Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion.
BACKGROUND:The control of schistosomiasis emphasizes preventive chemotherapy with praziquantel, which aims at decreasing infection intensity and thus morbidity in individuals, as well as transmission in communities. Standardizing methods to assess treatment efficacy is important to compare trial out...
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ftdoajarticles:oai:doaj.org/article:d3655891f24845818b56b8598a68e187 2023-05-15T15:14:27+02:00 Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. Piero L Olliaro Michel Vaillant Aïssatou Diawara Jean T Coulibaly Amadou Garba Jennifer Keiser Charles H King Stefanie Knopp Aly Landouré Eliézer K N'Goran Giovanna Raso Alexandra U Scherrer José Carlos Sousa-Figueiredo Katarina Stete Xiao-Nong Zhou Jürg Utzinger 2015-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0003821 https://doaj.org/article/d3655891f24845818b56b8598a68e187 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4473103?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003821 https://doaj.org/article/d3655891f24845818b56b8598a68e187 PLoS Neglected Tropical Diseases, Vol 9, Iss 6, p e0003821 (2015) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2015 ftdoajarticles https://doi.org/10.1371/journal.pntd.0003821 2022-12-31T10:46:05Z BACKGROUND:The control of schistosomiasis emphasizes preventive chemotherapy with praziquantel, which aims at decreasing infection intensity and thus morbidity in individuals, as well as transmission in communities. Standardizing methods to assess treatment efficacy is important to compare trial outcomes across settings, and to monitor program effectiveness consistently. We compared customary methods and looked at possible complementary approaches in order to derive suggestions for standardizing outcome measures. METHODOLOGY/PRINCIPAL FINDINGS:We analyzed data from 24 studies conducted at African, Asian, and Latin American sites, enrolling overall 4,740 individuals infected with Schistosoma mansoni, S. haematobium, or S. japonicum, and treated with praziquantel at doses of 40-80 mg/kg. We found that group-based arithmetic and geometric means can be used interchangeably to express egg reduction rates (ERR) only if treatment efficacy is high (>95%). For lower levels of efficacy, ERR estimates are higher with geometric than arithmetic means. Using the distribution of individual responses in egg excretion, 6.3%, 1.7% and 4.3% of the subjects treated for S. haematobium, S. japonicum and S. mansoni infection, respectively, had no reduction in their egg counts (ERR = 0). The 5th, 10th, and 25th centiles of the subjects treated for S. haematobium had individual ERRs of 0%, 49.3%, and 96.5%; the corresponding values for S. japonicum were 75%, 99%, and 99%; and for S. mansoni 18.2%, 65.3%, and 99.8%. Using a single rather than quadruplicate Kato-Katz thick smear excluded 19% of S. mansoni-infected individuals. Whilst the effect on estimating ERR was negligible by individual studies, ERR estimates by arithmetic means were 8% lower with a single measurement. CONCLUSIONS/SIGNIFICANCE:Arithmetic mean calculations of Schistosoma ERR are more sensitive and therefore more appropriate to monitor drug performance than geometric means. However, neither are satisfactory to identify poor responders. Group-based response estimated ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 9 6 e0003821 |
institution |
Open Polar |
collection |
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 Piero L Olliaro Michel Vaillant Aïssatou Diawara Jean T Coulibaly Amadou Garba Jennifer Keiser Charles H King Stefanie Knopp Aly Landouré Eliézer K N'Goran Giovanna Raso Alexandra U Scherrer José Carlos Sousa-Figueiredo Katarina Stete Xiao-Nong Zhou Jürg Utzinger Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:The control of schistosomiasis emphasizes preventive chemotherapy with praziquantel, which aims at decreasing infection intensity and thus morbidity in individuals, as well as transmission in communities. Standardizing methods to assess treatment efficacy is important to compare trial outcomes across settings, and to monitor program effectiveness consistently. We compared customary methods and looked at possible complementary approaches in order to derive suggestions for standardizing outcome measures. METHODOLOGY/PRINCIPAL FINDINGS:We analyzed data from 24 studies conducted at African, Asian, and Latin American sites, enrolling overall 4,740 individuals infected with Schistosoma mansoni, S. haematobium, or S. japonicum, and treated with praziquantel at doses of 40-80 mg/kg. We found that group-based arithmetic and geometric means can be used interchangeably to express egg reduction rates (ERR) only if treatment efficacy is high (>95%). For lower levels of efficacy, ERR estimates are higher with geometric than arithmetic means. Using the distribution of individual responses in egg excretion, 6.3%, 1.7% and 4.3% of the subjects treated for S. haematobium, S. japonicum and S. mansoni infection, respectively, had no reduction in their egg counts (ERR = 0). The 5th, 10th, and 25th centiles of the subjects treated for S. haematobium had individual ERRs of 0%, 49.3%, and 96.5%; the corresponding values for S. japonicum were 75%, 99%, and 99%; and for S. mansoni 18.2%, 65.3%, and 99.8%. Using a single rather than quadruplicate Kato-Katz thick smear excluded 19% of S. mansoni-infected individuals. Whilst the effect on estimating ERR was negligible by individual studies, ERR estimates by arithmetic means were 8% lower with a single measurement. CONCLUSIONS/SIGNIFICANCE:Arithmetic mean calculations of Schistosoma ERR are more sensitive and therefore more appropriate to monitor drug performance than geometric means. However, neither are satisfactory to identify poor responders. Group-based response estimated ... |
format |
Article in Journal/Newspaper |
author |
Piero L Olliaro Michel Vaillant Aïssatou Diawara Jean T Coulibaly Amadou Garba Jennifer Keiser Charles H King Stefanie Knopp Aly Landouré Eliézer K N'Goran Giovanna Raso Alexandra U Scherrer José Carlos Sousa-Figueiredo Katarina Stete Xiao-Nong Zhou Jürg Utzinger |
author_facet |
Piero L Olliaro Michel Vaillant Aïssatou Diawara Jean T Coulibaly Amadou Garba Jennifer Keiser Charles H King Stefanie Knopp Aly Landouré Eliézer K N'Goran Giovanna Raso Alexandra U Scherrer José Carlos Sousa-Figueiredo Katarina Stete Xiao-Nong Zhou Jürg Utzinger |
author_sort |
Piero L Olliaro |
title |
Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. |
title_short |
Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. |
title_full |
Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. |
title_fullStr |
Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. |
title_full_unstemmed |
Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. |
title_sort |
toward measuring schistosoma response to praziquantel treatment with appropriate descriptors of egg excretion. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2015 |
url |
https://doi.org/10.1371/journal.pntd.0003821 https://doaj.org/article/d3655891f24845818b56b8598a68e187 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 9, Iss 6, p e0003821 (2015) |
op_relation |
http://europepmc.org/articles/PMC4473103?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003821 https://doaj.org/article/d3655891f24845818b56b8598a68e187 |
op_doi |
https://doi.org/10.1371/journal.pntd.0003821 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
9 |
container_issue |
6 |
container_start_page |
e0003821 |
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1766344909001850880 |