Evaluation of Artesunate-mefloquine as a Novel Alternative Treatment for Schistosomiasis in African Children

The SchistoSAM study is an open label, two‐arm, individually‐randomized controlled trial with a non‐inferiority design, conducted in northern Senegal. The study aims at determining if the efficacy of one and of repeated courses of artesunate‐mefloquine (AM) is respectively similar to or higher than that of a standard praziquantel (PZQ) treatment. Secondly, the study will assess if novel DNA‐ and antigen‐based diagnostics are more accurate than microscopy in assessing antischistosomal treatment response. For this purpose, 660 school children, aged 6‐14 years old and infected with Schistosoma (as demonstrated by presence of eggs in stool and/or urine) will be randomized in one of the following arms: 1. AM, available in fixed dose tablets of 25/50 mg and 100/200 mg will be administered once daily for three days in a dose closest to 4 mg/kg artesunate and 8 mg/kg mefloquine. This treatment course will be repeated 2 times at 6‐week intervals. 2. PZQ, available in tablets of 600 mg, will be administered as a single dose of 40 mg/kg. Trial participants will be regularly followed‐up: 1. At each dose administration 2. At day 7 after each dose for follow‐up of safety 3. At week 4, 10 and 16 for parasitological assessment and follow‐up of safety 4. At week 6 and 12 for clinical assessment before the second and third drug administration (only in the AM arm) 5. At week 24 and 48 for assessment of Schistosoma spp. and malaria infection and associated morbidity (compared to baseline)