Preventive chemotherapy for schistosomiasis and soil-transmitted helminthiasis by cotreatment with praziquantel and albendazole

Abstract

Clin. Invest. (2014) 4(2), 163-176In disease-endemic areas, preventive chemotherapy with two orally administered anthelminthic drugs, praziquantel and albendazole, forms the foundation of control of schistosomiasis and soil-transmitted helminthiasis. Where diseases overlap, these two drugs are typically co-administered simultaneously, although albendazole is often interchangeable with mebendazole. With a supportive pharmaceutical industry that donates drugs and a strong international partnership that mobilizes donor funds for drug delivery, scale-up of treatment in school-aged children has expanded significantly in line with the WHO 2012-2020 strategic plan. Other high-risk groups, such as pre-school-aged children, are now benefiting from deworming campaigns conducted alongside other childhood interventions, such as vaccination, less so, however, for schistosomiasis as infections in this age class are not being treated. Looking to the future, maintaining an effective drug distribution and reporting system that regularly checks anthelminthic performance alongside documenting improvements in child health are essential for the long-term success of preventive chemotherapy with praziquantel and albendazole.

Changing Policy and Practice in the Control of Pediatric Schistosomiasis

“…Exclusion of these children from mass drug administration (MDA) programs is similar to treatment strategies 2 decades ago for soil-transmitted helminths (STHs). 3 In the case of STHs, because of the concerted attempts to produce an evidence base for the inclusion of preschool-aged children in MDA programs using the anthelminthics albendazole and mebendazole, as well as advocacy efforts (as noted by Stothard et al 3 ), these children are now included in STH control programs. 4 Primary schoolchildren in some helminthendemic areas are benefiting from mass drug coadministration of PZQ and albendazole or mebendazole (eg, Zimbabwe).…”

Equitable control of schistosomiasis and helminthiasis

“…[1][2][3][4] Set within a global strategy of preventive chemotherapy, as endorsed by WHO, the frontline public health method is routine co-administration by mass drug administration (MDA), of the anthelmintics praziquantel against schistosomiasis and albendazole against soiltransmitted helminth iasis. 5,6 In 2001, an ambitious target was set within resolution 54.19 of the World Health Assembly to attain regular treatment coverage of at least 75% in all school-age children at risk of morbidity. With noted progress falling short of this target by 2010, in January, 2012, several substantial pledges and commitments were made at the London Declaration on NTDs with an additional World Health Assembly resolution 65.21, and both called for intensifi cation of eff orts to better rally resources and to ensure an adequate provision of medications.…”

“…4 In low-income and middle-income countries, little is known about the role of group B streptococcus in neonatal deaths. 5 Disease estimates in these countries might be an underestimation of the true disease burden because the need for selective growth media to identify group B streptococcus has been under-recognised. 5,6 Group B streptococcus acquisition occurs through vertical transmission in 15-50% of infants born to a group B streptococcus colonised mother.…”

“…5 Disease estimates in these countries might be an underestimation of the true disease burden because the need for selective growth media to identify group B streptococcus has been under-recognised. 5,6 Group B streptococcus acquisition occurs through vertical transmission in 15-50% of infants born to a group B streptococcus colonised mother. 7 Maternal colonisation is a prerequisite for early-onset and a risk factor for late-onset disease.…”

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“…Intestinal helminthic infections often lead to iron deficiency anemia (IDA), protein-energy malnutrition, stunting (a measure of chronic under nutrition), wasting (a measure of acute under nutrition), listlessness and abdominal pain and may negatively affect classattentiveness of school children. The tropical climate and poor hygienic conditions under which the socioeconomically deprived rural dwellers live facilitate the development and transmission of these helminthes infections [4,5].…”