was provided by the study physician. In case vomiting occurred within 1.5 hours, children were re-administered a dose of PZQ. Twenty-four hours post-treatment, children were interviewed about the occurrence of adverse events. An adverse event was defined as any undesirable sign, symptom, or disease occurring to a participant during the study, whether or not related to PZQ treatment. Intensity of adverse events was graded by the study physician as mild, moderate, or severe, following guidelines by the European Medicine Agency.

Ethical clearance was obtained from Ethical Clearance Committee of Jimma University. The study participants involved in the study after informed written consent was obtained from their parents or guardians and assent from participating children. Children positive for S. mansoni have received single dose of praziquantel (Biltricide®, Bayer AG, Germany), 40 mg/kg body weight according to standard treatment guideline of Ethiopia (2010) and study participants identified as stunted and wasted were referred to Fincha’a sugar estate health center for necessary interventions.