Establishing a Surveillance System to Monitor the Global Patterns of Drug Efficacy and Emergence of Anthelmintic Resistance in Soil-transmitted Helminth Programs

OPP1120972_WP2

Soil-transmitted helminths (STHs) are a group of parasitic worms that infect millions of children in sub-tropical and tropical countries, resulting in malnutrition, growth stunting, intellectual retardation and cognitive deficits. To control the morbidity due to these worms, school-based deworming programs are implemented, in which anthelminthic drugs are administered to children without prior diagnosis. The continued fight against these worms is aided by the London declaration on neglected tropical diseases, which helps sustain and expand global drug donation program, resulting in an unprecedented growth of deworming programs. However, the high degree of drug pressure makes deworming programs vulnerable to the development of anthelmintic resistance because they only rely on one drug with sometimes suboptimal efficacy and there is no availability of alternative drugs. Moreover, at present, there is no surveillance system to monitor the emergence and spread of anthelmintic resistance. It remains unclear to what extent the efficacy of drugs may have dropped and whether anthelmintic resistance is already present. This project aims to strengthen the monitoring and surveillance of drug efficacy and anthelmintic resistance in STH programs. As such, it will support deworming programs in their quest to eliminate STHs as a public health problem. The overall aim of this study is to pilot a surveillance system to assess anthelmintic drug efficacy and the emergence of AR in 9 countries were drug pressure has been high over a long period of time. The specific objectives are to: 1. Assess the prevalence of moderate/heavy intensity infections of the different STH 2. Assess the drug efficacy of a single dose of BZ drugs against STH infections in these countries 3. Assess the frequency of the ß-tubulin SNPs linked to BZ resistance 4. Identify implementation-related barriers and opportunities for monitoring drug efficacy and AR in national PC programs for STH. 5. Expand the Starworms repository of STH field samples

2019-05-15

2022-12-31

2022-12-31

Completed

9457

Inclusion Criteria: * Subject, male or female, is 5-14 years of age * Subject is otherwise in healthy condition (based on medical history and physical examination) * Parent(s)/guardians of subject signed an informed consent document indicating that they understand the purpose of and procedures required for the study and that they are willing to have their child participate in the study * Subject of ≥6 years has assented to participate in the study * Subject of ≥12 years has signed an informed consent document indicating that they understand the purpose of the study and procedures required for the study and are willing to participate in the study * Subject has provided a stool sample of at least 5 grams. Exclusion Criteria: * Subject has active diarrhoea (defined as the passage of 3 or more loose or liquid stools per day) at baseline or follow-up. * Subject has an acute medical condition or is experiencing a severe concurrent medical condition * Subject has a known hypersensitivity to ALB or MEB * Subject has received anthelmintic treatment within 90 days prior to the start of the treatment * Subject vomited within 4 hours following drug ingestion. * Subject is not able to provide a stool sample of minimum 5 grams at baseline or follow-up. * Subject has not swallowed the entire tablet.

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2023-08-29