Dawaa Reference

infectious

Schistosomiasis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

Egyptian MOH Schistosomiasis Protocol 2020 for the national regimen, with the dose from Egyptian National Drug Formulary - Antimicrobial 2023, praziquantel monograph (endf-antimicrobial-2023.txt): "S. haematobium, Schistosoma intercalatum, or S. mansoni: Oral: 40 mg/kg/day as a single dose or in 2 divided doses for 1 day" and "S. japonicum or S. mekongi: Oral: 60 mg/kg/day in 2 -3 divided doses for 1 day". The formulary states no absolute milligram ceiling; the 3600 mg cap here is 60 mg/kg at 60 kg. · Egyptian MOH Schistosomiasis Protocol 2020 · CDC Yellow Book 2024 · WHO Schistosomiasis 2022

Verified against2 documents
  • Egyptian MOH Schistosomiasis Protocol 2020 for the national regimen, with the dose from Egyptian National Drug Formulary - Antimicrobial 2023, praziquantel monograph (endf-antimicrobial-2023.txt): "S. haematobium, Schistosoma intercalatum, or S. mansoni: Oral: 40 mg/kg/day as a single dose or in 2 divided doses for 1 day" and "S. japonicum or S. mekongi: Oral: 60 mg/kg/day in 2 -3 divided doses for 1 day". The formulary states no absolute milligram ceiling; the 3600 mg cap here is 60 mg/kg at 60 kg.
  • Egyptian MOH Schistosomiasis Protocol 2020

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (9)

  • Most people have no symptoms or only very mild, subtle complaints
  • An itchy, spotty rash can appear 2 to 7 days after larvae get through the skin during freshwater contact [itching · rash]
  • A feverish illness called Katayama fever can follow 3 to 8 weeks after the skin rash or water exposure [fever · rash]
  • Katayama fever often brings nonspecific fever, fatigue, and gut or chest symptoms, resolving on its own within 2 to 10 weeks [fatigue · fever]
  • Roughly 2 percent develop neurological features such as headache, seizures, or acute encephalopathy [headache · seizures]
  • Chronic bowel or liver disease can bring long-standing abdominal pain, intermittent diarrhoea, GI bleeding with anaemia, and progressive tiredness [abdominal pain · anaemia · bleeding · diarrhoea · fatigue]
  • Advanced portal hypertension can cause abdominal swelling, early fullness, or bleeding suggestive of varices [abdominal distension · bleeding · hypertension]
  • Gross terminal haematuria is the classic presenting complaint of urinary schistosomiasis [blood in the urine]
  • Men may also notice blood in the semen; both sexes may report dysuria, frequency, suprapubic discomfort, or pain with intercourse [abdominal pain · burning on passing urine · lower abdominal pain]

Signs — what you find (3)

  • Bleeding from the genital mucosa, unusual small blood vessels, and gritty sand-like patches over the vulva, perineum, or cervix are described [bleeding]
  • Speculum exam may reveal sandy patches, increased vascularity, and friability of the cervix or vaginal wall
  • An elevated absolute eosinophil count can be the only clue in otherwise silent chronic infection

Tests (11)

  • Kato-Katz stool microscopy is the reference test for S. mansoni, though sensitivity is limited
  • Stool testing covers S. mansoni, and also S. japonicum, S. mekongi, plus S. intercalatum; urine is the specimen for S. haematobium
  • Collecting three stool samples on separate days improves the diagnostic yield
  • Eggs seen on microscopy are large and oval, measuring 110 to 170 by 40 to 70 micrometres
  • A prominent terminal spine marks S. haematobium eggs, while a lateral spine marks S. mansoni eggs
  • Serology cannot tell active infection from past exposure in people living in endemic areas
  • Serology for acute disease is best drawn 6 to 8 weeks or more after exposure, giving antibodies time to appear
  • A point-of-care urine antigen test for circulating cathodic antigen is a specific, sensitive marker of active infection
  • Antigen levels fall over days to weeks after praziquantel treatment, useful for tracking response
  • Pelvic ultrasound can show bladder wall thickening or irregularity, hydronephrosis, polyps, or masses
  • Plain films can show bladder wall calcification in advanced disease, further characterised on CT

If not this — what else fits (6)

  • In acute disease, EBV, CMV, acute HIV, malaria, and enteric fever mimic Katayama fever
  • Strongyloidiasis, toxocariasis, rickettsial infection, and dengue or other arboviruses are also considered
  • Drug hypersensitivity should be considered, particularly when eosinophilia is present
  • Chronic hepatosplenic disease needs distinguishing from viral hepatitis, other causes of cirrhosis, noncirrhotic portal hypertension, and infiltrative liver disease
  • Urogenital disease overlaps with urinary infection, kidney stones, genitourinary TB, and a sexually transmitted infection
  • Other causes of infertility and bladder cancer are also on the urogenital differential

SourceStatPearls "Schistosomiasis" - disease-level clinical article

Presentation findings are traced to the source above.

1

PRAZIQUANTEL

1st line

Strength600 mg

Formoral.solid

Adult dose and duration

40 mg/kg single dose (or 60 mg/kg divided in 2 doses 4h apart) - single-dose

Paediatric dose

40-60 mg/kg/day [child max 3600 mg]

(Single dose or divided into 2 doses 4 hours apart; take after a meal)

Dose by weight
3kg120-180 mg/day
4kg160-240 mg/day
5kg200-300 mg/day
6kg240-360 mg/day
7kg280-420 mg/day
8kg320-480 mg/day
9kg360-540 mg/day
10kg400-600 mg/day
11kg440-660 mg/day
12kg480-720 mg/day
13kg520-780 mg/day
14kg560-840 mg/day
15kg600-900 mg/day
16kg640-960 mg/day
17kg680-1020 mg/day
18kg720-1080 mg/day
19kg760-1140 mg/day
20kg800-1200 mg/day
21kg840-1260 mg/day
22kg880-1320 mg/day
23kg920-1380 mg/day
24kg960-1440 mg/day
25kg1000-1500 mg/day
26kg1040-1560 mg/day
27kg1080-1620 mg/day
28kg1120-1680 mg/day
29kg1160-1740 mg/day
30kg1200-1800 mg/day
31kg1240-1860 mg/day
32kg1280-1920 mg/day
33kg1320-1980 mg/day
34kg1360-2040 mg/day
35kg1400-2100 mg/day
36kg1440-2160 mg/day
37kg1480-2220 mg/day
38kg1520-2280 mg/day
39kg1560-2340 mg/day
40kg1600-2400 mg/day
41kg1640-2460 mg/day
42kg1680-2520 mg/day
43kg1720-2580 mg/day
44kg1760-2640 mg/day
45kg1800-2700 mg/day
46kg1840-2760 mg/day
47kg1880-2820 mg/day
48kg1920-2880 mg/day
49kg1960-2940 mg/day
50kg2000-3000 mg/day
Dose source

Egyptian MOH Schistosomiasis Protocol 2020 for the national regimen, with the dose from Egyptian National Drug Formulary - Antimicrobial 2023, praziquantel monograph (endf-antimicrobial-2023.txt): "S. haematobium, Schistosoma intercalatum, or S. mansoni: Oral: 40 mg/kg/day as a single dose or in 2 divided doses for 1 day" and "S. japonicum or S. mekongi: Oral: 60 mg/kg/day in 2 -3 divided doses for 1 day". The formulary states no absolute milligram ceiling; the 3600 mg cap here is 60 mg/kg at 60 kg.

Why

Praziquantel is the sole listed treatment because it is the only drug in routine use; oxamniquine was withdrawn globally.

Cautions
  • Egyptian MOH: 40 mg/kg for S. haematobium, 60 mg/kg for S. mansoni
  • Abdominal pain may occur due to dead worm expulsion.
  • This is a bitter tablet - take it with liquid during a meal without chewing.
  • Dizziness and headache are common; do not drive for 24 hours.
Egyptian brands
Egyptian brandManufacturerIndicative price
PRAZIQUANTEL 600MG 4 F.C. TAB.UP PHARMA6.25 EGP (1.56/unit)
PRAZIQUANTEL 600MG 4 F.C.TAB.SEDICO6.50 EGP (1.62/unit)
EPIQUANTEL 600MG 4 F.C. TABS.EIPICO32.00 EGP (8.00/unit)
BILTRICIDE 600 MG 4 F.C.TABS.ALEXANDRIA33.00 EGP (8.25/unit)
SCHISTOCIDE 600MG/5ML SUSP. 15ML? strength differs? different route - not oral solidDELTA PHARMA7.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.