Evidence map›Paper›PMID 30439945›Full record

ArticlePLoS neglected tropical diseases2018

Accuracy of the WHO praziquantel dose pole for large-scale community treatment of urogenital schistosomiasis in northern Mozambique: Is it time for an update?

Pedro H Gazzinelli-Guimaraes, Neerav Dhanani, Charles H King, Carl H Campbell, Herminio O Aurelio, Josefo Ferro, Rassul Nala, Alan Fenwick, Anna E Phillips

Open access · goldAbstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 4 countries.

Pedro H Gazzinelli-GuimaraesSchistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom.ORCID 0000-0003-4932-2206
Neerav DhananiSchistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom.
Charles H KingCenter for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America.
Carl H CampbellSchistosomiasis Consortium for Operational Research and Evaluation, University of Georgia, Athens, Georgia, United States of America.ORCID 0000-0001-8103-7873
Herminio O AurelioSchistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom.
Josefo FerroFaculty of Health Sciences, Universidade Católica de Moçambique (UCM), Beira, Moçambique.
Rassul NalaMinistério da Saúde, Maputo, Moçambique.
Alan FenwickSchistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom.
Anna E PhillipsSchistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom.
Imperial College London · GBUniversity of Georgia · USCatholic University of Mozambique · MZLondon Centre for Neglected Tropical Disease Research · GBMinistério da Saúde · ST

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA pioneering strategy developed by the World Health Organization (WHO) for the control of schistosomiasis was the concept of a height-based dose pole to determine praziquantel (PZQ) dosing in large-scale treatment campaigns. However, some recent studies have shown variable accuracy for the dose pole in terms of predicting correct mg/Kg dosing, particularly for treatment of adults. According to the WHO, 91 million adults in 52 countries are targeted to be treated by 2020. METHODS/PRINCIPAL

findingsThe present study aimed to test the accuracy of the dose pole in determining PZQ dosage by comparing the number of tablets determined by the dose pole with the number of tablets determined according to total body weight. The analysis included height-for-weight data from 9,827 school-aged children (SAC) and adults from 42 villages in the province of Cabo Delgado in Mozambique. The results revealed that of the 7,596 SAC, 91.8% has received an appropriate dose (30-60mg/Kg), 6% received an insufficient dose (<30mg/Kg) and 2% an excessive dose (> 60mg/Kg). On the other hand, 13.7% out of 2,231 adults were treated inaccurately with 13.5% receiving an insufficient dose and 0.2% an excessive dose. When the percentage of insufficient dosing was disaggregated by gender, the frequency of adult females who were underdosed reached 18.3% versus 10.8% of adult males. Of note, Adult females aged 21-55 years were found to have an underdose frequency of 21.3%, compared to 11.8% of adult males in the same age range. The performance of a proposed modified dose pole was compared using the same dataset of adult Mozambicans. The results showed that the modified dose pole reduced the underdose frequency among adults from 13.5% to 10.4%, and subsequently increased the percentage of optimal dosing from 33.7% to 45.3%.

conclusionsOur findings highlight the need to update the WHO-dose pole to avoid administration of insufficient PZQ doses to adults and therefore minimize the potential emergence of PZQ-resistant strains.

trial registrationInternational Standard Randomized Controlled Trial registry under ISRTC number 14117624.

Indexed as

AdolescentAdultAgedAged, 80 and overAnthelminticsChildChild, PreschoolDrug Dosage CalculationsFemaleHumansMaleMiddle AgedMozambiquePraziquantelSchistosomiasis haematobiaWorld Health OrganizationAnthelminticsPraziquantel

Identifiers

PMID30439945
PMCPMC6264897
OpenAlexW2900793935

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.