Here, we present an evaluation of treatment outcome in patients treated for schistosomiasis at the Department for infectious diseases at Copenhagen University Hospital in 2003 to 2008 and review previous reported studies of treatment
results in non-endemic areas. Study population: In 2003 to 2008, a total of 49 patients were treated for schistosomiasis at Copenhagen University Hospital. All patients were treated with at least one dose of praziquantel 40 to 60 mg/kg more than 12 weeks after exposure. At this website the time of the present study 11 of the 49 patients had been reexamined for ova at least 3 months after treatment; the remaining 38 patients, who had not been reexamined or examined with blood samples only, were offered follow-up examination by microscopy of 24 h urine samples and/or rectal
mucosa biopsies and measurement of eosinophil count, IgE, and Schistosoma serology. Of the 38 patients 19 were reexamined and 19 did not respond to the invitation. None of the patients had been reexposed to freshwater in Schistosoma signaling pathway endemic areas after treatment. Serology: Serum samples were examined by an indirect hemagglutination assay (Cellognost-Schistosomiasis, Dade-Gehring, Marburg, Germany) and/or by immunofluorescence antibody test with measurement of antibody titer against gut associated antigen (GAA) and Levetiracetam membrane bound antigen (MBA) at Statens Serum Institute,
Denmark. Rectal biopsies: Two biopsies from the rectal mucosa were obtained by proctoscopy and were examined under a microscope as a crush preparation between two slides at 3 × 10 magnification. Urine: 24 h urine samples were filtered under vacuum; the filter was stained with ninhydrine and examined under a microscope. Feces: Two samples of feces were concentrated using the formol-ether technique and examined by microscopy. Feces was examined at the first consultation but not at follow-up because of the low sensitivity of this method compared to microscopy of rectal biopsies. Definitions: Treatment failure was defined by the finding of viable ova in rectal biopsies or urine >3 months after treatment. Viability of the ova was confirmed by finding a well-defined fully developed miracidium in unfixed fresh ova by microscopy, using a high-power objective. Microscopy was performed by a laboratory assistant, who has several years of experience in parasitology. Statistical analyses: Differences between groups were analyzed by Mann-Whitney ranksum test using Stata 9.2 software. This study was conducted as part of quality control of treatment of schistosomiasis in our department and was approved by the Danish Data Protection Agency. In 2003 to 2008, 49 patients were treated for schistosomiasis; 10 were immigrants, 19 were tourists and 20 were expatriates.