Drugs for neglected tropical diseases: availability of age-appropriate oral formulations for young children

Abstract

It is recognised that paediatric indications and age-appropriate formulations are required to ensure that paediatric populations receive appropriate pharmacotherapeutic treatment. The lack of information on dosing, efficacy and safety data (labelling) is a well-recognised problem for all diseases affecting children. For neglected tropical diseases, the fact that they affect to a large extent poor and marginalised populations in low- and middle-income countries means that there is a low economic return on investment into paediatric development activities compared to other diseases [e.g. human immunodeficiency virus (HIV)]. This review provides an introduction to issues affecting the availability and development of paediatric population-relevant data and appropriate formulations of drugs for NTDs. We are summarising why age-appropriate formulations are important to ensure treatment efficacy, safety and effectiveness, outline initiatives to increase the number of paediatric indications/labelling and age-appropriate formulations, provide an overview of publicly available information on the formulations of oral drugs for NTDs relative to age appropriateness and give an introduction to options for age-appropriate formulations. The review completes with ‘case studies’ of recently developed paediatric formulations for NTDs, complemented by case studies for fixed-dose combinations for HIV infection in children since such formulations have not been developed for NTDs. Graphical Abstract

Feasibility and safety of integrating mass drug administration for helminth control with seasonal malaria chemoprevention among Senegalese children: a randomized controlled, observer-blind trial

“…This finding resonated with the feedback obtained through qualitative interviews conducted among the parents/caregivers of the children enrolled in this trial, during which they expressed concerns about the bitter taste, smell, and vomiting-induced effect of praziquantel [ 29 ]. Previous studies have also documented the increased incidence of these adverse events with praziquantel [ 28 , 30 ]. Amodiaquine, which is a partner drug in the SMC regimen, has also been reported to cause nausea and vomiting in children [ 31 ], but this was not a significant issue in this study.…”

Parasitic infections: what do paediatricians need to know?

“…Although some parasite infections are simple and self-limiting, others, such as schistosomiasis or strongyloidiasis infections, may have long-term implications for health, and in some cases, such as Giardia, for public health. Although antiparasitic treatment is readily available and awareness of neglected tropical diseases is increasing,2 the economic environment has led to few new products reaching the market, as reviewed recently 3. Furthermore, paediatric prescribing presents particular challenges, including lack of familiarity, limited formulation availability and palatability, and more limited safety and efficacy data.…”