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Randomized Controlled Trial
. 2018 Dec 1:51:233-240.
doi: 10.1016/j.phymed.2018.10.014. Epub 2018 Oct 10.

Effect of Artemisia annua and Artemisia afra tea infusions on schistosomiasis in a large clinical trial

Jérôme Munyangi  1 , Lucile Cornet-Vernet  2 , Michel Idumbo  3 , Chen Lu  4 , Pierre Lutgen  5 , Christian Perronne  6 , Nadège Ngombe  7 , Jacques Bianga  8 , Bavon Mupenda  9 , Paul Lalukala  10 , Guy Mergeai  11 , Dieudonné Mumba  12 , Melissa Towler  13 , Pamela Weathers  13
Affiliations
Randomized Controlled Trial

Effect of Artemisia annua and Artemisia afra tea infusions on schistosomiasis in a large clinical trial

Jérôme Munyangi et al. Phytomedicine. .

Retraction in

Abstract

Background and objective: Schistosomiasis (bilharzia), a serious neglected tropical disease affecting millions, has few cost-effective treatments, so two Artemisia wormwood species, A. annua and A. afra, were compared with the current standard praziquantel (PZQ) treatment in an 800 patient clinical trial, August-November of 2015.

Methods: The double blind, randomized, superiority clinical trial had three treatment arms: 400 for PZQ, 200 for A. annua, and 200 for A. afra. PZQ-treated patients followed manufacturer posology. Artemisia-treated patients received 1 l/d of dry leaf/twig tea infusions divided into 3 aliquots daily, for 7 days with 28-day follow-up.

Results: Of 800 enrolled patients having an average of >700 Schistosoma mansoni eggs per fecal sample, 780 completed the trial. Within 14 days of treatment, all Artemisia-treated patients had no detectable eggs in fecal smears, a result sustained 28 days post treatment. Eggs in fecal smears of PZQ-treated patients were undetectable after D21. More males than females who entered the trial had melena, but both genders responded equally well to treatment; by D28 melena disappeared in all patients. In all arms, eosinophil levels declined by about 27% from D0 to D28. From D0 to D28 hemoglobin increases were greater in PZQ and A. afra-treated patients than in A. annua-treated patients. Hematocrit increases were greater from D0 to D28 for patients treated with either PZQ or A. annua compared to those treated with A. afra. Gender comparison showed that A. afra-treated males had significantly greater hemoglobin and hematocrit increases by D28 than either PZQ or A. annua-treated males. In contrast, PZQ and A. afra-treated females had greater hemoglobin and hematocrit increases than A. annua-treated females. Both adults and pediatric patients treated with A. annua responded better compared to PZQ treatment.

Conclusion: Both A. annua and A. afra provided faster effective treatment of schistosomiasis and should be considered for implementation on a global scale.

Keywords: Artemisia; Artemisinin; Bilharzia; Tea infusion; Wormwood.

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Conflict of interest statement

Conflict of interest

We confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this study that could have influenced its outcome.

Figures

Fig. 1.
Fig. 1.
Study design. PZQ, praziquantel.
Fig. 2.
Fig. 2.
Eggs disappeared faster in fecal samples and within 14 days for both A. annua and A. afra-treated patients compared to those treated with PZQ (praziquantel).
Fig. 3.
Fig. 3.
Log rank analysis of cumulative egg survival after treatment with A. annua, A. afra, or PZQ (praziquantel).
Fig. 4.
Fig. 4.
Serum differences in patients treated with praziquantel (PZQ), A. annua, and A. afra. A, eosinophil (%); B, hemoglobin (g/dl); C, hematocrit (%).
See this image and copyright information in PMC

Comment in

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