title: Putting the treatment of paediatric schistosomiasis into context.
abstract: Despite increased international efforts to control schistosomiasis using preventive chemotherapy, several challenges still exist in reaching the target populations. Until recently, preschool-aged children had been excluded from the recommended target population for mass drug administration, i.e. primary school children aged 6-15 years. Our studies and those of others provided the evidence base for the need to treat preschool-aged children that led to recommendations by the World Health Organization to include preschool-aged children in treatment programmes in 2010. The major challenge now lies in the unavailability of a child-size formulation of the appropriate anthelmintic drug, praziquantel.The currently available formulation of praziquantel presents several problems. First, it is a large tablet, making it difficult for young children and infants to swallow it and thus requires its breaking/crushing to allow for safe uptake. Second, it is bitter so it is often mixed with a sweetener to make it palatable for young children. Third, the current formulation of 600 mg does not allow for flexible dose adjustments for this age group. Thus, there is a need to formulate a child-appropriate praziquantel tablet.This paper discusses the target product profile for paediatric praziquantel, as well as knowledge gaps pertinent to the successful control of schistosome infection and disease in preschool-aged children.
authors.affiliation: Biochemistry Department, University of Zimbabwe, P.O. Box MP167, Mount Pleasant, Harare, Zimbabwe. tmduluza@yahoo.com.|School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa. tmduluza@yahoo.com.
authors.forename: Takafira
authors.identifier: http://orcid.org/0000-0002-5613-5014
authors.initials: T
authors.lastname: Mduluza
authors.affiliation: Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Charlotte Auerbach Road, Edinburgh, EH9 3FL, UK.
authors.forename: Francisca
authors.initials: F
authors.lastname: Mutapi
mesh_terms: D000293:Adolescent; D000871:Anthelmintics / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004339:Drug Compounding; D006801:Humans; D017410:Practice Guidelines as Topic; D011223:Praziquantel / Q000008:administration & dosage; D012552:Schistosomiasis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D014944:World Health Organization
chemical_list: D000871:Anthelmintics; D011223:Praziquantel
keywords: Child-size medicine; Drug pipeline; Paediatric schistosomiasis; Praziquantel; Target product profile