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3. Impact of Annual Albendazole versus Four-Monthly Test-and-Treat Approach of Intestinal Parasites on Children Growth—A Longitudinal Four-Arm Randomized Parallel Trial during Two Years of a Community Follow-Up in Bengo, Angola

Author

Gasparinho, Carolina, primary, Kanjungo, Aguinaldo, additional, Zage, Félix, additional, Clemente, Isabel, additional, Santos-Reis, Ana, additional, Brito, Miguel, additional, Sousa-Figueiredo, José Carlos, additional, Fortes, Filomeno, additional, and Gonçalves, Luzia, additional

Published
2021
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4. Efficacy and safety of single-dose 40 mg/kg oral praziquantel in the treatment of schistosomiasis in preschool-age versus school-age children: An individual participant data meta-analysis

Author

Olliaro, Piero L., primary, Coulibaly, Jean T., additional, Garba, Amadou, additional, Halleux, Christine, additional, Keiser, Jennifer, additional, King, Charles H., additional, Mutapi, Francisca, additional, N’Goran, Eliézer K., additional, Raso, Giovanna, additional, Scherrer, Alexandra U., additional, Sousa-Figueiredo, José Carlos, additional, Stete, Katarina, additional, Utzinger, Jürg, additional, and Vaillant, Michel T., additional

Published
2020
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5. Efficacy and safety of single 40 mg/kg oral praziquantel in the treatment of schistosomiasis in preschool-age versus school-age children: An individual participant data meta-analysis.

Author

Olliaro, Piero L., Coulibaly, Jean T., Garba, Amadou, Halleux, Christine, Keiser, Jennifer, King, Charles H., Mutapi, Francisca, N'Goran, Eliézer K., Raso, Giovanna, Scherrer, Alexandra U., Sousa-Figueiredo, José Carlos, Stete, Katarina, Utzinger, Jürg, and Vaillant, Michel T.

Subjects
PRAZIQUANTEL, RANDOM effects model, SCHISTOSOMA mansoni, HELMINTHS, ARITHMETIC mean
Abstract

Background: Better knowledge of the efficacy and safety of single 40 mg/kg oral praziquantel in preschool-age children is required, should preventive chemotherapy programs for schistosomiasis be expanded to include this age group. Methodology: We analyzed individual participant-level data from 16 studies (13 single-arm or cohort studies and three randomized trials), amounting to 683 preschool-age children (aged <6 years) and 2,010 school-age children (aged 6–14 years). Children had a documented Schistosoma mansoni or S. haematobium infection, were treated with single 40 mg/kg oral praziquantel, and assessed between 21 and 60 days post-treatment. Efficacy was expressed as arithmetic mean and individual egg reduction rate (ERR) and meta-analyzed using general linear models and mixed models. Safety was summarized using reported adverse events (AEs). Principal findings: Preschool-age children had significantly lower baseline Schistosoma egg counts and more losses to follow-up compared to school-age children. No difference in efficacy was found between preschool- and school-age children using a general linear model of individual-participant ERR with baseline log-transformed egg count as covariate and study, age, and sex as fixed variables, and a mixed model with a random effect on the study. Safety was reported in only four studies (n = 1,128 individuals); few AEs were reported in preschool-age children 4 and 24 hours post-treatment as well as at follow-up. Three severe but not serious AEs were recorded in school-age children during follow-up. Conclusions/Significance: There is no indication that single 40 mg/kg oral praziquantel would be less efficacious and safe in preschool-age children compared to school-age children, with the caveat that only few randomized comparisons exist between the two age groups. Preventive chemotherapy might therefore be extended to preschool-age children, with proper monitoring of its efficacy and safety. Author summary: Schistosomiasis is a diseases caused by helminths (parasitic worms) which affects the intestinal and urinary systems. In areas where schistosomiasis is endemic, the disease is controlled by the large scale distributing of praziquantel, primarily targeting school-age children. Younger children (preschool-age) too might be affected by schistosomiasis, but are currently not receiving praziquantel within treatment campaigns. Instead, preschool-age children are treated on a case-by-case basis because the current praziquantel formulation is not adapted to young children. Questions have also been raised as to whether the standard dose of 40 mg/kg given once is effective in preschool-age children. To answer this question, we collected individual-participant data from a series of studies in which 40 mg/kg of praziquantel had been given to children with intestinal or urogenital schistosomiasis, and compared its efficacy and tolerability across age-groups. Since few direct comparisons had been made, we used statistical tools to make these comparisons. We found no evidence that treatment is less efficacious in preschool- than in school-age children and conclude that 40 mg/kg praziquantel may be given to preschool-age children in large-scale programs. When this happens, efficacy and tolerability will have to be closely monitored. [ABSTRACT FROM AUTHOR]

Published
2020
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6. New approaches to measuring anthelminthic drug efficacy: parasitological responses of childhood schistosome infections to treatment with praziquantel

Author

Walker, Martin, primary, Mabud, Tarub S., additional, Olliaro, Piero L., additional, Coulibaly, Jean T., additional, King, Charles H., additional, Raso, Giovanna, additional, Scherrer, Alexandra U., additional, Stothard, J. Russell, additional, Sousa-Figueiredo, José Carlos, additional, Stete, Katarina, additional, Utzinger, Jürg, additional, and Basáñez, Maria-Gloria, additional

Published
2016
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7. Toward measuring schistosoma response to praziquantel treatment with appropriate descriptors of egg excretion

Author

Olliaro, Piero L, Vaillant, Michel, Diawara, Aïssatou, Coulibaly, Jean T, Garba, Amadou, Keiser, Jennifer, King, Charles H, Knopp, Stefanie, Landouré, Aly, N'Goran, Eliézer K, Raso, Giovanna, Scherrer, Alexandra U, Sousa-Figueiredo, José Carlos, Stete, Katarina, Zhou, Xiao-Nong, Utzinger, Jürg, Olliaro, Piero L, Vaillant, Michel, Diawara, Aïssatou, Coulibaly, Jean T, Garba, Amadou, Keiser, Jennifer, King, Charles H, Knopp, Stefanie, Landouré, Aly, N'Goran, Eliézer K, Raso, Giovanna, Scherrer, Alexandra U, Sousa-Figueiredo, José Carlos, Stete, Katarina, Zhou, Xiao-Nong, and Utzinger, Jürg

Abstract

BACKGROUND: The control of schistosomiasis emphasizes preventive chemotherapy with praziquantel, which aims at decreasing infection intensity and thus morbidity in individuals, as well as transmission in communities. Standardizing methods to assess treatment efficacy is important to compare trial outcomes across settings, and to monitor program effectiveness consistently. We compared customary methods and looked at possible complementary approaches in order to derive suggestions for standardizing outcome measures. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed data from 24 studies conducted at African, Asian, and Latin American sites, enrolling overall 4,740 individuals infected with Schistosoma mansoni, S. haematobium, or S. japonicum, and treated with praziquantel at doses of 40-80 mg/kg. We found that group-based arithmetic and geometric means can be used interchangeably to express egg reduction rates (ERR) only if treatment efficacy is high (>95%). For lower levels of efficacy, ERR estimates are higher with geometric than arithmetic means. Using the distribution of individual responses in egg excretion, 6.3%, 1.7% and 4.3% of the subjects treated for S. haematobium, S. japonicum and S. mansoni infection, respectively, had no reduction in their egg counts (ERR = 0). The 5th, 10th, and 25th centiles of the subjects treated for S. haematobium had individual ERRs of 0%, 49.3%, and 96.5%; the corresponding values for S. japonicum were 75%, 99%, and 99%; and for S. mansoni 18.2%, 65.3%, and 99.8%. Using a single rather than quadruplicate Kato-Katz thick smear excluded 19% of S. mansoni-infected individuals. Whilst the effect on estimating ERR was negligible by individual studies, ERR estimates by arithmetic means were 8% lower with a single measurement. CONCLUSIONS/SIGNIFICANCE: Arithmetic mean calculations of Schistosoma ERR are more sensitive and therefore more appropriate to monitor drug performance than geometric means. However, neither are satisfactory to identify p

Published
2015

8. Mapping of Schistosomiasis and Soil-Transmitted Helminths in Namibia: The First Large-Scale Protocol to Formally Include Rapid Diagnostic Tests

Author

Sousa-Figueiredo, José Carlos, primary, Stanton, Michelle C., additional, Katokele, Stark, additional, Arinaitwe, Moses, additional, Adriko, Moses, additional, Balfour, Lexi, additional, Reiff, Mark, additional, Lancaster, Warren, additional, Noden, Bruce H., additional, Bock, Ronnie, additional, and Stothard, J. Russell, additional

Published
2015
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9. Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion

Author

Olliaro, Piero L., primary, Vaillant, Michel, additional, Diawara, Aïssatou, additional, Coulibaly, Jean T., additional, Garba, Amadou, additional, Keiser, Jennifer, additional, King, Charles H., additional, Knopp, Stefanie, additional, Landouré, Aly, additional, N’Goran, Eliézer K., additional, Raso, Giovanna, additional, Scherrer, Alexandra U., additional, Sousa-Figueiredo, José Carlos, additional, Stete, Katarina, additional, Zhou, Xiao-Nong, additional, and Utzinger, Jürg, additional

Published
2015
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18. Investigating portable fluorescent microscopy (CyScope®) as an alternative rapid diagnostic test for malaria in children and women of child-bearing age

Author

Sousa-Figueiredo, José Carlos, primary, Oguttu, David, additional, Adriko, Moses, additional, Besigye, Fred, additional, Nankasi, Andrina, additional, Arinaitwe, Moses, additional, Namukuta, Annet, additional, Betson, Martha, additional, Kabatereine, Narcis B, additional, and Stothard, J Russell, additional

Published
2010
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19. Various pfcrtand pfmdr1Genotypes of Plasmodium falciparumCocirculate with P. malariae, P. ovalespp., and P. vivaxin Northern Angola

Author

Fançony, Cláudia, Gamboa, Dina, Sebastião, Yuri, Hallett, Rachel, Sutherland, Colin, Sousa-Figueiredo, José Carlos, and Nery, Susana Vaz

Abstract

ABSTRACTArtemisinin-based combination therapy for malaria has become widely available across Africa. Populations of Plasmodium falciparumthat were previously dominated by chloroquine (CQ)-resistant genotypes are now under different drug selection pressures. P. malariae, P. ovale curtisi, and P. ovale wallikeriare sympatric with P. falciparumacross the continent and are frequently present as coinfections. The prevalence of human Plasmodiumspecies was determined by PCR using DNA from blood spots collected during a cross-sectional survey in northern Angola. P. falciparumwas genotyped at resistance-associated loci in pfcrtand pfmdr1by real-time PCR or by direct sequencing of amplicons. Of the 3,316 samples collected, 541 (16.3%) contained Plasmodiumspecies infections; 477 (88.2%) of these were P. falciparumalone, 6.5% were P. falciparumand P. malariaetogether, and 1.1% were P. vivaxalone. The majority of the remainder (3.7%) harbored P. ovale curtisior P. ovale wallikerialone or in combination with other species. Of 430 P. falciparumisolates genotyped for pfcrt, 61.6% carried the wild-type allele CVMNK at codons 72 to 76, either alone or in combination with the resistant allele CVIET. No other pfcrtallele was found. Wild-type alleles dominated at codons 86, 184, 1034, 1042, and 1246 of the pfmdr1locus among the sequenced isolates. In contrast to previous studies, P. falciparumin the study area comprises an approximately equal mix of genotypes associated with CQ sensitivity and with CQ resistance, suggesting either lower drug pressure due to poor access to treatment in rural areas or a rapid impact of the policy change away from the use of standard monotherapies.

Published
2012
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