title: Monitoring the efficacy of drugs for neglected tropical diseases controlled by preventive chemotherapy.
abstract: In the last decade, pharmaceutical companies, governments and global health organisations under the leadership of the World Health Organization (WHO) have pledged large-scale donations of anthelmintic drugs, including ivermectin (IVM), praziquantel (PZQ), albendazole (ALB) and mebendazole (MEB). This worldwide scale-up in drug donations calls for strong monitoring systems to detect any changes in anthelmintic drug efficacy. This review reports on the outcome of the WHO Global Working Group on Monitoring of Neglected Tropical Diseases Drug Efficacy, which consists of three subgroups: (i) soil-transmitted helminthiases (ALB and MEB); (ii) onchocerciasis and lymphatic filariasis (IVM); and (iii) schistosomiasis (PZQ). Progress of ongoing work, challenges and research needs for each of the four main drugs used in helminthic preventive chemotherapy (PC) are reported, laying the ground for appropriate implementation of drug efficacy monitoring programmes under the co-ordination and guidelines of the WHO. Best practices for monitoring drug efficacy should be made available and capacity built as an integral part of neglected tropical disease (NTD) programme monitoring. Development of a disease-specific model to predict the impact of PC programmes, to detect outliers and to solicit responses is essential. Research studies on genetic polymorphisms in relation to low-efficacy phenotypes should be carried out to identify markers of putative resistance against all NTD drugs and ultimately to develop diagnostic assays. Development of combination and co-administration of NTD drugs as well as of new drug entities to boost the armamentarium of the few drugs available for NTD control and elimination should be pursued in parallel.
authors.affiliation: Fondazione Ivo de Carneri, via IV Marzo 14, 10122 Torino, Italy. Electronic address: albonico@tin.it.
authors.forename: M
authors.initials: M
authors.lastname: Albonico
authors.affiliation: Laboratory of Parasitology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Levecke
authors.affiliation: Departments of Biochemistry and Pathology, University of Texas Health Science Center, 7703 Floyd Curl Dr., MS7760, San Antonio, TX 78229-3900, USA.
authors.forename: P T
authors.initials: PT
authors.lastname: LoVerde
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, CH-1211 Geneva, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Montresor
authors.affiliation: Institute of Parasitology, McGill University, Macdonald Campus, 21 111 Lakeshore Road, St Anne-de-Bellevue, QC, Canada H9X 3V9.
authors.forename: R
authors.initials: R
authors.lastname: Prichard
authors.affiliation: Laboratory of Parasitology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Vercruysse
authors.affiliation: Department of Pathology and Pathogen Biology, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hawkshead Campus, North Mymms AL9 7TA, UK; Department of Infectious Disease Epidemiology, School of Public Health, St Mary's Hospital, Imperial College Faculty of Medicine, London W2 1PG, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Webster
keywords: Anthelmintic drugs; Drug efficacy; Drug resistance; Monitoring