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Le B, Clarke NE, Hii SF, Byrne A, Khattak A, Lake S, Lazu E, Wickham S, Wand H, Olsen N, Zendejas-Heredia PA, Sokana O, Romani L, Engelman D, Nasi T, Boara D, Kaldor J, Steer A, Traub R, Nery SV. Effectiveness of one and two doses of ivermectin mass drug administration in reducing the prevalence and intensity of soil-transmitted helminth (STH) infections in Western Province, Solomon Islands: a cluster-randomised, before-after analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100942. [PMID: 38357395 PMCID: PMC10865046 DOI: 10.1016/j.lanwpc.2023.100942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/23/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024]
Abstract
Background Ivermectin mass drug administration (MDA) is effective for controlling onchocerciasis and scabies, with evidence supporting its role in some species of soil-transmitted helminth (STH) infections. In the context of RISE, a cluster-randomised trial for scabies, this study evaluated the effectiveness of ivermectin MDA in reducing STH burden in the Western Province of Solomon Islands. Methods Twenty villages were randomised 1:1 to receive ivermectin MDA as one dose (IVM-1) or two doses (IVM-2) for scabies. The effectiveness of one and two doses in reducing STH prevalence and intensity was evaluated before (May 2019) and 21 months after (February 2021) MDA in May 2019. All residents aged 12 months or older in the study villages were eligible to participate and provide stool specimens. Species-specific STH infection and intensity were assessed using quantitative PCR. We compared prevalence and intensity of infection between baseline and 21 months in each intervention arm individually using cluster-level analysis (adjusted for clustering) and individual-level analysis (adjusted for sex, age, and clustering). The primary outcomes were the prevalence risk difference (RD) from the cluster-level analysis, and the change in adjusted odds of infection from the individual-level analysis. Secondary outcomes included change in incident rates of mean eggs per gram (epg) of stool from baseline to 21 months, relative risk difference in prevalence and relative change in odds of infection between arms at 21 months. Sex data (male/female) were self-reported. Findings Overall, STH infection was assessed in 830 participants from 18 villages at baseline and 1172 from 20 villages at follow-up. Females represented 58% (n = 478) of the sample at baseline and 59% (n = 690) at follow-up. We observed a reduction in Strongyloides spp. prevalence following two doses of ivermectin MDA in the cluster-level analysis from 7.0% (32/458 participants) to 1.2% (8/674 participants), corresponding to a RD of -0.07 (95% CI -0.14 to -0.01, p = 0.036), and in the individual-level analysis (OR 0.11, 95% CI 0.04-0.33, p < 0.001). T. trichiura prevalence decreased following one dose from 19.4% (74/372 participants) to 11.7% (56/505 participants) (OR 0.44, 95% CI 0.26-0.73, p = 0.0040), while egg count reduced in both arms (IVM-1: IRR 0.28, 95% CI 0.11-0.70, p = 0.0070; IVM-2: IRR 0.18, 95% CI 0.08-0.40, p < 0.001), in the individual-level analysis. We did not detect a significant difference in effect measures between the one- and two-dose arms for any species after 21 months. Interpretation Our study highlights the long-term benefits of ivermectin MDA in reducing the burden of Strongyloides spp. and T. trichiura. STH control programs should leverage the geographical overlap of NTDs, existing drug distribution channels, and broad-spectrum agents. Funding The National Health and Medical Research Council of Australia.
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Affiliation(s)
- Brandon Le
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Naomi E. Clarke
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sze Fui Hii
- The University of Melbourne, Melbourne, Australia
| | - Aisling Byrne
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Alam Khattak
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Susanna Lake
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | - Handan Wand
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Nick Olsen
- Stats Central, University of New South Wales, Sydney, Australia
| | | | - Oliver Sokana
- Ministry of Health & Medical Services, Honiara, Solomon Islands
| | - Lucia Romani
- The Kirby Institute, University of New South Wales, Sydney, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Titus Nasi
- Ministry of Health & Medical Services, Honiara, Solomon Islands
| | | | - John Kaldor
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Andrew Steer
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Susana Vaz Nery
- The Kirby Institute, University of New South Wales, Sydney, Australia
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Naqvi FA, Das JK, Salam RA, Raza SF, Lassi ZS, Bhutta ZA. Interventions for Neglected Tropical Diseases Among Children and Adolescents: A Meta-analysis. Pediatrics 2022; 149:186947. [PMID: 35503336 DOI: 10.1542/peds.2021-053852e] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are a group of communicable diseases affecting the poorest populations around the world. OBJECTIVE To assess the effectiveness of interventions, including mass drug administration (MDA), water, sanitation, and hygiene (WASH), vector control, health education, and micronutrients supplementation, for NTDs among children and adolescents. METHODS We conducted a literature search on the Cochrane Controlled Trials Register, Medline, and other databases until December 2020. We included randomized controlled trials and quasi-experimental studies conducted among children and adolescents. Two authors independently screened studies for relevance. Two authors independently extracted data, assessed the risk of bias, performed metaanalysis, and rated the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS We included 155 studies (231 articles) involving 262 299 participants. For soil-transmitted helminthiasis, MDA may reduce the prevalence of Ascaris, Trichuris, and hookworm by 58%, 36%, and 57%, respectively. We are uncertain of the effect of health education, WASH, and iron supplementation on soil-transmitted helminthiasis prevalence. For Schistosomiasis, health education probably reduces the intensity and prevalence of S. mansoni, whereas micronutrient supplementation may reduce anemia prevalence and the infection intensity of S. hematobium compared with no supplementation. We are uncertain of the effect of MDA and vector control on Schistosomiasis outcomes. For trachoma, health education probably reduces the prevalence of active Trachoma, whereas we are uncertain of the effect of MDA, WASH, and vector control on Trachoma outcomes. There is limited data on the effectiveness of interventions for NTDs targeting children and adolescents. CONCLUSION Future studies are needed to evaluate the relative effectiveness and cost-effectiveness of various interventions specifically targeting children and adolescents.
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Affiliation(s)
- Fatima Abbas Naqvi
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Syeda Fatima Raza
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, the University of Adelaide, Adelaide, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.,Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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Gebrezgabiher G, Yewhalaw D, Ayana M, Hailu A, Mekonnen Z. Impact of ivermectin mass drug administration on burden of soil-transmitted helminths in onchocerciasis control and elimination programs, Yeki district, southwest Ethiopia. PLoS One 2022; 17:e0263625. [PMID: 35143567 PMCID: PMC8830686 DOI: 10.1371/journal.pone.0263625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/21/2022] [Indexed: 11/18/2022] Open
Abstract
Community-directed treatment with ivermectin (CDTi) is the primary strategy employed to control and eliminate human onchocerciasis in Ethiopia. After long-term mass distribution for onchocerciasis, ivermectin is expected to have additional benefits beyond the envisioned targets by reducing the burden of other co-endemic parasitic infections as to STHs. To date, studies focused on the collateral impact of CDTi on STH in Ethiopia are scanty. Two community-based cross-sectional surveys (baseline in 1997 and post-CDTi in 2017) were conducted to evaluate the impact of long-term CDTi employed to control and eliminate onchocerciasis on the burden of STH infections in Yeki district of southwest Ethiopia. Stool samples were collected and examined using Ritchie`s concentration and Kato-Katz techniques in the baseline and current study, respectively. Overall, 188(38.3%, 95% Confidence interval (CI) 34.1–42.7%) individuals were positive at least for any of the STH species from 491 study participants in the post-CDTi. The prevalence of A. lumbricoides, hookworms, and T. trichiura was 11.2% (95% CI 8.7–14.3%), 16.3% (95% CI 13.3–19.8%), and 29.9% (95% CI 26.1–34.1%), respectively. Individuals aged 5–9 years had a significantly higher prevalence of A. lumbricoides (Adjusted odds ratio (AOR) 6.5, 95% CI 1.7–25.4), T. trichuria (AOR 8, 95% CI 2.6–25.1), and any STH infection (AOR 5, 95% CI 1.7–14.7) than those of ≥ 51 years. Also, significantly higher prevalences of T. trichuria infection were observed in individuals aged 10–14 years (AOR 4.1, 95% CI 1.7–9.9), 15–20 years (AOR 3.1, 95% CI 1.2–8.1), 21–30 years (AOR 2.4, 95% CI 1.1–5.5), and 31–40 years (AOR 3.2, 95% CI 1.3–7.5) compared with those of ≥ 51 years. The prevalence of A. lumbricoides was significantly higher in males (AOR 0.5, 95% CI 0.3–0.9). Of the 491 study participants, only data from 400 individuals who had not been involved in a mass drug administration (MDA) with other STH anthelmintics were considered in the comparative analysis. Before CDTi, the prevalence of A. lumbricoides, T. trichiura, hookworm, and any STH infection was 47.1% (95% CI 41.6–52.7%), 3.3% (95% CI 1.8–5.9%), 37.9% (95% CI 32.7–43.5%), and 58.8% (95% CI 53.2–64.1%), respectively. Long-term CDTi considerably reduced the prevalences of A. lumbricoides and hookworm by 76.2% and 56.9%, respectively (p < 0.001). Nonetheless, CDTi did not affect the prevalence of T. trichiura infection and, in contrast, it was significantly higher in the current study (P < 0.001). Overall post-CDTi prevalence of any STH infection was considerably lower than reported in the baseline (p < 0.001). It is evidenced that long-term CDTi for onchocerciasis control and elimination had additional benefits by reducing the prevalence of STH infections specifically of A. lumbricoides and hookworm, but had no impact on infections with T. trichuria. Our finding of additional health benefits of large-scale ivermectin administration taking it will aid to increase positive engagement and sustain participation of communities during MDA campaigns, and strengthen governmental and non-governmental organizations (NGOs) support for the undergoing national onchocerciasis elimination program.
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Affiliation(s)
- Gebremedhin Gebrezgabiher
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- College of Veterinary Medicine, Samara University, Samara, Ethiopia
- * E-mail:
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia
| | - Mio Ayana
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Djune-Yemeli L, Nana-Djeunga HC, Lenou-Nanga CG, Donfo-Azafack C, Domche A, Fossuo-Thotchum F, Niamsi-Emalio Y, Ntoumi F, Kamgno J. Serious limitations of the current strategy to control Soil-Transmitted Helminths and added value of Ivermectin/Albendazole mass administration: A population-based observational study in Cameroon. PLoS Negl Trop Dis 2020; 14:e0008794. [PMID: 33141853 PMCID: PMC7665818 DOI: 10.1371/journal.pntd.0008794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 11/13/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infections remain a public health concern in sub-Saharan Africa. School-based mass drug administration (MDA) using the anthelminthic drug Mebendazole/Albendazole have succeeded in controlling morbidity associated to these diseases but failed to interrupt their transmission. In areas were filarial diseases are co-endemic, another anthelminthic drug (Ivermectin) is distributed to almost the entire population, following the community-directed treatment with ivermectin (CDTI) strategy. Since Ivermectin is a broad spectrum anthelmintic known to be effective against STH, we conducted cross-sectional surveys in two health districts with very contrasting histories of Ivermectin/Albendazole-based PC in order to investigate whether CDTI might have contributed in STH transmission interruption. METHODOLOGY Cross-sectional surveys were conducted in two health districts with similar socio-environmental patterns but with very contrasting CDTI histories (Akonolinga health district where CDTI was yet to be implemented vs. Yabassi health district where CDTI has been ongoing for two decades). Stool samples were collected from all volunteers aged >2 years old and analyzed using the Kato-Katz technique. Infections by different STH species were compared between Akonolinga and Yabassi health districts to decipher the impact of Ivermectin/Albendazole-based MDA on STH transmission. PRINCIPAL FINDINGS A total of 610 and 584 participants aged 2-90 years old were enrolled in Akonolinga and Yabassi health districts, respectively. Two STH species (Ascaris lumbricoides and Trichuris trichiura) were found, with prevalence significantly higher in Akonolinga health district (43.3%; 95% CI: 38.1-46.6) compared to Yabassi health district (2.5%; 95% CI: 1.1-5.1) (chi-square: 90.8; df: 1; p < 0.001). CONCLUSION/SIGNIFICANCE These findings (i) suggest that Mebendazole- or Albendazole-based MDA alone distributed only to at-risk populations might not be enough to eliminate STH, (ii) support the collateral impact of Ivermectin/Albendazole MDA on A. lumbricoides and T. trichiura infections, and (iii) suggest that Ivermectin/Albendazole-based PC could accelerate STH transmission interruption.
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Affiliation(s)
- Linda Djune-Yemeli
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.,Molecular Diagnosis Research Group, Biotechnology Centre-University of Yaoundé I (BTC-UY-I), Yaoundé, Cameroon
| | - Hugues C Nana-Djeunga
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.,Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Cédric G Lenou-Nanga
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon
| | - Cyrille Donfo-Azafack
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon
| | - André Domche
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.,Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Yannick Niamsi-Emalio
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo.,Marien Ngouabi University, Brazzaville, Republic of the Congo
| | - Joseph Kamgno
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.,Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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5
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El-Sakkary N, Chen S, Arkin MR, Caffrey CR, Ribeiro P. Octopamine signaling in the metazoan pathogen Schistosoma mansoni: localization, small-molecule screening and opportunities for drug development. Dis Model Mech 2018; 11:dmm033563. [PMID: 29925529 PMCID: PMC6078403 DOI: 10.1242/dmm.033563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/12/2018] [Indexed: 11/20/2022] Open
Abstract
Schistosomiasis is a tropical disease caused by a flatworm trematode parasite that infects over 200 million people worldwide. Treatment and control of the disease rely on just one drug, praziquantel. The possibility of drug resistance coupled with praziquantel's variable efficacy encourages the identification of new drugs and drug targets. Disruption of neuromuscular homeostasis in parasitic worms is a validated strategy for drug development. In schistosomes, however, much remains to be understood about the organization of the nervous system, its component neurotransmitters and potential for drug discovery. Using synapsin as a neuronal marker, we map the central and peripheral nervous systems in the Schistosoma mansoni adult and schistosomulum (post-infective larva). We discover the widespread presence of octopamine (OA), a tyrosine-derived and invertebrate-specific neurotransmitter involved in neuromuscular coordination. OA labeling facilitated the discovery of two pairs of ganglia in the brain of the adult schistosome, rather than the one pair thus far reported for this and other trematodes. In quantitative phenotypic assays, OA and the structurally related tyrosine-derived phenolamine and catecholamine neurotransmitters differentially modulated schistosomulum motility and length. Similarly, from a screen of 28 drug agonists and antagonists of tyrosine-derivative signaling, certain drugs that act on OA and dopamine receptors induced robust and sometimes complex concentration-dependent effects on schistosome motility and length; in some cases, these effects occurred at concentrations achievable in vivo The present data advance our knowledge of the organization of the nervous system in this globally important pathogen and identify a number of drugs that interfere with tyrosine-derivative signaling, one or more of which might provide the basis for a new chemotherapeutic approach to treat schistosomiasis.This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Nelly El-Sakkary
- Institute of Parasitology, McGill University, Macdonald Campus, 21, 111 Lakeshore Road, Ste Anne de Bellevue, Quebec, Canada H9X-3V9
| | - Steven Chen
- Small Molecule Discovery Center, Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, CA 94158, USA
| | - Michelle R Arkin
- Small Molecule Discovery Center, Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, CA 94158, USA
| | - Conor R Caffrey
- Center for Discovery and Innovation in Parasitic Diseases, Department of Pathology, University of California San Francisco, San Francisco, CA 94158, USA
| | - Paula Ribeiro
- Institute of Parasitology, McGill University, Macdonald Campus, 21, 111 Lakeshore Road, Ste Anne de Bellevue, Quebec, Canada H9X-3V9
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Wimmersberger D, Coulibaly JT, Schulz JD, Puchkow M, Huwyler J, N’Gbesso Y, Hattendorf J, Keiser J. Efficacy and Safety of Ivermectin Against Trichuris trichiura in Preschool-aged and School-aged Children: A Randomized Controlled Dose-finding Trial. Clin Infect Dis 2018; 67:1247-1255. [DOI: 10.1093/cid/ciy246] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/22/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- David Wimmersberger
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute
- University of Basel Switzerland
| | - Jean T Coulibaly
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute
- University of Basel Switzerland
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Jessica D Schulz
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute
- University of Basel Switzerland
| | - Maxim Puchkow
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel, Switzerland
| | - Jörg Huwyler
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel, Switzerland
| | - Yves N’Gbesso
- Centre de Santé Urbain d’Azaguié, Departement d’Agboville, Côte d’Ivoire
| | - Jan Hattendorf
- University of Basel Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute
- University of Basel Switzerland
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Oluwole AS, Isiyaku S, Aliero AA, Nwosu C, William A, Elhassan E, Ekpo UF. Assessment of the burden of soil-transmitted helminthiasis after five years of mass drug administration for Onchocerciasis and Lymphatic filariasis in Kebbi State, Nigeria. Parasite Epidemiol Control 2017; 2:21-29. [PMID: 29774278 PMCID: PMC5952656 DOI: 10.1016/j.parepi.2017.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/10/2017] [Accepted: 01/10/2017] [Indexed: 01/28/2023] Open
Abstract
There is a hypothesis that Mass drug administration (MDA) of ivermectin and albendazole for the treatment of onchocerciasis and lymphatic filariasis could have an impact on the burden of soil-transmitted helminthiasis (STH) in MDA communities. We, therefore, assessed the burden of STH (Ascaris lumbricoides, Trichuris trichiura, and hookworm) infections in nine communities from 3 LGAs (two MDA local government areas (LGAs) and one control LGA) in Kebbi State, Nigeria after 5-years (2010–2015) of MDA for onchocerciasis and/or lymphatic filariasis. We also administered questionnaire to obtain demographic information and history of MDA in the past five years. The three LGAs are Bagudo (Ivermectin MDA); Zuru (Ivermectin/Albendazole MDA) and Dandi (No MDA). The study was a cross sectional survey. The total number of people that complied with provision of stool samples and questionnaire were 1357 persons; stool samples collected were examined for STH infections in the three LGAs. Zuru LGA had the highest prevalence of STH (41.89, 95% CI: 37.08–46.81) followed by Dandi LGA (24.66, 95% CI: 20.69–28.97) and Bagudo LGA (3.36, 95% CI: 1.97–5.32). Prevalence of STH infection was not significantly different among age group and sex. Geometric mean intensity per gram of infection for both A. lumbricoides and Hookworm were highest in Zuru LGA with (1.16 GMI, 95% CI: 0.97–1.36) and (1.49 GMI, 95% CI: 1.29–1.70) respectively. Treatment coverage was less than 65% from 2010 to 2013 in the intervention LGAs. The study shows that STH is still a public health problem in Zuru LGA (IVM + ALB) and requires MDA of albendazole for STH control to continue, while Dandi LGA (No MDA history) requires MDA with albendazole to scale up treatment for STH control.
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Affiliation(s)
| | - Sunday Isiyaku
- Sightsavers Nigeria Country Office, 1 Golf Course Road, P.O Box 503, Kaduna, Nigeria
| | | | - Christian Nwosu
- Sightsavers Nigeria Country Office, 1 Golf Course Road, P.O Box 503, Kaduna, Nigeria
| | - Adamani William
- Sightsavers Nigeria Country Office, 1 Golf Course Road, P.O Box 503, Kaduna, Nigeria
| | | | - Uwem Friday Ekpo
- Federal University of Agriculture, Abeokuta 110001, Ogun State, Nigeria
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Richards FO, Klein RE, de León O, Mendizábal-Cabrera R, Morales AL, Cama V, Crovella CG, Díaz Espinoza CE, Morales Z, Sauerbrey M, Rizzo N. A Knowledge, Attitudes and Practices Survey Conducted Three Years after Halting Ivermectin Mass Treatment for Onchocerciasis in Guatemala. PLoS Negl Trop Dis 2016; 10:e0004777. [PMID: 27341104 PMCID: PMC4920414 DOI: 10.1371/journal.pntd.0004777] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/23/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Mass drug administration (MDA) with ivermectin for onchocerciasis was provided in Guatemala's Central Endemic Zone (CEZ) over a 24 year period (1988-2011). Elimination of Onchocerca volvulus transmission was declared in 2015 after a three year post MDA surveillance period (2012-2014) showed no evidence of recrudescence. The purpose of the present study was to evaluate the knowledge, attitudes and practices (KAP) towards onchocerciasis and ivermectin among residents in the post endemic CEZ. A major interest in this study was to determine what community residents thought about the end of the ivermectin MDA program. METHODOLOGY/PRINCIPAL FINDINGS A total of 148 interviews were conducted in November 2014 in four formerly hyperendemic communities using a standard questionnaire on smart phones. The majority (69%) of respondents knew that the MDA program had ended because the disease was no longer present in their communities, but a slight majority (53%) was personally unsure that onchocerciasis had really been eliminated. Sixty-three percent wanted to continue to receive ivermectin because of this uncertainty, or because ivermectin is effective against intestinal worms. Eighty-nine percent of respondents said that they would seek medical attention immediately if a family member had symptoms of onchocerciasis (especially the presence of a nodule), which is a finding very important for ongoing surveillance. CONCLUSIONS/SIGNIFICANCE Many respondents wanted to continue receive ivermectin and more than half did not believe onchocerciasis had been eliminated. The ministry of health outreach services should be prepared to address ongoing concerns about onchocerciasis in the post endemic CEZ.
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Affiliation(s)
- Frank O. Richards
- River Blindness Elimination Program, Lymphatic Filariasis Elimination Program, and Schistosomiasis Control Program, The Carter Center, Atlanta, Georgia, United States of America
| | - Robert E. Klein
- Center for Health Studies (CHS), Universidad del Valle de Guatemala (UVG), Guatemala City, Guatemala
| | - Oscar de León
- Center for Health Studies (CHS), Universidad del Valle de Guatemala (UVG), Guatemala City, Guatemala
| | - Renata Mendizábal-Cabrera
- Center for Health Studies (CHS), Universidad del Valle de Guatemala (UVG), Guatemala City, Guatemala
| | - Alba Lucía Morales
- Onchocerciasis Elimination Program for the Americas, The Carter Center, Guatemala City, Guatemala
| | - Vitaliano Cama
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Carol G. Crovella
- Onchocerciasis Sub-Program, National Ministry of Health, Guatemala City, Guatemala
| | | | - Zoraida Morales
- Onchocerciasis Sub-Program, National Ministry of Health, Guatemala City, Guatemala
| | - Mauricio Sauerbrey
- Onchocerciasis Elimination Program for the Americas, The Carter Center, Guatemala City, Guatemala
| | - Nidia Rizzo
- Center for Health Studies (CHS), Universidad del Valle de Guatemala (UVG), Guatemala City, Guatemala
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Anselmi M, Buonfrate D, Guevara Espinoza A, Prandi R, Marquez M, Gobbo M, Montresor A, Albonico M, Racines Orbe M, Martin Moreira J, Bisoffi Z. Mass Administration of Ivermectin for the Elimination of Onchocerciasis Significantly Reduced and Maintained Low the Prevalence of Strongyloides stercoralis in Esmeraldas, Ecuador. PLoS Negl Trop Dis 2015; 9:e0004150. [PMID: 26540412 PMCID: PMC4635009 DOI: 10.1371/journal.pntd.0004150] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/17/2015] [Indexed: 11/21/2022] Open
Abstract
Objectives To evaluate the effect of ivermectin mass drug administration on strongyloidiasis and other soil transmitted helminthiases. Methods We conducted a retrospective analysis of data collected in Esmeraldas (Ecuador) during surveys conducted in areas where ivermectin was annually administered to the entire population for the control of onchocerciasis. Data from 5 surveys, conducted between 1990 (before the start of the distribution of ivermectin) and 2013 (six years after the interruption of the intervention) were analyzed. The surveys also comprised areas where ivermectin was not distributed because onchocerciasis was not endemic. Different laboratory techniques were used in the different surveys (direct fecal smear, formol-ether concentration, IFAT and IVD ELISA for Strongyloides stercoralis). Results In the areas where ivermectin was distributed the strongyloidiasis prevalence fell from 6.8% in 1990 to zero in 1996 and 1999. In 2013 prevalence in children was zero with stool examination and 1.3% with serology, in adult 0.7% and 2.7%. In areas not covered by ivermectin distribution the prevalence was 23.5% and 16.1% in 1996 and 1999, respectively. In 2013 the prevalence was 0.6% with fecal exam and 9.3% with serology in children and 2.3% and 17.9% in adults. Regarding other soil transmitted helminthiases: in areas where ivermectin was distributed the prevalence of T. trichiura was significantly reduced, while A. lumbricoides and hookworms were seemingly unaffected. Conclusions Periodic mass distribution of ivermectin had a significant impact on the prevalence of strongyloidiasis, less on trichuriasis and apparently no effect on ascariasis and hookworm infections. Strongyloides stercoralis (Ss) is a soil-transmitted helminth (STH) that is not yet targeted by control programs, although it is highly prevalent in many areas of the world and may cause severe consequences, in particular to immunosuppressed patients, with a high fatality rate. Unfortunately, albendazole, the drug most commonly used for the control of the other STH (hookworm, Ascaris lumbricoides and Trichuris trichiura) has little effect on Ss. The drug of choice, ivermectin, has been extensively used in mass drug administration (MDA) for the filarial worms Onchocerca volvulus and Wuchereria bancrofti. In the province of Esmeraldas, in Ecuador, we studied Ss (and other STH) prevalence from 1990 (prior to MDA initiation) to 2013 (6 years after MDA cessation) in rural communities where MDA was regularly executed for onchocerciasis compared with neighboring communities where ivermectin was not distributed because onchocerciasis was not present. Ss prevalence remained high over the years in the areas with no MDA, while in those with MDA prevalence fell to zero, and remained very low 6 years after MDA cessation. A less important effect was observed for T. trichiura. Adding ivermectin to MDA programs for STH would importantly contribute to the control of Ss infection.
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Affiliation(s)
- Mariella Anselmi
- Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
| | - Dora Buonfrate
- Centro per le Malattie tropicali, Negrar (Verona), Italy
| | | | - Rosanna Prandi
- Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
| | - Monica Marquez
- Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
| | - Maria Gobbo
- Centro per le Malattie tropicali, Negrar (Verona), Italy
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases (NTD), World Health Organization (WHO), Geneva, Switzerland
| | | | - Marcia Racines Orbe
- Facultad de Ciencias Medicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Juan Martin Moreira
- Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
| | - Zeno Bisoffi
- Centro per le Malattie tropicali, Ospedale Sacro Cuore, Negrar (Verona), Italy
- * E-mail:
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10
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Krotneva SP, Coffeng LE, Noma M, Zouré HGM, Bakoné L, Amazigo UV, de Vlas SJ, Stolk WA. African Program for Onchocerciasis Control 1995-2010: Impact of Annual Ivermectin Mass Treatment on Off-Target Infectious Diseases. PLoS Negl Trop Dis 2015; 9:e0004051. [PMID: 26401658 PMCID: PMC4581698 DOI: 10.1371/journal.pntd.0004051] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/12/2015] [Indexed: 12/17/2022] Open
Abstract
Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment. Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections. In this study, we roughly assessed the additional impact of APOC activities on the burden of the most important off-target infections: soil-transmitted helminthiases (STH; ascariasis, trichuriasis, hookworm, and strongyloidiasis), lymphatic filariasis (LF), and scabies. Based on a literature review, we formulated assumptions about the impact of ivermectin treatment on the disease burden of these off-target infections. Using data on the number of ivermectin treatments in APOC regions and the latest estimates of the burden of disease, we then calculated the impact of APOC activities on off-target infections in terms of disability-adjusted life years (DALYs) averted. We conservatively estimated that between 1995 and 2010, annual ivermectin mass treatment has cumulatively averted about 500 thousand DALYs from co-endemic STH infections, LF, and scabies. This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported. Onchocerciasis, or river blindness, is an infectious disease caused by the worm Onchocerca volvulus, which is transmitted between humans through the bites of blackflies and causes deforming skin disease, itch, and vision loss. The African Programme for Onchocerciasis Control (APOC) aims to control morbidity due to onchocerciasis by implementing mass drug administration (MDA) with ivermectin in endemic areas, targeting the whole population except for children under five and pregnant women. Aside from its effect on onchocerciasis, ivermectin also affects other parasitic infections such as lymphatic filariasis, intestinal worm infections, and scabies, which are all significantly co-endemic in areas covered by APOC. In this paper, the researchers roughly estimate the health impact of ivermectin MDA on off-target infections based on the number of dispensed treatments up to 2010, published estimates of the disease burden of off-target infections, and the expected effect of ivermectin treatment on the burden of these infections (based on literature review). This off-target health impact of APOC constitutes about 500 thousand years worth of healthy years of life (an additional 5.5% on top of the impact of APOC on the burden of onchocerciasis) and indicates that the cost-effectiveness of APOC is even higher than previously estimated.
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Affiliation(s)
- Stanimira P. Krotneva
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
| | - Mounkaila Noma
- African Programme for Onchocerciasis Control, Ouagadougou, Burkina Faso
| | | | - Lalle Bakoné
- African Programme for Onchocerciasis Control, Ouagadougou, Burkina Faso
| | | | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wilma A. Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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11
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Anderson RM, Turner HC, Truscott JE, Hollingsworth TD, Brooker SJ. Should the Goal for the Treatment of Soil Transmitted Helminth (STH) Infections Be Changed from Morbidity Control in Children to Community-Wide Transmission Elimination? PLoS Negl Trop Dis 2015; 9:e0003897. [PMID: 26291538 PMCID: PMC4546270 DOI: 10.1371/journal.pntd.0003897] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Roy M. Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, St. Marys Campus, Imperial College London, London, United Kingdom
- * E-mail:
| | - Hugo C. Turner
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, St. Marys Campus, Imperial College London, London, United Kingdom
| | - James E. Truscott
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, St. Marys Campus, Imperial College London, London, United Kingdom
| | - T. Déirdre Hollingsworth
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Simon J. Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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12
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Dunn C, Callahan K, Katabarwa M, Richards F, Hopkins D, Withers PC, Buyon LE, McFarland D. The Contributions of Onchocerciasis Control and Elimination Programs toward the Achievement of the Millennium Development Goals. PLoS Negl Trop Dis 2015; 9:e0003703. [PMID: 25996946 PMCID: PMC4440802 DOI: 10.1371/journal.pntd.0003703] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the "big three" diseases--namely HIV, tuberculosis (TB), and malaria--has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda.
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Affiliation(s)
- Caitlin Dunn
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Kelly Callahan
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Moses Katabarwa
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Frank Richards
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Donald Hopkins
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - P. Craig Withers
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Lucas E. Buyon
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
- College of Arts and Sciences, Emory University, Atlanta, Georgia, United States of America
| | - Deborah McFarland
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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13
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Tomczyk S, Deribe K, Brooker SJ, Clark H, Rafique K, Knopp S, Utzinger J, Davey G. Association between footwear use and neglected tropical diseases: a systematic review and meta-analysis. PLoS Negl Trop Dis 2014; 8:e3285. [PMID: 25393620 PMCID: PMC4230915 DOI: 10.1371/journal.pntd.0003285] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/22/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. METHODOLOGY We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM), leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH) infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) were calculated as a measure of intervention effect, using random effects meta-analyses. PRINCIPAL FINDINGS Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR=0.15; 95% CI: 0.08-0.29), CLM (OR=0.24; 95% CI: 0.06-0.96), tungiasis (OR=0.42; 95% CI: 0.26-0.70), hookworm infection (OR=0.48; 95% CI: 0.37-0.61), any STH infection (OR=0.57; 95% CI: 0.39-0.84), strongyloidiasis (OR=0.56; 95% CI: 0.38-0.83), and leptospirosis (OR=0.59; 95% CI: 0.37-0.94). No significant association between footwear use and podoconiosis (OR=0.63; 95% CI: 0.38-1.05) was found and no data were available for mycetoma, myiasis, and snakebite. The main limitations were evidence of heterogeneity and poor study quality inherent to the observational studies included. CONCLUSIONS/SIGNIFICANCE Our results show that footwear use was associated with a lower odds of several different NTDs. Access to footwear should be prioritized alongside existing NTD interventions to ensure a lasting reduction of multiple NTDs and to accelerate their control and elimination. PROTOCOL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42012003338.
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Affiliation(s)
- Sara Tomczyk
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Kebede Deribe
- Brighton & Sussex Medical School, Brighton, United Kingdom
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Simon J. Brooker
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hannah Clark
- Brighton & Sussex Medical School, Brighton, United Kingdom
| | - Khizar Rafique
- Brighton & Sussex Medical School, Brighton, United Kingdom
| | - Stefanie Knopp
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Gail Davey
- Brighton & Sussex Medical School, Brighton, United Kingdom
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14
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Kobylinski KC, Alout H, Foy BD, Clements A, Adisakwattana P, Swierczewski BE, Richardson JH. Rationale for the coadministration of albendazole and ivermectin to humans for malaria parasite transmission control. Am J Trop Med Hyg 2014; 91:655-62. [PMID: 25070998 PMCID: PMC4183382 DOI: 10.4269/ajtmh.14-0187] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022] Open
Abstract
Recently there have been calls for the eradication of malaria and the elimination of soil-transmitted helminths (STHs). Malaria and STHs overlap in distribution, and STH infections are associated with increased risk for malaria. Indeed, there is evidence that suggests that STH infection may facilitate malaria transmission. Malaria and STH coinfection may exacerbate anemia, especially in pregnant women, leading to worsened child development and more adverse pregnancy outcomes than these diseases would cause on their own. Ivermectin mass drug administration (MDA) to humans for malaria parasite transmission suppression is being investigated as a potential malaria elimination tool. Adding albendazole to ivermectin MDAs would maximize effects against STHs. A proactive, integrated control platform that targets malaria and STHs would be extremely cost-effective and simultaneously reduce human suffering caused by multiple diseases. This paper outlines the benefits of adding albendazole to ivermectin MDAs for malaria parasite transmission suppression.
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Affiliation(s)
- Kevin C Kobylinski
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Haoues Alout
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Brian D Foy
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Archie Clements
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Poom Adisakwattana
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Brett E Swierczewski
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Jason H Richardson
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
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15
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Richards FO, Emukah E, Graves PM, Nkwocha O, Nwankwo L, Rakers L, Mosher A, Patterson A, Ozaki M, Nwoke BEB, Ukaga CN, Njoku C, Nwodu K, Obasi A, Miri ES. Community-wide distribution of long-lasting insecticidal nets can halt transmission of lymphatic filariasis in southeastern Nigeria. Am J Trop Med Hyg 2013; 89:578-87. [PMID: 23939708 PMCID: PMC3771303 DOI: 10.4269/ajtmh.12-0775] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 05/17/2013] [Indexed: 11/07/2022] Open
Abstract
Lymphatic filariasis (LF) in rural southeastern Nigeria is transmitted mainly by Anopheles spp. mosquitoes. Potential coinfection with Loa loa in this area has prevented use of ivermectin in the mass drug administration (MDA) strategy for LF elimination because of potential severe adverse L. loa-related reactions. This study determined if long-lasting insecticidal net (LLIN) distribution programs for malaria would interrupt LF transmission in such areas, without need for MDA. Monthly entomologic monitoring was conducted in sentinel villages before and after LLIN distribution to all households and all age groups (full coverage) in two districts, and to pregnant women and children less than five years of age in the other two districts. No change in human LF microfilaremia prevalence was observed, but mosquito studies showed a statistically significant decrease in LF infection and infectivity with full-coverage LLIN distribution. We conclude that LF transmission can be halted in southeastern Nigeria by full-coverage LLIN distribution, without MDA.
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Affiliation(s)
- Frank O Richards
- Malaria, River Blindness, Lymphatic Filariasis, and Schistosomiasis Programs, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, USA.
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16
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Kandeel M, Elgazar W, Kitade Y. The Binding Interactions of the Macrolide Endectocide Ivermectin with the Antibiotics Ampicillin, Chloramphenicol and Tetracycline HCL. Indian J Pharm Sci 2013; 74:592-6. [PMID: 23798790 PMCID: PMC3687934 DOI: 10.4103/0250-474x.110635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/11/2012] [Accepted: 12/22/2012] [Indexed: 12/26/2022] Open
Abstract
Ivermectin, chloramphenicol, ampicillin and tetracycline HCl are common drugs in human and veterinary practice. The purpose of this study is to investigate the possible binding interactions between ivermectin and the antibiotics chloramphenicol, ampicillin and tetracycline HCl. Isothermal titration calorimetry was used to determine the binding interactions between ivermectin and these antibiotics. Results indicated that, about three molecules of ampicillin can bind to one molecule of ivermectin and about one molecule of chloramphenicol with one molecule of ivermectin. However, no binding stoichiometry can be detected with tetracycline HCl-ivermectin titration. Furthermore, the binding interactions were accompanied by various biophysical and biochemical mechanisms. This is the first report of such interactions of ivermectin with chloramphenicol, ampicillin and tetracycline HCl. There are possible binding interactions of ivermectin with chloramphenicol and ampicillin. Further studies are required for detecting the impact of this binding on biological aspects of drug actions.
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Affiliation(s)
- M Kandeel
- United Graduate School of Drug Discovery and Medical Information Sciences,Gifu University, Yanagido 1-1, Gifu 501-1193, Japan
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17
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Chaccour CJ, Kobylinski KC, Bassat Q, Bousema T, Drakeley C, Alonso P, Foy BD. Ivermectin to reduce malaria transmission: a research agenda for a promising new tool for elimination. Malar J 2013; 12:153. [PMID: 23647969 PMCID: PMC3658945 DOI: 10.1186/1475-2875-12-153] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 05/01/2013] [Indexed: 11/11/2022] Open
Abstract
Background The heterogeneity of malaria transmission makes widespread elimination a difficult goal to achieve. Most of the current vector control measures insufficiently target outdoor transmission. Also, insecticide resistance threatens to diminish the efficacy of the most prevalent measures, indoor residual spray and insecticide treated nets. Innovative approaches are needed. The use of endectocides, such as ivermectin, could be an important new addition to the toolbox of anti-malarial measures. Ivermectin effectively targets outdoor transmission, has a novel mechanism of action that could circumvent resistance and might be distributed over the channels already in place for the control of onchocerciasis and lymphatic filariasis. Methods The previous works involving ivermectin and Anopheles vectors are reviewed and summarized. A review of ivermectin’s safety profile is also provided. Finally three definitive clinical trials are described in detail and proposed as the evidence needed for implementation. Several smaller and specific supportive studies are also proposed. Conclusions The use of ivermectin solves many challenges identified for future vector control strategies. It is an effective and safe endectocide that was approved for human use more than 25 years ago. Recent studies suggest it might become an effective and complementary strategy in malaria elimination and eradication efforts; however, intensive research will be needed to make this a reality.
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Affiliation(s)
- Carlos J Chaccour
- Internal Medicine Department, Clínica Universidad de Navarra, Av, Pio XII 36, Pamplona 31008, Spain.
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18
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A qualitative study exploring barriers related to use of footwear in rural highland ethiopia: implications for neglected tropical disease control. PLoS Negl Trop Dis 2013; 7:e2199. [PMID: 23638211 PMCID: PMC3636134 DOI: 10.1371/journal.pntd.0002199] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 03/27/2013] [Indexed: 11/19/2022] Open
Abstract
Background The role of footwear in protection against a range of Neglected Tropical Diseases (NTDs) is gaining increasing attention. Better understanding of the behaviors that influence use of footwear will lead to improved ability to measure shoe use and will be important for those implementing footwear programs. Methodology/Principal Findings Using the PRECEDE-PROCEED model we assessed social, behavioral, environmental, educational and ecological needs influencing whether and when children wear shoes in a rural highland Ethiopian community endemic for podoconiosis. Information was gathered from 242 respondents using focus groups, semi-structured interviews and extended case studies. Shoe-wearing norms were said to be changing, with going barefoot increasingly seen as ‘shameful’. Shoes were thought to confer dignity as well as protection against injury and cold. However, many practical and social barriers prevented the desire to wear shoes from being translated into practice. Limited financial resources meant that people were neither able to purchase more than one pair of shoes to ensure their longevity nor afford shoes of the preferred quality. As a result of this limited access, shoes were typically preserved for special occasions and might not be provided for children until they reached a certain age. While some barriers (for example fit of shoe and fear of labeling through use of a certain type of shoe) may be applicable only to certain diseases, underlying structural level barriers related to poverty (for example price, quality, unsuitability for daily activities and low risk perception) are likely to be relevant to a range of NTDs. Conclusions/Significance Using well established conceptual models of health behavior adoption, we identified several barriers to shoe wearing that are amenable to intervention and which we anticipate will be of benefit to those considering NTD prevention through shoe distribution. Consistently wearing shoes may help in preventing onset or progression of a wide range of Neglected Tropical Diseases (NTDs). This study assessed the factors that influenced shoe wearing behaviors among people living in a rural community in highland Ethiopia. In this community, a substantial proportion of people are at risk for podoconiosis, a debilitating lower leg condition that can be prevented by wearing shoes. We conducted semi-structured individual interviews, focus group discussions and extended case studies among 242 adults and systematically analyzed the information. We found that shoe wearing is intermittent, and that different factors such as cost and ability to use the shoes for certain activities (such as farming) influenced consistent shoe wearing for most people. Some factors (such as shoe size, fear of stigma) were more relevant for podoconiosis patients. Social norms were found to be increasingly supportive of shoe wearing, and children exhibited greater desire to wear shoes than adults. These findings have relevance for preventing development and progression of a variety of NTDs in a range of settings.
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Kobylinski KC, Sylla M, Chapman PL, Sarr MD, Foy BD. Ivermectin mass drug administration to humans disrupts malaria parasite transmission in Senegalese villages. Am J Trop Med Hyg 2011; 85:3-5. [PMID: 21734116 DOI: 10.4269/ajtmh.2011.11-0160] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Ivermectin mass drug administration (MDA) to humans is used to control onchocerciasis and lymphatic filariasis. Recent field studies have shown an added killing effect of ivermectin MDA against malaria vectors. We report that ivermectin MDA reduced the proportion of Plasmodium falciparum infectious Anopheles gambiae sensu stricto (s.s.) in treated villages in southeastern Senegal. Ivermectin MDA is a different delivery method and has a different mode of action from current malaria control agents. It could be a powerful and synergistic new tool to reduce malaria transmission in regions with epidemic or seasonal malaria transmission, and the prevalence and intensity of neglected tropical diseases.
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Affiliation(s)
- Kevin C Kobylinski
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado 80523-1692, USA.
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Hodges M, Koroma MM, Baldé MS, Turay H, Fofanah I, Divall MJ, Winkler MS, Zhang Y. Current status of schistosomiasis and soil-transmitted helminthiasis in Beyla and Macenta Prefectures, Forest Guinea. Trans R Soc Trop Med Hyg 2011; 105:672-4. [PMID: 21871646 DOI: 10.1016/j.trstmh.2011.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 07/15/2011] [Accepted: 07/15/2011] [Indexed: 12/11/2022] Open
Abstract
A cross-sectional survey was undertaken in children aged 9-14 years in Beyla and Macenta Prefectures, Forest Guinea. Stool samples were examined by Kato-Katz and urine samples were examined by the centrifugation method. The overall prevalence and intensity of infection was 66.2% and 462.4 eggs per gram of faeces (epg) for Schistosoma mansoni, 21.0% and 17.8 eggs per 10ml of urine for S. haematobium, 51.2% and 507.5 epg for hookworm, 8.1% and 89.1 epg for Ascaris lumbricoides and 2.4% and 16.7 epg for Trichuris trichiura. The overall prevalence of schistosomiasis (S. mansoni and/or S. haematobium) was 70.7%. The prevalence of schistosomiasis was similar to those reported in the 1990s in the region; however, the prevalence of soil-transmitted helminths has since fallen. These findings illustrate the need for schistosomiasis control in Guinea.
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Affiliation(s)
- Mary Hodges
- Helen Keller International, P.O. Box 369, Freetown, Sierra Leone.
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Foy BD, Kobylinski KC, da Silva IM, Rasgon JL, Sylla M. Endectocides for malaria control. Trends Parasitol 2011; 27:423-8. [PMID: 21727027 DOI: 10.1016/j.pt.2011.05.007] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 05/27/2011] [Accepted: 05/31/2011] [Indexed: 02/03/2023]
Abstract
Systemic endectocidal drugs, used to control nematodes in humans and other vertebrates, can be toxic to Anopheles spp. mosquitoes when they take a blood meal from a host that has recently received one of these drugs. Recent laboratory and field studies have highlighted the potential of ivermectin to control malaria parasite transmission if this drug is distributed strategically and more often. There are important theoretical benefits to this strategy, as well as caveats. A better understanding of drug effects against vectors and malaria ecologies are needed. In the near future, ivermectin and other endectocides could serve as potent and novel malaria transmission control tools that are directly linked to the control of neglected tropical diseases in the same communities.
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Affiliation(s)
- Brian D Foy
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523-1692, USA.
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Potential drug development candidates for human soil-transmitted helminthiases. PLoS Negl Trop Dis 2011; 5:e1138. [PMID: 21695247 PMCID: PMC3111745 DOI: 10.1371/journal.pntd.0001138] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 02/19/2011] [Indexed: 01/16/2023] Open
Abstract
Background Few drugs are available for soil-transmitted helminthiasis (STH); the benzimidazoles albendazole and mebendazole are the only drugs being used for preventive chemotherapy as they can be given in one single dose with no weight adjustment. While generally safe and effective in reducing intensity of infection, they are contra-indicated in first-trimester pregnancy and have suboptimal efficacy against Trichuris trichiura. In addition, drug resistance is a threat. It is therefore important to find alternatives. Methodology We searched the literature and the animal health marketed products and pipeline for potential drug development candidates. Recently registered veterinary products offer advantages in that they have undergone extensive and rigorous animal testing, thus reducing the risk, cost and time to approval for human trials. For selected compounds, we retrieved and summarised publicly available information (through US Freedom of Information (FoI) statements, European Public Assessment Reports (EPAR) and published literature). Concomitantly, we developed a target product profile (TPP) against which the products were compared. Principal Findings The paper summarizes the general findings including various classes of compounds, and more specific information on two veterinary anthelmintics (monepantel, emodepside) and nitazoxanide, an antiprotozoal drug, compiled from the EMA EPAR and FDA registration files. Conclusions/Significance Few of the compounds already approved for use in human or animal medicine qualify for development track decision. Fast-tracking to approval for human studies may be possible for veterinary compounds like emodepside and monepantel, but additional information remains to be acquired before an informed decision can be made. There are few drugs - none ideal - for the treatment and control of gastrointestinal helminths (soil-transmitted nematodes) which, as chronic infections jeopardize children's growth, learning and ultimately individual, community and country development. Drugs for helminths are not attractive in human medicine, but are lucrative in animal health. Traditionally, investment in veterinary medicines has benefited humans for these diseases. With modern regulations an approved veterinary medicine can be tested in humans with little adaptation, reducing time and cost of development. We searched for products that could easily be transitioned into humans, having the necessary characteristics for use in communities exposed to these infections. A limited number of candidates met the main criteria for selection. We provide here a detailed analysis of two veterinary products, emodepside and monepantel, and nitazoxanide, which is approved for human use. In addition we include a less detailed analysis of all products examined, and the criteria on which the analysis was based. It is clear that the pipeline of easily obtainable human anthelminthics remains extremely limited, and further efforts are needed to find replacements for the inadequate number of products available today.
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Sylla M, Kobylinski KC, Gray M, Chapman PL, Sarr MD, Rasgon JL, Foy BD. Mass drug administration of ivermectin in south-eastern Senegal reduces the survivorship of wild-caught, blood fed malaria vectors. Malar J 2010; 9:365. [PMID: 21171970 PMCID: PMC3016374 DOI: 10.1186/1475-2875-9-365] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 12/20/2010] [Indexed: 11/25/2022] Open
Abstract
Background In south-eastern Senegal, malaria and onchocerciasis are co-endemic. Onchocerciasis in this region has been controlled by once or twice yearly mass drug administration (MDA) with ivermectin (IVM) for over fifteen years. Since laboratory-raised Anopheles gambiae s.s. are susceptible to ivermectin at concentrations found in human blood post-ingestion of IVM, it is plausible that a similar effect could be quantified in the field, and that IVM might have benefits as a malaria control tool. Methods In 2008 and 2009, wild-caught blood fed An. gambiae s.l. mosquitoes were collected from huts of three pairs of Senegalese villages before and after IVM MDAs. Mosquitoes were held in an insectary to assess their survival rate, subsequently identified to species, and their blood meals were identified. Differences in mosquito survival were statistically analysed using a Glimmix model. Lastly, changes in the daily probability of mosquito survivorship surrounding IVM MDAs were calculated, and these data were inserted into a previously developed, mosquito age-structured model of malaria transmission. Results Anopheles gambiae s.s. (P < 0.0001) and Anopheles arabiensis (P = 0.0191) from the treated villages had significantly reduced survival compared to those from control villages. Furthermore, An gambiae s.s. caught 1-6 days after MDA in treated villages had significantly reduced survival compared to control village collections (P = 0.0003), as well as those caught pre-MDA (P < 0.0001) and >7 days post-MDA (P < 0.0001). The daily probability of mosquito survival dropped >10% for the six days following MDA. The mosquito age-structured model of malaria transmission demonstrated that a single IVM MDA would reduce malaria transmission (Ro) below baseline for at least eleven days, and that repeated IVM MDAs would result in a sustained reduction in malaria Ro. Conclusions Ivermectin MDA significantly reduced the survivorship of An. gambiae s.s. for six days past the date of the MDA, which is sufficient to temporarily reduce malaria transmission. Repeated IVM MDAs could be a novel and integrative malaria control tool in areas with seasonal transmission, and which would have simultaneous impacts on neglected tropical diseases in the same villages.
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Affiliation(s)
- Massamba Sylla
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology & Pathology, Colorado State University, Fort Collins, Colorado, USA.
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