scholarly journals 2,4-Diaminothieno[3,2-d]pyrimidines, a new class of anthelmintic with activity against adult and egg stages of whipworm

2018 ◽  
Author(s):  
Frederick A. Partridge ◽  
Ruth Forman ◽  
Nicky J. Willis ◽  
Carole J.R. Bataille ◽  
Emma A. Murphy ◽  
...  

AbstractThe human whipworm Trichuris trichiura is a parasite that infects around 500 million people globally, with consequences including damage to physical growth and educational performance. Current drugs such as mebendazole have a notable lack of efficacy against whipworm, compared to other soil-transmitted helminths. Mass drug administration programs are therefore unlikely to achieve eradication and new treatments for trichuriasis are desperately needed. All current drug control strategies focus on post-infection eradication, targeting the parasite in vivo. Here we propose developing novel anthelmintics which target the egg stage of the parasite in the soil as an adjunct environmental strategy. As evidence in support of such an approach we describe the actions of a new class of anthelmintic compounds, the 2,4-diaminothieno[3,2-d]pyrimidines (DATPs). This compound class has found broad utility in medicinal chemistry, but has not previously been described as having anthelmintic activity. Importantly, these compounds show efficacy against not only the adult parasite, but also both the embryonated and unembryonated egg stages and thereby may enable a break in the parasite lifecycle.Author SummaryThe human whipworm, Trichuris trichiura, infects around 500 million people globally, impacting on their physical growth and educational performance. There are currently huge mass drug administration (MDA) programs aiming to control whipworm, along with the other major soil transmitted helminths, Ascaris and hookworm. However single doses of albendazole and mebendazole, which are used in MDA, have particularly poor effectiveness against whipworm, with cure rates less than 40%. This means that MDA may not be able to control and eliminate whipworm infection, and risks the spread of resistance to albendazole and mebendazole in the parasite population.We are attempting to develop new treatments for parasitic worm infection, particularly focused on whipworm. We report the identification of a class of compounds, diaminothienopyrimidines (DATPs), which have not previously been described as anthelmintics. These compounds are effective against adult stages of whipworm, and also block the development of the model nematode C. elegans.Our DATP compounds reduce the ability of treated eggs to successfully establish infection in a mouse model of human whipworm. These results support a potential environmental spray to control whipworm by targeting the infectious egg stage in environmental hotspots.

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049734
Author(s):  
Katya Galactionova ◽  
Maitreyi Sahu ◽  
Samuel Paul Gideon ◽  
Saravanakumar Puthupalayam Kaliappan ◽  
Chloe Morozoff ◽  
...  

ObjectiveTo present a costing study integrated within the DeWorm3 multi-country field trial of community-wide mass drug administration (cMDA) for elimination of soil-transmitted helminths.DesignTailored data collection instruments covering resource use, expenditure and operational details were developed for each site. These were populated alongside field activities by on-site staff. Data quality control and validation processes were established. Programmed routines were used to clean, standardise and analyse data to derive costs of cMDA and supportive activities.SettingField site and collaborating research institutions.Primary and secondary outcome measuresA strategy for costing interventions in parallel with field activities was discussed. Interim estimates of cMDA costs obtained with the strategy were presented for one of the trial sites.ResultsThe study demonstrated that it was both feasible and advantageous to collect data alongside field activities. Practical decisions on implementing the strategy and the trade-offs involved varied by site; trialists and local partners were key to tailoring data collection to the technical and operational realities in the field. The strategy capitalised on the established processes for routine financial reporting at sites, benefitted from high recall and gathered operational insight that facilitated interpretation of the estimates derived. The methodology produced granular costs that aligned with the literature and allowed exploration of relevant scenarios. In the first year of the trial, net of drugs, the incremental financial cost of extending deworming of school-aged children to the whole community in India site averaged US$1.14 (USD, 2018) per person per round. A hypothesised at-scale routine implementation scenario yielded a much lower estimate of US$0.11 per person treated per round.ConclusionsWe showed that costing interventions alongside field activities offers unique opportunities for collecting rich data to inform policy toward optimising health interventions and for facilitating transfer of economic evidence from the field to the programme.Trial registration numberNCT03014167; Pre-results.


2020 ◽  
Author(s):  
Legese Chelkeba ◽  
Tsegaye Melaku ◽  
Daniel Emana ◽  
Worku Jimma

Abstract Background: Comprehensive nationwide on prevalence, geographic distribution of different species and time trends of soil-transmitted helminths (STHs) are lacking. Therefore, the aim of this study was to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia. Methods: The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science and Google Scholar on data published between 1995 to Fabruary 2020 for studies describing rate of STHs infection among preschool and school-age in Ethiopian. We followed Patient, intervention, Comparsion and Outcome (PICO) approach to identify the studies. Endnote citation manager software version X9 for Windows was utilized to collect and organize search outcomes (into relevant and irrelevant studies) and for removal duplicate articles . We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using ‘metaprop’ command using STATA software version 14.Results: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48 % (95%CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95%CI : 31% - 58%) in SNNPR, 34%((95%CI : 28% - 41%) in Amhara region, 31% (95%CI : 19% - 43%) in Oromia region and 10% (95%CI : 7% - 12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI:30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI:25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A. lumbricoides was the predominant species with a prevalence of 17%. Conclusion: Southern Nations Nationalities and Peoples Region , Amhara and Oromia regions carry the highest burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring mass drug administration (MDA) once annually with Albendazole or Mebendazole. Prevalence of SHTs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia.


2020 ◽  
Vol 14 (4) ◽  
pp. e0008258 ◽  
Author(s):  
Hugo Legge ◽  
Stella Kepha ◽  
Mateo Prochazka ◽  
Katherine Halliday ◽  
Rachel Pullan ◽  
...  

2016 ◽  
Vol 37 (1) ◽  
pp. 10
Author(s):  
Richard S Bradbury ◽  
Patricia M Graves

Soil transmitted helminths (STH), comprising Ascaris, Trichuris, Strongyloides and the hookworms remain a significant cause of morbidity amongst people in many parts of the world, including Australia. Other important helminth infections include lymphatic filariasis (LF), schistosomiasis and onchocerciasis. Preventive chemotherapy (mass drug administration [MDA]) campaigns are frequently conducted for these helminth infections in endemic areas, but the target population groups, duration of campaigns, cointerventions (e.g. vector control) criteria for inclusion, drugs used and doses of drugs differ.


2017 ◽  
Vol 2 (Suppl 2) ◽  
pp. A58.2-A58
Author(s):  
Buhari Adamu Hamidu ◽  
Tettevi Edward Jenner ◽  
Larbi John Asiedu ◽  
Mike Osei-Atweneboana

2021 ◽  
Author(s):  
Peter Makaula ◽  
Sekeleghe Amos Kayuni ◽  
Kondwani Chidzammbuyo Mamba ◽  
Grace Bongololo ◽  
Mathias Funsanani ◽  
...  

Abstract Background Mass drug administration (MDA) is one of the key interventions recommended by WHO for prevention and control of neglected tropical diseases. In Malawi, MDA is widely carried out annually since 2012 for prevention and control of schistosomiasis and soil transmitted helminths (STH). No study has been carried out to assess effectiveness of the approach and to document perceptions of health providers and beneficiaries regarding use of MDA. This study aimed to examine perceived strengths and weaknesses, successes and failures, as well as health providers’ and beneficiaries’ perspectives of implementing the strategy in Malawi. Methods As a cross-sectional implementation research, the study was carried out in three southern Malawi districts of Chiradzulu, Mangochi and Zomba. In each district, four health centres and 16 villages were randomly selected to participate. A mixed-methods approach to data collection focusing on quantitative data for coverage and knowledge, attitudes and practices assessments; and qualitative data for assessing perceptions of health providers and beneficiaries regarding MDA was used. Quantitative data were processed and analyzed using IBM SPSS software version 26 while qualitative data were analysed using NVivo 12 for Windows. Results Knowledge levels about schistosomiasis and STH in the districts varied according to disease aspects asked about. Majority are more knowledgeable about what schistosomiasis is (78%) and whether STH are treatable with drugs (97%); with least knowledgeable about the organism that transmits schistosomiasis (18%), types of schistosomiasis (11%) and what causes STH (20%). In 2018 and 2019 the districts registered high coverage rates for praziquantel and albendazole using community-based MDA (73%-100%) and using school-based MDA (75%-91%). Both the health authorities and community members perceived the MDA approach as good because it brings treatment closer to people. Conclusion With the high MDA coverage obtained in schools and communities, the implementation of MDA in the target districts is satisfactory. There are, however, several challenges including disproportionate knowledge levels, which are hampering progress towards attainment of the 2030 global NTD goals. There is a need for promotion of community participation and partnerships as well as implementation of other recommended interventions for sustainable prevention and control of schistosomiasis and STH.


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