Background. Praziquantel mass drug administration (MDA) is recommended in schistosomiasis-endemic areas. Animal models demonstrate Schistosoma parasite resistance to praziquantel after repeated... Show moreBackground. Praziquantel mass drug administration (MDA) is recommended in schistosomiasis-endemic areas. Animal models demonstrate Schistosoma parasite resistance to praziquantel after repeated exposure.Methods. We conducted a parasitological survey in 26 fishing communities in Uganda after 4 years of quarterly (13 communities) or annual (13 communities) praziquantel MDA, with Schistosoma infection detected by single-stool-sample Kato-Katz. A test of cure was done in participants who were positive on both urine circulating cathodic antigen test and 3-sample Kato-Katz. We calculated cure rates (CRs) and egg reduction rates (ERRs) based on 3-sample Kato-Katz and infection intensity using worm-specific circulating anodic antigen (CAA) in blood, comparing these between quarterly and annually treated participants.Results. Single-sample Kato-Katz Schistosoma mansoni prevalence was 22% in 1,056 quarterly treated participants and 34% in 1,030 annually treated participants (risk ratio, 0.62; 95% confidence interval [CI], 0.40 to 0.94). Among 110 test-of-cure participants, CRs were 65% and 51% in annually and quarterly treated villages, respectively (odds ratio, 0.65; 95% CI, 0.27 to 1.58); ERRs were 94% and 81% (difference, -13%; 95% CI, -48% to 2%). There was no impact of quarterly vs annual praziquantel on S. mansoni by CAA.Conclusions. In this schistosomiasis hot spot, there was little evidence of decreased praziquantel efficacy. However, in the absence of alternative therapies, there remains a need for continued vigilance of praziquantel efficacy in the MDA era. Show less
Egesa, M.; Lubyayi, L.; Tukahebwa, E.M.; Bagaya, B.S.; Chalmers, I.W.; Wilson, S.; ... ; Cose, S. 2018
Purpose: Sensitive diagnosis, monitoring of disease progression and the evaluation of chemotherapeutic interventions are of prime importance for the improvement of control and prevention strategies... Show morePurpose: Sensitive diagnosis, monitoring of disease progression and the evaluation of chemotherapeutic interventions are of prime importance for the improvement of control and prevention strategies for Schistosomiasis. The aim of the present study was to identify novel markers of Schistosoma mansoni infection and disease using urine samples from a large cohort from an area endemic for S. mansoni. Experimental design: Urine samples were collected and processed on an automated sample clean-up and fractionation system combining strong cation exchange and reversed phase, and analyzed by MS (MALDI ToF MS). The ClinPro Tools(TM) (CPT) software and the Discrete Wavelet Transformation-Support Vector Machine (DWT-SVM) procedure were used for classification and statistical analysis. Results: We observed a large difference in urinary peptide profiles between children and adults but classification based on infection was possible only for children. Here, in the external validation data set, 93% of the infected children were classified correctly with DWT-SVM (versus 76% for CPT). In addition 91% of low-infected children were classified correctly using DWT-SVM (versus 85% for CPT). The discriminating peptides were identified as fragments of collagen 1A1 and 1A3, and uromodulin. Conclusions and clinical relevance: In conclusion, we provide the usefulness of a peptidomics profiling approach combined with DWT-SVM in the monitoring of S. mansoni infection. Show less
