Does Intensive Treatment Select for Praziquantel Resistance in High-Transmission Settings? Parasitological Trends and Treatment Efficacy Within a Cluster-Randomized Trial

Autor:	Alison M. Elliott, Jacent Nassuuna, Samuel Kiwanuka, Joel Sserubanja, Emily L. Webb, James Kaweesa, Paul L. A. M. Corstjens, Prossy Kabuubi, LaVIISWA Trial Team, Narcis B. Kabatereine, Lawrence Lubyayi, Govert J. van Dam, John Vianney Tushabe, Edridah M. Tukahebwa, Richard E. Sanya, William Ssenyonga, Elson Abayo
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	medicine.medical_specialty 030231 tropical medicine Schistosomiasis 03 medical and health sciences 0302 clinical medicine Internal medicine schistosomiasis parasitic diseases medicine Major Article 030212 general & internal medicine Mass drug administration Schistosoma mass drug administration drug resistance biology business.industry praziquantel Odds ratio medicine.disease biology.organism_classification Confidence interval Praziquantel Infectious Diseases AcademicSubjects/MED00290 Oncology Relative risk Schistosoma mansoni business medicine.drug
Zdroj:	Open Forum Infectious Diseases Open Forum Infectious Diseases, 7(4). OXFORD UNIV PRESS INC
ISSN:	2328-8957
Popis:	Background Praziquantel mass drug administration (MDA) is recommended in schistosomiasis-endemic areas. Animal models demonstrate Schistosoma parasite resistance to praziquantel after repeated exposure. Methods We conducted a parasitological survey in 26 fishing communities in Uganda after 4 years of quarterly (13 communities) or annual (13 communities) praziquantel MDA, with Schistosoma infection detected by single-stool-sample Kato-Katz. A test of cure was done in participants who were positive on both urine circulating cathodic antigen test and 3-sample Kato-Katz. We calculated cure rates (CRs) and egg reduction rates (ERRs) based on 3-sample Kato-Katz and infection intensity using worm-specific circulating anodic antigen (CAA) in blood, comparing these between quarterly and annually treated participants. Results Single-sample Kato-Katz Schistosoma mansoni prevalence was 22% in 1,056 quarterly treated participants and 34% in 1,030 annually treated participants (risk ratio, 0.62; 95% confidence interval [CI], 0.40 to 0.94). Among 110 test-of-cure participants, CRs were 65% and 51% in annually and quarterly treated villages, respectively (odds ratio, 0.65; 95% CI, 0.27 to 1.58); ERRs were 94% and 81% (difference, –13%; 95% CI, –48% to 2%). There was no impact of quarterly vs annual praziquantel on S. mansoni by CAA. Conclusions In this schistosomiasis hot spot, there was little evidence of decreased praziquantel efficacy. However, in the absence of alternative therapies, there remains a need for continued vigilance of praziquantel efficacy in the MDA era.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ab61bcdf78db568c7f366507d4967fa5 http://europepmc.org/articles/PMC7148002 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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