This protocol addresses patients with chronic hepatointestinal schistosomiasis caused by Schistosoma intercalatum, S. guineensis, S. japonicum, S. mekongi, or S. malayensis, in whom standard first-line treatment has not achieved the expected clearance of infection.
Active infection is confirmed by egg detection in faeces. Chronic hepatointestinal involvement can present with abdominal pain, chronic diarrhoea, and rectal bleeding. Advanced disease may include liver fibrosis, portal hypertension, splenomegaly, ascites, or variceal bleeding.
First-line Praziquantel was administered but did not meet its treatment goals: vital schistosome eggs remained detectable in stool at 3 months after treatment, or eosinophilia had not resolved by 6 months. Either finding signals treatment failure or reinfection, and triggers escalation to this retreatment protocol.