Managing anthelmintic resistance: modelling strategic use of a new anthelmintic class to slow the development of resistance to existing classes

Benchmarking Australian sheep parasite control: Changes in gastrointestinal nematode control practices reported from surveys between 2003 and 2019

Cross-sectional surveys of sheep parasite control practices in Australia were conducted in 2004, 2012 and 2019 to document parasite problems, control practices and measure change over time. This article reports the results pertaining to gastrointestinal nematode infection; comparisons between years are mostly descriptive and not based on statistical inference. There was a general increase in the use of grazing management to prepare clean pastures for sheep to control gastrointestinal nematode infections with the largest increases in the use of: cropping, long acting anthelmintics to prepare clean pastures, feeding strategies, selecting rams for resistance to nematodes, and leaving some sheep untreated. The proportion of respondents using faecal worm egg count monitoring (WEC) and the number of WEC monitors per year were similar in 2003 (weaners: 3.0 WEC/year, adult ewes: 2.6 WEC/year) and 2018 (lambs and weaners and adult ewes both 3.1 WEC/year) but lower in 2011(lambs and weaners: 2.0 WEC/year, adult ewes: 2.9 WEC/year), whilst there was a higher number of anthelmintic treatments given in 2011 than 2003 and 2018 which were similar. There was an increase in the proportion of respondents carrying out WEC monitors themselves from 2011 (21%) to 2018 (30%) and a corresponding reduction in the use of private laboratories, government laboratories and veterinarians with regional differences in who carried out WECs. The top three anthelmintic groups used did not differ between the three survey years with macrocyclic lactones the most used followed by benzimidazoles (BZ) and levamisole (LEV) although the percentage of MLs used in 2011 and 2018 was lower than in 2003 with higher proportions of respondents using BZ and LEV groups in the latter two survey years. Moxidectin was in the most commonly used active in all survey years. There was an increase in the use of combination of anthelmintics from different groups, especially for a combination of three anthelmintics (2003: 4.4%, 2011: 19.1%, 2018: 21.5%), with lower use of single anthelmintics in 2011 (57.0%) and 2018 (55.4%) compared with 2003 (74.5%). The use of testing for anthelmintic resistance was generally low across the survey years with a lower proportion of respondents using tests in 2011 and 2018 than in 2003 (2003:48%, 2011: 29%, 2018: 37%). Time of year, results from WEC and seasonal weather condition were the most important factors when deciding when to apply anthelmintic treatment.

A journey through 50 years of research relevant to the control of gastrointestinal nematodes in ruminant livestock and thoughts on future directions

This review article provides an historical perspective on some of the major research advances of relevance to ruminant livestock gastrointestinal nematode control over the last 50 years. Over this period, gastrointestinal nematode control has been dominated by the use of broad-spectrum anthelmintic drugs. Whilst this has provided unprecedented levels of successful control for many years, this approach has been gradually breaking down for more than two decades and is increasingly unsustainable which is due, at least in part, to the emergence of anthelmintic drug resistance and a number of other factors discussed in this article. We first cover the remarkable success story of the discovery and development of broad-spectrum anthelmintic drugs, the changing face of anthelmintic drug discovery research and the emergence of anthelmintic resistance. This is followed by a review of some of the major advances in the increasingly important area of non-pharmaceutical gastrointestinal nematode control including immunology and vaccine development, epidemiological modelling and some of the alternative control strategies such as breeding for host resistance, refugia-based methods and biological control. The last 50 years have witnessed remarkable innovation and success in research aiming to improve ruminant livestock gastrointestinal nematode control, particularly given the relatively small size of the research community and limited funding. In spite of this, the growing global demand for livestock products, together with the need to maximise production efficiencies, reduce environmental impacts and safeguard animal welfare - as well as specific challenges such as anthelmintic drug resistance and climate change- mean that gastrointestinal nematode researchers will need to be as innovative in the next 50 years as in the last.

What Modeling Parasites, Transmission, and Resistance Can Teach Us

Veterinarians and farmers must contend with the development of drug resistance and climate variability, which threaten the sustainability of current parasite control practices. Field trials evaluating competing strategies for controlling parasites while simultaneously slowing the development of resistance are time consuming and expensive. In contrast, modelling studies can rapidly explore a wide range of scenarios and have generated an array of decision support tools for veterinarians and farmers such as real-time weather-dependent infection risk alerts. Models have also been valuable for predicting the development of anthelmintic resistance, evaluating the sustainability of current parasite control practices and promoting the responsible use of novel anthelmintics.

Multigeneric resistance to monepantel on a UK sheep farm

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Multigeneric monepantel resistance detected in UK sheep flock.

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Teladorsagia, Trichostrongylus and Oesophagostomum genera implicated post treatment.

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Monepantel efficacy based on worm burden reduction ranged from 22 to 78%.

The amino acetonitrile derivative, monepantel, represented the first new broad spectrum anthelmintic to be brought to market for use in sheep for over 25 years when it was introduced in 2009. This study characterised monepantel efficacy, using faecal egg count reduction and controlled efficacy tests, against gastrointestinal nematodes following a report of treatment failure in a UK lowland sheep flock. Twelve lambs were each artificially administered 15,000 infective larvae that had been propagated from lamb faeces collected from the farm of interest. The controlled efficacy test showed that a recommended dose rate of monepantel (2.5 mg/kg body weight) administered at day 28 post infection was ineffective at removing the infection in the treated lambs. The result demonstrated simultaneous resistance to monepantel in Teladorsagia circumcincta, Trichostrongylus vitrinus and Oesophagostomum venulosum with efficacies based on adult worm burden reductions, compared to untreated controls, of 78%, 27% and 22% respectively. Monepantel efficacy based on undifferentiated egg count in treated animals, seven day post administration, compared to untreated controls was 85%. The results raise questions about the origins of, and predisposing factors for, resistance development in the three different species, and reinforces the value of differentiating post treatment faecal egg counts to genus or species level.

Farmer Behavior and Gastrointestinal Nematodes in Ruminant Livestock-Uptake of Sustainable Control Approaches

Gastrointestinal nematode (GIN) infections are a common constraint in pasture-based herds and cause a decrease in animal health, productivity and farm profitability. Current control practices to prevent production losses of GIN infections in livestock depend largely on the use of anthelmintic drugs. However, due to the continued use of these drugs over more than three decades, the industry is now increasingly confronted with nematode populations resistant to the available anthelmintics. This emerging anthelmintic resistance (AR) in cattle nematodes emphasizes the need for a change toward more sustainable control approaches that limit, prevent or reverse the development of AR. The uptake of diagnostic methods for sustainable control could enable more informed treatment decisions and reduce excessive anthelmintic use. Different diagnostic and targeted or targeted selective anthelmintic control approaches that slow down the selection pressure for anthelmintic resistance have been developed and evaluated recently. Now it is time to transform these insights into guidelines for sustainable control and communicate them across the farmer community. This article reviews the current uptake of such sustainable practices with a focus on farmer's socio-psychological factors affecting this uptake. We investigate communication as a possible tool to change current behavior and successfully implement more sustainable anthelmintic treatment strategies.

Worm Control in Livestock: Bringing Science to the Field

Parasitic roundworm infections are ubiquitous in grazing livestock. Chemical control through the frequent 'blanket' administration of anthelmintics (wormers) has been, and remains, the cornerstone in controlling these infections, but this practice is unsustainable. Alternative strategies are available but, even with the plethora of best practice advice available, have yet to be integrated into routine farming practice. This is probably due to a range of factors, including contradictory advice from different sources, changes to advice following increased scientific understanding, and top-down knowledge exchange patterns. In this article, we discuss the worm control options available, the translation of new best practice advice from science bench to field, and ideas for future work and directions.

Comparative pharmacokinetic and pharmacodynamic response of single and double intraruminal doses of ivermectin and moxidectin in nematode-infected lambs

AIMS

To compare the pharmacokinetics, distribution and efficacy (pharmacodynamic response) of intraruminal ivermectin (IVM) and moxidectin (MXD) administered at 0.2 and 0.4 mg/kg to naturally nematode-infected lambs, and to determine the ex vivo accumulation of these anthelmintics by Haemonchus contortus.

METHODS

Romney Marsh lambs, naturally infected with IVM-resistant H. contortus, were allocated to treatment groups based on faecal nematode egg counts. They received 0.2 or 0.4 mg/kg IVM or MXD (n=10 per group), or no treatment (Control; n=6), on Day 0. Samples from four animals from each treatment group, including abomasal parasites, were obtained on Day 1. Plasma samples were also collected from Day 0 to 14, and a faecal egg count reduction test (FECRT) and a controlled efficacy trial were carried out on Day 14. Concentrations of IVM and MXD in plasma, in abomasal and intestinal tissues and in H. contortus were evaluated by high-performance liquid chromatography. Additionally, the ex vivo drug accumulation of IVM and MXD by H. contortus was determined.

RESULTS

Peak plasma concentrations and the area under the concentration vs. time curve for both IVM and MXD were higher for 0.4 than 0.2 mg/kg treatments (p<0.05), but there were no differences for other parameters. Concentrations of IVM and MXD in the gastrointestinal target tissues and in H. contortus were higher compared to those measured in plasma. Concentrations of both drugs in H. contortus were correlated with those observed in the abomasal content (r=0.86; p<0.0001). The exposure of H. contortus to IVM and MXD was related to the administered dose. Mean FECRT and efficacy for removal of adult H. contortus was 0% for IVM at 0.2 and 0.4 mg/kg. For MXD, FECRT were >95% for both treatments, and efficacy against H. contortus was 85.1% and 98.1% for 0.2 and 0.4 mg/kg, respectively. The ex vivo accumulation of IVM and MXD in H. contortus was directly related to the drug concentration present in the environment and was influenced by the duration of exposure.

CONCLUSION

Administration of IVM and MXD at 0.4 compared with 0.2 mg/kg accounted for enhanced drug exposure in the target tissues, as well as higher drug concentrations within resistant nematodes. The current work is a further contribution to the evaluation of the relationship between drug efficacy and basic pharmacological issues in the presence of resistant parasite populations.

Evidence for reversion towards anthelmintic susceptibility in Teladorsagia circumcincta in response to resistance management programmes

Maintaining production and economic viability in the face of resistance to multiple anthelmintic actives is a challenge for farmers in many countries. In this situation, most farmers in New Zealand rely on the use of combination products, containing multiple actives with similar spectra of activity, in order to maintain control. However, there are concerns that use of combinations, once resistance has already developed to the individual actives, could rapidly lead to complete failure of all actives. This study followed seven farms, previously diagnosed with resistance to at least two classes of anthelmintic, which were implementing a tailored programme of 'best practice parasite management'. The aim was to ascertain whether the programmes, which included the almost exclusive use of combination anthelmintics, were able to prevent resistance from developing further. Strategies implemented on each farm varied, but had consistent underlying principles i.e. to avoid over-use of anthelmintics; to minimise parasite challenge to susceptible stock; to maintain refugia of susceptibility and to ensure that only effective anthelmintics were used. Annual faecal egg count reduction tests (FECRT) were undertaken in lambs on all farms to monitor anthelmintic efficacy over 5 years. The efficacy of albendazole, ivermectin and levamisole was calculated and the changes in efficacy against Teladorsagia circumcincta assessed. Overall, there was a significant improvement in the effectiveness of both levamisole and ivermectin against T. circumcincta, and a positive but non-significant trend in efficacy of albendazole, i.e. there was evidence for reversion towards susceptibility. Hence, the almost exclusive use of combination anthelmintics, integrated with other resistance management strategies, did not result in further resistance development despite all farms exhibiting resistance to multiple actives at the outset. What-is-more, the measured increases in anthelmintic efficacy suggests that adoption of best practice management strategies may extend the useful life of anthelmintics even after resistance has been diagnosed.

A systematic review and meta-analysis of factors associated with anthelmintic resistance in sheep

BACKGROUND

Anthelmintic drugs have been widely used in sheep as a cost-effective means for gastro-intestinal nematode (GIN) control. However, growing anthelmintic resistance (AHR) has created a compelling need to identify evidence-based management recommendations that reduce the risk of further development and impact of AHR.

OBJECTIVE

To identify, critically assess, and synthesize available data from primary research on factors associated with AHR in sheep.

METHODS

Publications reporting original observational or experimental research on selected factors associated with AHR in sheep GINs and published after 1974, were identified through two processes. Three electronic databases (PubMed, Agricola, CAB) and Web of Science (a collection of databases) were searched for potentially relevant publications. Additional publications were identified through consultation with experts, manual search of references of included publications and conference proceedings, and information solicited from small ruminant practitioner list-serves. Two independent investigators screened abstracts for relevance. Relevant publications were assessed for risk of systematic bias. Where sufficient data were available, random-effects Meta-Analyses (MAs) were performed to estimate the pooled Odds Ratio (OR) and 95% Confidence Intervals (CIs) of AHR for factors reported in ≥2 publications.

RESULTS

Of the 1712 abstracts screened for eligibility, 131 were deemed relevant for full publication review. Thirty publications describing 25 individual studies (15 observational studies, 7 challenge trials, and 3 controlled trials) were included in the qualitative synthesis and assessed for systematic bias. Unclear (i.e. not reported, or unable to assess) or high risk of selection bias and confounding bias was found in 93% (14/15) and 60% (9/15) of the observational studies, respectively, while unclear risk of selection bias was identified in all of the trials. Ten independent studies were included in the quantitative synthesis, and MAs were performed for five factors. Only high frequency of treatment was a significant risk factor (OR=4.39; 95% CI=1.59, 12.14), while the remaining 4 variables were marginally significant: mixed-species grazing (OR=1.63; 95% CI=0.66, 4.07); flock size (OR=1.02; 95% CI=0.97, 1.07); use of long-acting drug formulations (OR=2.85; 95% CI=0.79, 10.24); and drench-and-shift pasture management (OR=4.08; 95% CI=0.75, 22.16).

CONCLUSIONS

While there is abundant literature on the topic of AHR in sheep GINs, few studies have explicitly investigated the association between putative risk or protective factors and AHR. Consequently, several of the current recommendations on parasite management are not evidence-based. Moreover, many of the studies included in this review had a high or unclear risk of systematic bias, highlighting the need to improve study design and/or reporting of future research carried out in this field.

The management of anthelmintic resistance in grazing ruminants in Australasia--strategies and experiences

In many countries the presence of anthelmintic resistance in nematodes of small ruminants, and in some cases also in those infecting cattle and horses, has become the status quo rather than the exception. It is clear that consideration of anthelmintic resistance, and its management, should be an integral component of anthelmintic use regardless of country or host species. Many years of research into understanding the development and management of anthelmintic resistance in nematodes of small ruminants has resulted in an array of strategies for minimising selection for resistance and for dealing with it once it has developed. Importantly, many of these strategies are now supported by empirical science and some have been assessed and evaluated on commercial farms. In sheep the cost of resistance has been measured at about 10% of the value of the lamb at sale which means that losses due to undetected resistance far outweigh the cost of testing anthelmintic efficacy. Despite this many farmers still do not test for anthelmintic resistance on their farm. Many resistance management strategies have been developed and some of these have been tailored for specific environments and/or nematode species. However, in general, most strategies can be categorised as either; identify and mitigate high risk management practices, maintain an anthelmintic-susceptible population in refugia, choose the optimal anthelmintic (combinations and formulations), or prevent the introduction of resistant nematodes. Experiences with sheep farmers in both New Zealand and Australia indicate that acceptance and implementation of resistance management practices is relatively easy as long as the need to do so is clear and the recommended practices meet the farmer's criteria for practicality. A major difference between Australasia and many other countries is the availability and widespread acceptance of combination anthelmintics as a resistance management tool. The current situation in cattle and horses in many countries indicates a failure to learn the lessons from resistance development in small ruminants. The cattle and equine industries have, until quite recently, remained generally oblivious to the issue of anthelmintic resistance and the need to take pre-emptive action. In Australasia, as in other countries, a perception was held that resistance in cattle parasites would develop very slowly, if it developed at all. Such preconceptions are clearly incorrect and the challenge ahead for the cattle and equine industries will be to maximise the advantages for resistance management from the extensive body of research and experience gained in small ruminants.

Managing anthelmintic resistance--parasite fitness, drug use strategy and the potential for reversion towards susceptibility

The rotation of different anthelmintic classes, on an approximately annual basis, has been widely promoted and adopted as a strategy to delay the development of anthelmintic resistance in nematode parasites. Part of the rationale for recommending this practice was the expectation that resistant genotype worms have a lower ecological fitness than susceptible worms, at least in the early stages of selection, and so reversion towards susceptibility could be expected in those years when an alternative class of anthelmintic was used. The routine use of combination anthelmintics might be expected to negate this opportunity for reversion because multiple classes of anthelmintic would be used simultaneously. A simulation model was used to investigate whether the optimal strategy for use of multiple drug classes (i.e. an annual rotation of two classes of anthelmintic or continuous use of two classes in combination) changed with the size of the fitness cost associated with resistance. Model simulations were run in which the fitness cost associated with each resistance gene was varied from 0% to 15% and the rate at which resistance developed was compared for each of the drug-use strategies. Other factors evaluated were the initial frequency of the resistance genes and the proportion of the population not exposed to treatment (i.e. in refugia). Increasing the proportion of the population in refugia always slowed the development of resistance, as did using combinations in preference to an annual rotation. As the fitness cost associated with resistance increased, resistance developed more slowly and this was more pronounced when a combination was used compared to a rotation. If the fitness cost was sufficiently high then resistance did not develop (i.e. the resistance gene frequency declined over time) and this occurred at lower fitness costs when a combination was used. The results, therefore, indicate that the optimal drug-use strategy to maximise the benefit of any fitness cost associated with resistance is the use of combinations of different anthelmintic classes. Manual calculations confirmed that, within the model, the only resistant genotypes capable of surviving treatment with a combination are those carrying multiple resistance genes. These individuals are less fit, resulting in the worm population surviving treatment having a lower overall ecological fitness. This is a previously unreported perspective on the use of combination anthelmintics and strengthens the argument that any new class of anthelmintic, for which resistance genes can be expected to be rare, should be brought to market in combination.

A telephone survey of internal parasite control practices on sheep farms in Spain

A telephone survey of farmers was conducted to determine current internal parasite control practices on sheep farms in Spain; the farmers were interviewed by their veterinarians. Anthelmintic choice was largely on veterinary advice and dominated by benzimidazoles and macrocyclic lactones. Anthelmintic rotation was separated into: no rotation (42% of farms); annual rotation (36%); rotate within year (20%); and rotate every second year (2%). The mean annual number of treatments varied subtly by region; ewes and rams 1.6-2.1, replacement lambs 1.7-2.1. Anthelmintics are administered primarily during spring and early summer (47% of treatments), and autumn (41%). Thirty-two percent of farmers introduced sheep to their properties and more than half did not quarantine drench the arrivals.

Moxidectin and the avermectins: Consanguinity but not identity

The avermectins and milbemycins contain a common macrocyclic lactone (ML) ring, but are fermentation products of different organisms. The principal structural difference is that avermectins have sugar groups at C13 of the macrocyclic ring, whereas the milbemycins are protonated at C13. Moxidectin (MOX), belonging to the milbemycin family, has other differences, including a methoxime at C23. The avermectins and MOX have broad-spectrum activity against nematodes and arthropods. They have similar but not identical, spectral ranges of activity and some avermectins and MOX have diverse formulations for great user flexibility. The longer half-life of MOX and its safety profile, allow MOX to be used in long-acting formulations. Some important differences between MOX and avermectins in interaction with various invertebrate ligand-gated ion channels are known and could be the basis of different efficacy and safety profiles. Modelling of IVM interaction with glutamate-gated ion channels suggest different interactions will occur with MOX. Similarly, profound differences between MOX and the avermectins are seen in interactions with ABC transporters in mammals and nematodes. These differences are important for pharmacokinetics, toxicity in animals with defective transporter expression, and probable mechanisms of resistance. Resistance to the avermectins has become widespread in parasites of some hosts and MOX resistance also exists and is increasing. There is some degree of cross-resistance between the avermectins and MOX, but avermectin resistance and MOX resistance are not identical. In many cases when resistance to avermectins is noticed, MOX produces a higher efficacy and quite often is fully effective at recommended dose rates. These similarities and differences should be appreciated for optimal decisions about parasite control, delaying, managing or reversing resistances, and also for appropriate anthelmintic combination.

Anthelmintic resistance in sheep farms: update of the situation in the American continent

The present paper reviews the frequency of anthelmintic resistance in sheep farms in different countries of the American continent and describes some aspects that might influence the trend in sheep farms. The situation of anthelmintic resistance in sheep farms has been explored mainly in south of the continent (Argentina, Brazil and Uruguay) where sheep farming is an important industry. In those three countries, as well as in Paraguay, the first comprehensive surveys of anthelmintic resistance were performed among countries in the continent, which showed evidence of high frequency of sheep farms with anthelmintic resistance. Today, it is common to find sheep flocks with multiple-resistant worms. In North and Central America, a similar situation has been reported in sheep farms in the south of the United States of America, parts of Mexico and Costa Rica. On the other hand, other areas of the continent show low frequency of farms with anthelmintic resistance. From many areas no results have been published regarding situation on anthelmintic resistance or, alternatively, published results have received limited dissemination. Although the diagnosis of anthelmintic resistance is important for decision making of helminth management/control at the farm level, this is still an aspiration rather than a reality. For decades, researchers working on anthelmintic resistance in the American continent have expressed the need to change farmers' attitudes towards anthelmintic drugs. A common advice has been to check the anthelmintic drug efficacy regularly and reduce the dependence on these with alternative control measures. In spite of such advice, the challenge to stop/delay the advancement of anthelmintic resistance against the available anthelmintic drugs is still present. The evidence suggests that anthelmintic resistance is a growing phenomenon in the American continent. The situation described might be the tip of the iceberg, as anthelmintic resistance is still largely under-diagnosed. Hence, a different approach to tackle the advancement of anthelmintic resistance in sheep farms must be found. Awareness of farmers on the importance of diagnosis of anthelmintic resistance is not enough. Technical support schemes that provide the diagnostic service cheaply and timely must be implemented together with the research aiming at the adoption of control methods to reduce the dependence on conventional anthelmintic drugs. Unless these elements are readily available for producers, the negative consequences of anthelmintic resistance on sheep farming in America will continue to worsen with time.

The comparative efficacy of abamectin, monepantel and an abamectin/derquantel combination against fourth-stage larvae of a macrocyclic lactone-resistant Teladorsagia spp. isolate infecting sheep

Anthelmintic resistance by gastrointestinal nematodes of sheep continues to be an issue of global interest. While the recent introduction in some countries of one or two new anthelmintic classes (amino-acetonitrile derivatives [AAD] and spiroindoles [SI]) has been welcomed, it is important that there is no relaxation in parasite control and the management of drug resistance. Monepantel (an AAD) was the first new anthelmintic to be approved for use (New Zealand, 2009) and was followed a year later in the same country by a combination of derquantel (a SI) and abamectin. The present study determined the efficacy of the new anthelmintic products and abamectin against fourth-stage larvae of macrocyclic lactone-resistant Teladorsagia spp. in lambs. Efficacies were calculated by comparing post-mortem nematode burdens of treated animals with those of untreated control sheep, and were 98.5, 86.3 and 34.0% for monepantel, abamectin/derquantel and abamectin, respectively. The nematode burdens of monepantel- and abamectin/derquantel-treated sheep were significantly lower than those sheep treated with abamectin and the untreated controls. Similarly, the burden of the monepantel group was significantly lower than that of the abamectin/derquantel group. These findings provide an opportunity to reinforce the recommendation that farmers and animal health advisors need to know the resistance status of nematode populations on subject farms to ensure effective control programs are designed and implemented. Such control programs should include an appropriate choice of anthelmintic(s), monitoring parasite burdens for correct timing of treatments, and pasture management to reduce larval challenge balanced with the maintenance of drug-susceptible populations in refugia.

An inconvenient truth: global worming and anthelmintic resistance

Over the past 10-15 years, we have witnessed a rapid increase in both the prevalence and magnitude of anthelmintic resistance, and this increase appears to be a worldwide phenomenon. Reports of anthelmintic resistance to multiple drugs in individual parasite species, and in multiple parasite species across virtually all livestock hosts, are increasingly common. In addition, since the introduction of ivermectin in 1981, no novel anthelmintic classes were developed and introduced for use in livestock until recently with the launch of monepantel in New Zealand. Thus, livestock producers are often left with few options for effective treatment against many important parasite species. While new anthelmintic classes with novel mechanisms of action could potentially solve this problem, new drugs are extremely expensive to develop, and can be expected to be more expensive than older drugs. Thus, it seems clear that the "Global Worming" approach that has taken hold over the past 40-50 years must change, and livestock producers must develop a new vision for parasite control and sustainability of production. Furthermore, parasitologists must improve methods for study design and data analysis that are used for diagnosing anthelmintic resistance, especially for the fecal egg count reduction test (FECRT). Currently, standards for diagnosis of anthelmintic resistance using FECRT exist only for sheep. Lack of standards in horses and cattle and arbitrarily defined cutoffs for defining resistance, combined with inadequate analysis of the data, mean that errors in assigning resistance status are common. Similarly, the lack of standards makes it difficult to compare data among different studies. This problem needs to be addressed, because as new drugs are introduced now and in the future, the lack of alternative treatments will make early and accurate diagnosis of anthelmintic resistance increasingly important.

Oral dosing with papaya latex is an effective anthelmintic treatment for sheep infected with Haemonchus contortus

BACKGROUND

The cysteine proteinases in papaya latex have been shown to have potent anthelmintic properties in monogastric hosts such as rodents, pigs and humans, but this has not been demonstrated in ruminants.

METHODS

In two experiments, sheep were infected concurrently with 5,000 infective larvae of Haemonchus contortus and 10,000 infective larvae of Trichostrongylus colubriformis and were then treated with the supernatant from a suspension of papaya latex from day 28 to day 32 post-infection. Faecal egg counts were monitored from a week before treatment until the end of the experiment and worm burdens were assessed on day 35 post-infection.

RESULTS

We found that the soluble fraction of papaya latex had a potent in vivo effect on the abomasal nematode H. contortus, but not on the small intestinal nematode T. colubriformis. This effect was dose-dependent and at tolerated levels of gavage with papaya latex (117 μmol of active papaya latex supernatant for 4 days), the H. contortus worm burdens were reduced by 98%. Repeated treatment, daily for 4 days, was more effective than a single dose, but efficacy was not enhanced by concurrent treatment with the antacid cimetidine.

CONCLUSIONS

Our results provide support for the idea that cysteine proteinases derived from papaya latex may be developed into novel anthelmintics for the treatment of lumenal stages of gastro-intestinal nematode infections in sheep, particularly those parasitizing the abomasum.

Monitoring macrocyclic lactone resistance in Cooperia oncophora on a Belgian cattle farm during four consecutive years

In this study we have used the faecal egg count reduction test (FECRT) to monitor the evolution of ivermectin resistance on a Belgian cattle farm between 2006 and 2009. The presence of ivermectin resistant Cooperia oncophora worms on this farm was first detected in 2006. During the following years, the FECRs on day 21 post-treatment decreased from 73% (95% CI: 8-99) in 2006, over 40% (95% CI: 0-89) in 2007, to 0% (95% CI: 0-41) in 2008. The ivermectin resistant C. oncophora showed side-resistance against moxidectin, indicated by a FECR of 83%, suggesting that the use of any type of ML is discouraged once ivermectin resistance has been detected. Benzimidazoles on the other hand were still fully effective on this farm. The resistant C. oncophora larvae collected in 2007 (CoIVR07) and 2008 (CoIVR08) were also used to evaluate a modified version of the larval migration inhibition assay (LMIA). The results indicated that it is possible with the LMIA to differentiate susceptible from ivermectin resistant C. oncophora isolates. The EC50 values of CoIVR07 (542 nM) and CoIVR08 (698 nM) were, respectively, 4.5- and 5.8-fold higher than the value of a susceptible isolate (120 nM). Furthermore, the results of the LMIA reflected the outcome of the FECRT, with the C. oncophora isolate collected in 2008 being more resistant than the isolate collected in 2007. However, the test should be further optimized, e.g. more isolates with different susceptibility to ivermectin and mixtures of species, in order to use the test in field conditions.