Efficacy and safety of single 40 mg/kg oral praziquantel in the treatment of schistosomiasis in preschool-age versus school-age children: An individual participant data meta-analysis
Efficacy and safety of single 40 mg/kg oral praziquantel in the treatment of schistosomiasis in preschool-age versus school-age children: An individual participant data meta-analysis
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DOI：
10.1371/journal.pntd.0008277
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发表时间：
2020-06-01
影响因子：
3.8
通讯作者：
Vaillant, Michel T.
中科院分区：
文献类型：
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作者：
Olliaro, Piero L.;Coulibaly, Jean T.;Vaillant, Michel T.
作者摘要 血吸虫病是一种由蠕虫（寄生虫）引起的疾病，影响肠道和泌尿系统。在血吸虫病流行地区，通过大规模发放吡喹酮来控制该病，主要针对学龄儿童。年幼的儿童（学龄前）也可能受到血吸虫病的影响，但目前在治疗活动中尚未接受吡喹酮。相反，学龄前儿童需要根据具体情况进行治疗，因为目前的吡喹酮配方不适合幼儿。也有人质疑一次给予40毫克/公斤的标准剂量对学龄前儿童是否有效。为了回答这个问题，我们从一系列研究中收集了个体参与者的数据，在这些研究中，患有肠道或泌尿生殖系统血吸虫病的儿童服用了 40 mg/kg 的吡喹酮，并比较了不同年龄组的疗效和耐受性。由于很少进行直接比较，我们使用统计工具进行这些比较。我们没有发现任何证据表明学龄前儿童的治疗效果低于学龄儿童，并得出结论，可以在大规模项目中向学龄前儿童给予 40 mg/kg 吡喹酮。当这种情况发生时，必须密切监测疗效和耐受性。 背景 如果血吸虫病预防性化疗方案扩大到包括学龄前儿童，则需要更好地了解学龄前儿童单次口服 40 mg/kg 吡喹酮的疗效和安全性。我们分析了 16 项研究（13 项单臂或队列研究和 3 项随机试验）的个体参与者水平数据，涉及 683 名学龄前儿童（年龄
Author summary Schistosomiasis is a diseases caused by helminths (parasitic worms) which affects the intestinal and urinary systems. In areas where schistosomiasis is endemic, the disease is controlled by the large scale distributing of praziquantel, primarily targeting school-age children. Younger children (preschool-age) too might be affected by schistosomiasis, but are currently not receiving praziquantel within treatment campaigns. Instead, preschool-age children are treated on a case-by-case basis because the current praziquantel formulation is not adapted to young children. Questions have also been raised as to whether the standard dose of 40 mg/kg given once is effective in preschool-age children. To answer this question, we collected individual-participant data from a series of studies in which 40 mg/kg of praziquantel had been given to children with intestinal or urogenital schistosomiasis, and compared its efficacy and tolerability across age-groups. Since few direct comparisons had been made, we used statistical tools to make these comparisons. We found no evidence that treatment is less efficacious in preschool- than in school-age children and conclude that 40 mg/kg praziquantel may be given to preschool-age children in large-scale programs. When this happens, efficacy and tolerability will have to be closely monitored.Background Better knowledge of the efficacy and safety of single 40 mg/kg oral praziquantel in preschool-age children is required, should preventive chemotherapy programs for schistosomiasis be expanded to include this age group. Methodology We analyzed individual participant-level data from 16 studies (13 single-arm or cohort studies and three randomized trials), amounting to 683 preschool-age children (aged