Is anthelmintic resistance a concern for the control of human soil-transmitted helminths?

Vercruysse, Jozef, Albonico, Marco, Behnke, Jerzy M., Kotze, Andrew C., Prichard, Roger K., McCarthy, James S., Montresor, Antonio and Levecke, Bruno (2011) Is anthelmintic resistance a concern for the control of human soil-transmitted helminths?. International Journal for Parasitology: Drugs and Drug Resistance, 1 1: 14-27. doi:10.1016/j.ijpddr.2011.09.002


Author Vercruysse, Jozef
Albonico, Marco
Behnke, Jerzy M.
Kotze, Andrew C.
Prichard, Roger K.
McCarthy, James S.
Montresor, Antonio
Levecke, Bruno
Title Is anthelmintic resistance a concern for the control of human soil-transmitted helminths?
Journal name International Journal for Parasitology: Drugs and Drug Resistance   Check publisher's open access policy
ISSN 2211-3207
Publication date 2011-12-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.ijpddr.2011.09.002
Open Access Status DOI
Volume 1
Issue 1
Start page 14
End page 27
Total pages 14
Place of publication Oxford, United Kingdom
Publisher Elsevier
Formatted abstract
The major human soil-transmitted helminths (STH), Ascaris lumbricoides, hookworms (Necator americanus and Ancylostoma duodenale) and Trichuris trichiura have a marked impact on human health in many parts of the world. Current efforts to control these parasites rely predominantly on periodic mass administration of anthelmintic drugs to school age children and other at-risk groups. After many years of use of these same drugs for controlling roundworms in livestock, high levels of resistance have developed, threatening the sustainability of these livestock industries in some locations. Hence, the question arises as to whether this is likely to also occur in the human STH, thereby threatening our ability to control these parasites. This is particularly important because of the recent increase in mass control programmes, relying almost exclusively on benzimidazole anthelmintics. It will be important to ensure that resistance is detected as it emerges in order to allow the implementation of mitigation strategies, such as use of drug combinations, to ensure that the effectiveness of the few existing anthelmintic drugs is preserved. In this review we address these issues by firstly examining the efficacy of anthelmintics against the human STH, and assessing whether there are any indications to date that resistance has emerged. We then consider the factors that influence the effect of current drug-use patterns in selecting for resistant parasite populations. We describe the tools currently available for resistance monitoring (field-based coprological methods), and those under development (in vitro bioassays and molecular tests), and highlight confounding factors that need to be taken into account when interpreting such resistance-monitoring data. We then highlight means to ensure that the currently available tools are used correctly, particularly with regard to study design, and we set appropriate drug-efficacy thresholds. Finally, we make recommendations for monitoring drug efficacy in the field, as components of control programmes, in order to maximise the ability to detect drug resistance, and if it arises to change control strategy and prevent the spread of resistance.
Keyword Anthelmintic resistance
Anthelmintics
Guidelines
Soil-transmitted helminths
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
 
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