Treatment with praziquantel (PZQ) has become virtually the sole basis of schistosomiasis control in sub-Saharan Africa 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 PZQs mechanisms of action at the molecular level, the need for more work to be done on schistosome isolates that have been recently collected from endemic areas rather than those maintained in laboratory conditions for long periods, and our reliance for experimental work mainly on Schistosoma mansoni, little 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 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 effect complete cures in populations given a routine treatment should therefore solicit grave concern. With few alternatives to PZQ now available, 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.
Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs
Cioli D;
2009
Abstract
Treatment with praziquantel (PZQ) has become virtually the sole basis of schistosomiasis control in sub-Saharan Africa 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 PZQs mechanisms of action at the molecular level, the need for more work to be done on schistosome isolates that have been recently collected from endemic areas rather than those maintained in laboratory conditions for long periods, and our reliance for experimental work mainly on Schistosoma mansoni, little 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 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 effect complete cures in populations given a routine treatment should therefore solicit grave concern. With few alternatives to PZQ now available, 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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
