Safety of integrated preventive chemotherapy for neglected tropical diseases.
Background Preventive chemotherapy (PC) is a central strategy for control and elimination of neglected tropical diseases (NTDs). Increased emphasis has been given to "integration" of NTD programs within health systems and coadministration of NTD drugs offers significant programmatic benefi...
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ftdoajarticles:oai:doaj.org/article:8f348c8d499243ab83d42b8e7d07662c 2023-05-15T15:15:41+02:00 Safety of integrated preventive chemotherapy for neglected tropical diseases. Allan M Ciciriello Jessica K Fairley Emma Cooke Paul M Emerson Pamela J Hooper Birgit Bolton Genevieve LaCon David G Addiss 2022-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010700 https://doaj.org/article/8f348c8d499243ab83d42b8e7d07662c EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010700 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010700 https://doaj.org/article/8f348c8d499243ab83d42b8e7d07662c PLoS Neglected Tropical Diseases, Vol 16, Iss 9, p e0010700 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010700 2022-12-30T21:35:46Z Background Preventive chemotherapy (PC) is a central strategy for control and elimination of neglected tropical diseases (NTDs). Increased emphasis has been given to "integration" of NTD programs within health systems and coadministration of NTD drugs offers significant programmatic benefits. Guidance from the World Health Organization (WHO) reflects current evidence for safe drug coadministration and highlights measures to prevent choking of young children during PC. Methodology To understand how coadministration of NTD drugs might affect PC safety, we reviewed literature on choking risk in young children and safety of coadministered NTD drugs. To understand current practices of drug coadministration, we surveyed 15 NTD program managers and implementing partners. Principal findings In high-income countries, choking on medication is an infrequent cause of death in young children. In low-resource settings, data are limited, but age-appropriate drug formulations are less available. During PC, fatal choking, although infrequent, occurs primarily in young children; forcing them to swallow tablets appears to be the major risk factor. The WHO currently recommends 6 drugs and 5 possible drug combinations for use in PC. Of 105 nations endemic for the 5 PC-NTDs, 72 (68.6%) are co-endemic for 2 or more diseases and could benefit from drug coadministration during PC. All 15 survey respondents reported coadministering medications during PC. Reported responses to a child refusing to take medicine included: not forcing the child to do so (60.0%), encouraging the child (46.7%), bringing the child back later (26.7%), offering powder for oral suspension (POS) for azithromycin (13.3%), and having parents or community members intervene to calm the child (6.7%). Conclusions Coadministration of NTD drugs during PC appears to be increasingly common. Safety of coadministered PC drugs requires attention to choking prevention, use of approved drug combinations, and increased access to age-appropriate drug formulations. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 16 9 e0010700 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Allan M Ciciriello Jessica K Fairley Emma Cooke Paul M Emerson Pamela J Hooper Birgit Bolton Genevieve LaCon David G Addiss Safety of integrated preventive chemotherapy for neglected tropical diseases. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Preventive chemotherapy (PC) is a central strategy for control and elimination of neglected tropical diseases (NTDs). Increased emphasis has been given to "integration" of NTD programs within health systems and coadministration of NTD drugs offers significant programmatic benefits. Guidance from the World Health Organization (WHO) reflects current evidence for safe drug coadministration and highlights measures to prevent choking of young children during PC. Methodology To understand how coadministration of NTD drugs might affect PC safety, we reviewed literature on choking risk in young children and safety of coadministered NTD drugs. To understand current practices of drug coadministration, we surveyed 15 NTD program managers and implementing partners. Principal findings In high-income countries, choking on medication is an infrequent cause of death in young children. In low-resource settings, data are limited, but age-appropriate drug formulations are less available. During PC, fatal choking, although infrequent, occurs primarily in young children; forcing them to swallow tablets appears to be the major risk factor. The WHO currently recommends 6 drugs and 5 possible drug combinations for use in PC. Of 105 nations endemic for the 5 PC-NTDs, 72 (68.6%) are co-endemic for 2 or more diseases and could benefit from drug coadministration during PC. All 15 survey respondents reported coadministering medications during PC. Reported responses to a child refusing to take medicine included: not forcing the child to do so (60.0%), encouraging the child (46.7%), bringing the child back later (26.7%), offering powder for oral suspension (POS) for azithromycin (13.3%), and having parents or community members intervene to calm the child (6.7%). Conclusions Coadministration of NTD drugs during PC appears to be increasingly common. Safety of coadministered PC drugs requires attention to choking prevention, use of approved drug combinations, and increased access to age-appropriate drug formulations. |
format |
Article in Journal/Newspaper |
author |
Allan M Ciciriello Jessica K Fairley Emma Cooke Paul M Emerson Pamela J Hooper Birgit Bolton Genevieve LaCon David G Addiss |
author_facet |
Allan M Ciciriello Jessica K Fairley Emma Cooke Paul M Emerson Pamela J Hooper Birgit Bolton Genevieve LaCon David G Addiss |
author_sort |
Allan M Ciciriello |
title |
Safety of integrated preventive chemotherapy for neglected tropical diseases. |
title_short |
Safety of integrated preventive chemotherapy for neglected tropical diseases. |
title_full |
Safety of integrated preventive chemotherapy for neglected tropical diseases. |
title_fullStr |
Safety of integrated preventive chemotherapy for neglected tropical diseases. |
title_full_unstemmed |
Safety of integrated preventive chemotherapy for neglected tropical diseases. |
title_sort |
safety of integrated preventive chemotherapy for neglected tropical diseases. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010700 https://doaj.org/article/8f348c8d499243ab83d42b8e7d07662c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 9, p e0010700 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010700 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010700 https://doaj.org/article/8f348c8d499243ab83d42b8e7d07662c |
op_doi |
https://doi.org/10.1371/journal.pntd.0010700 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
16 |
container_issue |
9 |
container_start_page |
e0010700 |
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1766346029035159552 |