Impact of a 3-year mass drug administration pilot project for taeniasis control in Madagascar

Abstract

Taenia solium is endemic in Madagascar and presents a significant burden on the population and the health system. The parasite cycles through humans who host the adult tapeworm, and pigs that host the larval stages. Accidental infection of humans may occur with the larval stages which encyst in the nervous central system causing neurocysticercosis, a major cause of seizure disorders and a public health problem. One of the interventions to facilitate the control of the disease is mass drug administration (MDA) of the human population with taeniacide. Here we describe a pilot project conducted in Antanifotsy district of Madagascar from 2015 to 2017 where three annual rounds of MDA (praziquantel, 10mg/Kg) were undertaken in 52 villages. Changes in the prevalence of taeniasis were assessed before, during and after the treatments. A total of 221,308 treatments were given to all eligible people above 5 years of age representing a 95% coverage of the targeted population. No major adverse effects were notified related to the implementation of the MDA. The prevalence of taeniasis was measured using Kato-Katz and copro-antigen techniques. Analyses undertaken combining the results of the Kato-Katz with copro-antigen, or using the Kato-Katz results alone, showed that there was a significant reduction in taeniasis 4 months after the last MDA, but 12 months later (16 months after the last MDA) the taeniasis prevalence had returned to its original levels. Results of the pilot project emphasize the need of a multisectorial One-Health approach for the sustained control of T. solium.

Safety of praziquantel in persons with and without schistosomiasis: systematic review and meta-analysis

“…Of the 134 studies, 71 (53.0%) were described by the authors as RCTs, 37 studies (27.6%) were non-randomized clinical trials, 21 (15.7%) were MDA and one case series (Cherit et al 2014) and one case study (Bada et al 1988). The design of three studies (Ahmed et al 1988; Braae et al 2016; Ramiandrasoa et al 2020) was not stated by the authors but data were extracted and reported as unclear study design. Twenty-four (24) of the RCTs had multiple arms, and we analyzed according to arms in order to preserve the randomization code.…”

“…None of the 20 people treated with 10 mg/kg PZQ experienced any adverse event. Ramiandrasoa et al 2020 recorded adverse events in less than 0.5% in each of the three rounds of MDA that treated 221,308 people. Majorly, nausea and temporary diarrhoea were the reported adverse events.…”

“…Two studies (Braae et al, 2016; Ramiandrasoa et al 2020) reported on the use of PZQ in treating Taeniasis. In two of the studies (Braae et al 2016 and; Ramiandrasoa et al 2020), the treated species was Taenia solium but the species in Hong 2018 was not known as the study relied on data from a drug safety surveillance database where safety issues were self-reported. The two former studies both administered PZQ at the WHO recommended dose of 10 mg/kg for treating Taeniasis, much lower than the 40 mg/kg for treating Schistosomiasis.…”

Development of a dose-response model for porcine cysticercosis

“…In conjunction with the high infectivity of eggs shown in this study, these processes may help T . solium maintain its endemic stability and return to the original levels of disease after the completion of control programs if these are not focused on the treatment of both human and porcine population [ 54 , 56 ]. Enhancing biosecurity levels to mitigate the risk of accidental ingestion of eggs is also recommended based on the high infectivity of T .…”

Practices in research, surveillance and control of neglected tropical diseases by One Health approaches: A survey targeting scientists from French-speaking countries

“…Additionally, our results are more representative of One Health experiences on research than on control/surveillance given that 55% of the respondents worked in research institutions and 15% in universities. Even though research and control/surveillance activities can be jointly implemented [ 59 ], it would have been valuable to stratify our analysis based on the distinction between them. Further similar surveys should therefore ask respondents to make this distinction and to provide additional information on their background (e.g.…”