Parasitology

SECTION 5 TOWARDS FUTURE USE OF PRAZIQUANTEL

Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs

M. J. DOENHOFFa1 c1, P. HAGANa2, D. CIOLIa3, V. SOUTHGATEa4, L. PICA-MATTOCCIAa3, S. BOTROSa5, G. COLESa6, L. A. TCHUEM TCHUENTÉa7, A. MBAYEa8 and D. ENGELSa9

a1 School of Biology, University of Nottingham, University Park, Nottingham NG7 2RD, UK

a2 Faculty of Biomedical and Life Sciences, Division of Infection and Immunity, University of Glasgow, Scotland, G12 8QQ, UK

a3 Institute of Cell Biology, 32 Via Ramarini, 00015 Monterotondo, Rome, Italy

a4 Parasitology Division, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, Cromwell Road, South Kensington, London SW7 5BD, UK

a5 Theodor Bilharz Research Institute, Warrak El-Hadar Imbaba, P.O. Box 30, Imbaba, Giza, 12411 Egypt

a6 Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK

a7 Centre for Schistosomiasis and Parasitology, University of Yaoundé I, P.O. Box 7244, Yaoundé, Cameroon

a8 Institut Médecine Tropicale Appliquée, University of Dakar, B.P. 11294, Dakar Peytavin, Senegal

a9 World Health Organization, Department of Neglected Tropical Diseases, Preventive Chemotherapy and Transmission Control, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland

SUMMARY

Treatment with praziquantel (PZQ) has become virtually the sole basis of schistosomiasis control in sub-Saharan Africa and elsewhere, and the drug is reviewed here in the context of the increasing rate that it is being used for this purpose. Attention is drawn to our relative lack of knowledge about the mechanisms of action of PZQ at the molecular level, the need for more work to be done on schistosome isolates that have been collected recently from endemic areas rather than those maintained in laboratory conditions for long periods, and our reliance for experimental work mainly on Schistosoma mansoni, little work having been done on S. haematobium. There is no evidence that resistance to PZQ has been induced in African schistosomes as a result of its large-scale use on that continent to date, but there is also no assurance that PZQ and/or schistosomes are in any way unique and that resistant organisms will not be selected as a result of widespread drug usage. The failure of PZQ to produce complete cures in populations given a routine treatment should therefore solicit considerable concern. With few alternatives to PZQ currently available and/or on the horizon, methods to monitor drug-susceptibility in African schistosomes need to be devised and used to help ensure that this drug remains effective for as long a time as possible.

(Online publication March 13 2009)

Correspondence:

c1 Corresponding author: Michael J. Doenhoff, School of Biology, University of Nottingham, University Park, Nottingham NG7 2RD, UK. Tel: +44 1115 951-3304; Fax: +44 115 951-3251; E-mail: mike.doenhoff@nottingham.ac.uk

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