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This is to certify that the research work, "efficacy of artesunate in the treatment of urinary schistosomiasis at mubi south adamawa state" by ---, Reg. No. --/H2007/01430 submitted in partial fulfillment of the requirement award of a Higher National Diploma on --- has been approved.

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The efficacy of artesunate in the treatment of urinary schistosomiasis was assessed amongschool children aged 5-16 years. Urine samples from 367 primary school children were examined  forov  aof Schistosomahaematobium. Using standard parasitologicalprocedures(filtrationmethod), S. haematobium ova was found in the urine samples of 29(7.9%) pupils.High infection rates of 16.0% and 13.2% were recorded in two primary schools with anoverallegg outputof10.55 eggs/10mls urine (geometric mean). The prevalence was higher in the males (10.10%) thanin the females (5.0%) and among the 12-16 years age group (15.1; p<0.05). Infected pupils whoreported for treatment were given oral dose of artesunate (4mg/kg/day) for 3 days. When thetreated children were examined 2 weeks post treatment, the intensity reduced to 1.59eggs/10mlurine and the drug had an 85.12% egg reduction and efficacy rates. The treatment regimens werewell tolerated. This study confirmed that the treatment of urinary schistosomiasis with artesunate is safe and effective but its widespread use for the treatment of schistosomiasis has to be considered carefully so that it does not compromise the efficacy of the drug as an anti-malaria and there by increasing the risk of resistance developing in local Plasmodium.

Keywords:Urinaryschistosomiasis,schoolchildren,artesunate

CHAPTER ONE

1.0                                                                   INTRODUCTION

1.1                                                     BACKGROUND OF THE STUDY

Schistosomiasis is a serious debilitating, sometimes fatal parasitic disease. It is the second most prevalent tropical disease in Africa after malaria and of great public health and socio- economic importance in thedevelopingworld(WHO,2002).The first obvious symptom of the infection is blood in the urine. Earlysigns of morbidity common to the infection and which manifest in school age children areanaemia, impaired growth, and development, poor cognition and substandard school performance (Cetron et al., 1996).The late and life threatening consequences of schistosomiasis include bladder cancer or serious kidney malfunction caused by S.haematobium, and severe complications of the liver and spleen in the caseofintestinalschistosomiasis(Cheesbrough,2002).
Globally up to 120 million of the estimated 200 millioninfected people are believed to be symptomatic and asmanyas 20 million may well be sufferingsevereconsequencesofthisinfection.Theannualdeathsassociated with schistosomiasis are estimated at 20,000whileabout 500-600millionpeopleworldwideareat risk(WHO, 2001). Nigeria is one of the countries known tobe highly endemicwhere it is reported to affectall the36 statesofthecountryincludingAbuja.
There is yet no vaccine available for the prevention ofschistosomiasis.Thecurrentmainstayofcontrolischemotherapywithpraziquantelwhichisgivenasasingle oral dose against all human schistosomeparasite(WHO, 2002). Recently, Borrman et al (2001), Inyang-Etoh et al (2004) and Inyang- Etoh et al (2005) havevariouslystudiedtheefficacyoftheartemisininderivatives (well known for its anti-malarial properties)for the treatment of all human schistosomiasis. Somecompoundsexhibitingactivitiesagainsttheyoungdevelopmental stages of the parasites are relevant aspraziquantel isineffectiveinthisarea (Cioli,2000).
Artesunate has also been used in human to obtaincureandeggcountreductionagainstSchistosomaspecies infection.Report on the efficacy ofartesunateinthetreatmentofurinaryschistosomiasis is scarceespeciallyin Nigeria and Anambrastatein particular.
1.2                                                           PROBLEM STATEMENT
Schistosomiasis is one of the most prevalent helminthic infections in the world. In mid-2003, the population at risk was estimated to be 779 million individuals, and more than 200 million people were infected.1 This parasitosis affects people living in tropical and subtropical areas of Africa – Nigeria. Schistosomiasis is acquired through the skin by contact with cercariae while bathing or wading in fresh water. Chronic infection in endemic areas is associated with liver and intestinal disease (Schistosomamansoni, Schistosomaintercalatum, Schistosomajaponicum, and Schistosomamekongi) or kidney and bladder dysfunction (Schistosomahaematobium).
Urinary schistosomiasis is an important cause of morbidity in Africa. It is normally acquired during childhood and up to 60% of schoolchildren have been found to be infected in some settings, even an 80% prevalence has been reported, indicating that schoolchildren is one of the most, if not the most affected group by chronic urinary schistosomiasis (Ahmed et al., 2019). Chronic infection can lead to chronic anemia, undernutrition, reduced exercise tolerance, and loss of performance (King et al., 2015).Schistosomiasis was responsible for the loss of at least 13–15 million disability-adjusted-life-years in 2004 (King et al., 2010). Moreover, squamous cell carcinoma of the bladder is a well-known complication and has been reported as the most frequent cancer in endemic areas (Mostafa et al, 2019).There are many Urinary schistosomiasis treatment. It would be more cost-effective to treat urinary schistosomiasis with artesunate. The potential efficacy of artesunate derivatives led us to study the role of these drugs in the treatment of urinary schistosomiasis.
1.3                                              AIM AND OBJECTIVES OF THE STUDY
The main aim of this work is to access the efficacy and tolerability of oral artesunate for the treatment of urinary schistosomiasis was assessed among. The objectives of this study:

1. To determine the effectiveness of artesunatein treatment of urinary schistosomiasis
2. To study the chemical composition of artesunate
3. To determine the prevalence of urinary schistosomiasis among children.

1.4                                                     SIGNIFICANCE OF THE STUDY
This study will bring a clear understanding of the efficacy of artesunateinthetreatmentofurinaryschistosomiasis to drug distributor, producers and consumers. This study will serve as a means of promoting the general use of artesunate.

1.5                                                            RESEARCH QUESTION

1. What are the symptoms of urinary schistosomiasis?
2. How do one get urinary schistosomiasis?
3. If artesunateinthetreatmentofurinaryschistosomiasis effective?
4. Can you see schistosomiasis in urine?
5. Can urinary schistosomiasis be cured with artesunate?

1.6                                               SCOPE / LIMITATION OF THE STUDY
There are many means and different drugs for the treatment of treatment of urinary schistosomiasis. However, this work covers the efficacy ofartesunateurinary schistosomiasis at MUBI South Adamawa State. From the study, Urine samples from primary school children were examined forova of Schistosomahaematobium.Using standard parasitological procedures(filtrationmethod).

 

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