Abstract
To eliminate soil-transmitted helminth (STH) infections as a public health problem, the administration of benzimidazole (BZ) drugs to children has recently intensified. But, as drug pressure increases, the development of anthelmintic drug resistance (AR) becomes a major concern. Currently, there is no global surveillance system to monitor drug efficacy and the emergence of AR. Consequently, it is unclear what the current efficacy of the used drugs is and whether AR is already present. The aim of this study is to pilot a global surveillance system to assess anthelmintic drug efficacy and the emergence of AR in STH control programs. For this, we will incorporate drug efficacy trials into national STH control programs of eight countries (Bangladesh, Cambodia, Lao PDR, Vietnam, Ghana, Rwanda, Senegal and a yet to be defined country in the Americas). In each country, one trial will be performed in one program implementation unit to assess the efficacy of BZ drugs against STHs in school-aged children by faecal egg count reduction test. Stool samples will be collected before and after treatment with BZs for Kato-Katz analysis and preserved to purify parasite DNA. The presence and frequency of known single nucleotide polymorphisms (SNPs) in the β-tubulin genes of the different STHs will subsequently be assessed. This study will provide a global pattern of drug efficacy and emergence of AR in STH control programs. The results will provide complementary insights on the validity of known SNPs in the ß-tubulin gene as a marker for AR in human STHs as well as information on the technical and financial resources required to set up a surveillance system. Finally, the collected stool samples will be an important resource to validate different molecular technologies for the detection of AR markers or to identify novel potential molecular markers associated with AR in STH.
Highlights
Today, preventive chemotherapy (PC) is the main strategy to control the morbidity that is caused by soil-transmitted helminths (STHs), which include (Ascaris lumbricoides, Trichuris trichiura, Necator americanus and Ancylostoma duodenale)
The ever-increasing amount of anthelmintic treatments provided to the population could eventually give rise to the development of anthelmintic resistance (AR), as it has occurred in veterinary medicine[5,6,7], where AR was detected in helminth populations within a decade following the introduction of any anthelmintic class[8]
In a first work package of the Starworms project, we evaluated different diagnostic methods to measure drug efficacy and further investigated the presence and distribution of AR-related single nucleotide polymorphisms in STHs16,17
Summary
Any reports and responses or comments on the article can be found at the end of the article. Keywords Soil-transmitted helminths, Kato-Katz thick smear, egg reduction rate, preventive chemotherapy, benzimidazoles, anthelmintic drug resistance, single nucleotide polymorphisms, generation sequencing, loop-mediated isothermal amplification. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
