Treatment of Schistosomiasis in Chronic Hepatointestinal Disease with Faecal Egg Detection

This protocol covers the management of chronic hepatointestinal schistosomiasis caused by Schistosoma intercalatum, S. guineensis, S. japonicum, S. mekongi, or S. malayensis, where eggs are detected in faeces.

Clinical scenario

Chronic hepatointestinal schistosomiasis may present with abdominal pain, chronic diarrhoea, rectal bleeding, liver fibrosis, ascites, portal hypertension, splenomegaly, and variceal bleeding. Confirmation relies on detection of eggs in faeces.

Treatment approach

Treatment involves an oral antiparasitic agent administered in two scheduled rounds, with dosing adjusted according to the specific Schistosoma species identified — full regimen details, including species-dependent adjustments, are in the complete protocol.

Treatment goals

No vital eggs detectable in stool at 3 months post-treatment; detection at that point indicates treatment failure or reinfection. Eosinophilia should be resolved by 6 months after treatment.

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References

Hepatointestinal S.: abdominal pain, chronic diarrhoea, rectal bleeding, liver fibrosis, ascites, portal hypertension, splenomegaly, variceal bleeding

Egg detection in urine (S. h.) or faeces (other S. spp.)

S. h., S. man., S. i.: 60 mg/kg/d p.o. (in 2 or 3 doses) on day 0 and on day 21‐30

S. j., S. me., S. mal.: 75 mg/kg/d p.o. (in 2 or 3 doses) on day 0 and on day 21‐30

Detection of vital eggs 3 months after treatment indicates treatment failure or reinfection.

Eosinophilia should be cleared at 6 months after treatment

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