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Patterns of praziquantal usage and monitoring of possible resistance in Africa

Objective

To establish a network of scientists, field workers and health administrators dealing with the treatment of schistosomiasis, a parasitic disease affecting about 200 million people in tropical and sub-tropical countries. Since treatment is almost universally performed using a single drug, praziquantel, the objective of this Concerted Action is to examine in a global perspective various issues related to praziquantel usage, among which:

* to determine the most cost-effective ways of procuring, distributing and evaluating the drug;

* to compare various local experiences regarding drug dosage and administration schedules;

* to collect information on major side-effects and possibly identify any associated risk factors;

* to compare and evaluate all available data on the suspected appearance of drug resistance in the human population;

* to organise the collection of possible resistant isolates of the parasite, their propagation in the laboratory and their testing in experimental animal models;

* to distribute biological samples to research laboratories in order to study the still largely unknown mechanisms of praziquantel action;

* to identify a number of "reference centres" for the monitoring of drug resistance;

* to formulate policies to assist national health authorities to deal with any occurrence of drug resistance.
Expected Outcome

This study will collect a broad range of data on praziquantel usage to help field workers and health administrators in the planning and implementation of antischistosomal chemotherapy. The controversial issue of drug resistance will be tackled by organising the collection and the analysis of potentially resistant parasite isolates. The use of such isolates for the study of basic mechanisms of drug activity will be pursued. Guidelines will be developed for the most rational use of praziquantel and for alternative strategies in case of resistance.
The initial nucleus of six European and nine African members will hold three general meetings, which will be extended to outside experts and additional participants, as deemed appropriate. Guidelines and protocols for the monitoring of resistance will be developed and field-tested, suspected resistant isolates will be collected and distributed to research laboratories. One or more reference centres will be established in Africa and basic equipment and training will be supplied. Information on drug procurement, costs, suggested delivery schedules and observed side-effects will be distributed to all interested bodies and individuals.

Funding Scheme

CON - Coordination of research actions

Coordinator

Consorzio per lo Sviluppo della Medicina Tropicale
Address
Viale Marx 43
00137 Roma
Italy

Participants (14)

INSTITUT AGRONOMIQUE ET VETERINAIRE HASSAN II
Morocco
Address
10101,Avenue Allal El Fassi, Rabat Institutes
10101 Rabat / Agdal
INSTITUTE OF TROPICAL MEDICINE PRINCE LEOPOLD
Belgium
Address
155,Nationalestraat 155
2000 Anvers /Antwerpen
Ministry of Health - Saoudi Arabia
Saudi Arabia
Address

10 Gizan
Ministry of Health and Population - Republic of Egypt
Egypt
Address
51,Wezrat El Zeraa Street
11511 Cairo
Ministry of Health of Tanzania
Tanzania
Address

10 Zanzibar
National Centre for Research
Sudan
Address

1111 Khartoum
Région Médicale de St.Louis du Sénégal - Ministère de la Santé Publique et Action Sociale
Senegal
Address

40 Saint Louis
The Natural History Museum
United Kingdom
Address
Cromwell Road
SW7 5BD London
UNIVERSITY OF GLASGOW
United Kingdom
Address
University Avenue, Graham Kerr Building
G12 8QQ Glasgow
UNIVERSITY OF WALES - BANGOR
United Kingdom
Address
Deiniol Road
LL57 2UW Bangor - Gwynedd
University of Alexandria
Egypt
Address
Horreya Avenue
21561 Alexandria
University of Natal
South Africa
Address
4014,Dalbridge
7000 Durban
University of Zagazig
Egypt
Address
Sharkia Governorate
44111 Zaqazil.el
World Health Organization
Switzerland
Address
20,Avenue Appia
1211 Genève 27