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

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Walker, Martin, Mabud, Tarub S, Olliaro, Piero L, Coulibaly, Jean T, King, Charles H, Raso, Giovanna, Scherrer, Alexandra U, Stothard, Russell ORCID: https://orcid.org/0000-0002-9370-3420, Sousa-Figueiredo, José Carlos, Stete, Katarina, Utzinger, Jürg and Basáñez, Maria-Gloria (2016) 'New approaches to measuring anthelminthic drug efficacy: parasitological responses of childhood schistosome infections to treatment with praziquantel'. Parasites & Vectors, Vol 9, Issue 41.

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Abstract

Background
By 2020, the global health community aims to control and eliminate human helminthiases, including schistosomiasis in selected African countries, principally by preventive chemotherapy (PCT) through mass drug administration (MDA) of anthelminthics. Quantitative monitoring of anthelminthic responses is crucial for promptly detecting changes in efficacy, potentially indicative of emerging drug resistance. Statistical models offer a powerful means to delineate and compare efficacy among individuals, among groups of individuals and among populations.

Methods
We illustrate a variety of statistical frameworks that offer different levels of inference by analysing data from nine previous studies on egg counts collected from African children before and after administration of praziquantel.

Results
We quantify responses to praziquantel as egg reduction rates (ERRs), using different frameworks to estimate ERRs among population strata, as average responses, and within strata, as individual responses. We compare our model-based average ERRs to corresponding model-free estimates, using as reference the World Health Organization (WHO) 90 % threshold of optimal efficacy. We estimate distributions of individual responses and summarize the variation among these responses as the fraction of ERRs falling below the WHO threshold.

Conclusions
Generic models for evaluating responses to anthelminthics deepen our understanding of variation among populations, sub-populations and individuals. We discuss the future application of statistical modelling approaches for monitoring and evaluation of PCT programmes targeting human helminthiases in the context of the WHO 2020 control and elimination goals.

Item Type: Article
Subjects: QV Pharmacology > QV 38 Drug action.
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 810 Schistosomiasis
WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 200 General works
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1186/s13071-016-1312-0
Depositing User: Jessica Jones
Date Deposited: 11 Mar 2016 12:46
Last Modified: 06 Feb 2018 13:12
URI: http://archive.lstmed.ac.uk/id/eprint/5755

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