Evaluation of the therapeutic efficacy of praziquantel against schistosomes in seven countries with ongoing large-scale deworming programs.

Autor:	Levecke B; Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Belgium. Electronic address: bruno.levecke@ugent.be., Vlaminck J; Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Belgium., Andriamaro L; Reseau International Schistosomiase Environnement Amenagement et Lutte (RISEAL), Madagascar., Ame S; Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, United Republic of Tanzania., Belizario V; Department of Parasitology, College of Public Health, University of the Philippines, Manilla, Philippines., Degarege A; Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA., Engels D; Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland., Erko B; Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia., Garba AD; Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland., Kaatano GM; National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza City, United Republic of Tanzania., Mekonnen Z; Jimma University Institute of Health, Jimma University, Jimma, Ethiopia., Montresor A; Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland., Olliaro P; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Pieri OS; Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil., Sacko M; Service de Parasitologie, Institut National de Recherche en Santé Publique, Bamako, Mali., Sam-Wobo SO; Department of Pure and Applied Zoology, Federal University of Agriculture Abeokuta, Nigeria., Tchuem Tchuenté LA; Centre for Schistosomiasis and Parasitology, Faculty of Sciences, University of Yaoundé I, Cameroon., Webster JP; Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, UK., Vercruysse J; Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Belgium.
Jazyk:	angličtina
Zdroj:	International journal for parasitology. Drugs and drug resistance [Int J Parasitol Drugs Drug Resist] 2020 Dec; Vol. 14, pp. 183-187. Date of Electronic Publication: 2020 Oct 17.
DOI:	10.1016/j.ijpddr.2020.10.003
Abstrakt:	The World Health Organization (WHO) recommends periodic assessment of the therapeutic efficacy of praziquantel (PZQ) to detect reduced efficacy that may arise from drug resistance in schistosomes. In this multi-country study (2014), we assessed the therapeutic efficacy of a single oral dose of PZQ (40 mg/kg) against Schistosoma mansoni (Brazil, Cameroon, Ethiopia, Mali, Madagascar and Tanzania), S. haematobium (Cameroon, Ethiopia, Mali, Tanzania and Zanzibar) and S. japonicum (the Philippines) infections in school-aged children, across a total of 12 different trials. Each trial was performed according to the standardized methodology for evaluating PZQ efficacy as described by the WHO. Overall, therapeutic efficacy, measured as the reduction in arithmetic mean of schistosome egg counts following drug administration (egg reduction rate; ERR), was high for all three schistosome species (S. mansoni: 93.4% (95%CI: 88.8-96.8); S. haematobium: 97.7% (95%CI: 96.5-98.7) and S. japonicum: 90.0% (95%CI: 68.4-99.3). At the trial level, therapeutic efficacy was satisfactory (point estimate ERR ≥90%) for all three Schistosoma species with the exception of S. mansoni in Cameroon where the ERR was 88.5% (95%CI: 79.0-95.1). Furthermore, we observed that in some trials individual drug response could vary significantly (wide 95%CI) and that few non-responsive individuals could significantly impact ERR point estimates. In conclusion, these results do not suggest any established reduced efficacy of the standard PZQ treatment to any of the three schistosome species within these countries. Nevertheless, the substantial degree of variation in individual responses to treatment in some countries underpins the need for future monitoring. The reported ERR values serve as reference values to compare with outcomes of future PZQ efficacy studies to ensure early detection of reduced efficacies that could occur as drug pressure continues increase. Finally, this study highlights that 95%CI should be considered in WHO guidelines to classify the therapeutic efficacy of PZQ. (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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