PMID- 32569275 OWN - NLM STAT- MEDLINE DCOM- 20200810 LR - 20200810 IS - 1935-2735 (Electronic) IS - 1935-2727 (Print) IS - 1935-2727 (Linking) VI - 14 IP - 6 DP - 2020 Jun TI - Efficacy and safety of single-dose 40 mg/kg oral praziquantel in the treatment of schistosomiasis in preschool-age versus school-age children: An individual participant data meta-analysis. PG - e0008277 LID - 10.1371/journal.pntd.0008277 [doi] LID - e0008277 AB - BACKGROUND: Better knowledge of the efficacy and safety of single-dose 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 <6 years) and 2,010 school-age children (aged 6-14 years). Children had a documented Schistosoma mansoni or S. haematobium infection, were treated with single 40 mg/kg oral praziquantel, and assessed between 21 and 60 days post-treatment. Efficacy was expressed as arithmetic mean and individual egg reduction rate (ERR) and meta-analyzed using general linear models and mixed models. Safety was summarized using reported adverse events (AEs). PRINCIPAL FINDINGS: Preschool-age children had significantly lower baseline Schistosoma egg counts and more losses to follow-up compared to school-age children. No difference in efficacy was found between preschool- and school-age children using a general linear model of individual-participant ERR with baseline log-transformed egg count as covariate and study, age, and sex as fixed variables, and a mixed model with a random effect on the study. Safety was reported in only four studies (n = 1,128 individuals); few AEs were reported in preschool-age children 4 and 24 hours post-treatment as well as at follow-up. Three severe but not serious AEs were recorded in school-age children during follow-up. CONCLUSIONS/SIGNIFICANCE: There is no indication that single-dose 40 mg/kg oral praziquantel would be less efficacious and less safe in preschool-age children compared to school-age children, with the caveat that only few randomized comparisons exist between the two age groups. Preventive chemotherapy might therefore be extended to preschool-age children, with proper monitoring of its efficacy and safety. FAU - Olliaro, Piero L AU - Olliaro PL AD - Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom. FAU - Coulibaly, Jean T AU - Coulibaly JT AD - Swiss Tropical and Public Health Institute, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. AD - Unite de Formation et de Recherche Biosciences, Universite Felix Houphouet-Boigny, Abidjan, Cote d'Ivoire. AD - Centre Suisse de Recherches Scientifiques en Cote d'Ivoire, Abidjan, Cote d'Ivoire. FAU - Garba, Amadou AU - Garba A AD - Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland. FAU - Halleux, Christine AU - Halleux C AD - UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland. FAU - Keiser, Jennifer AU - Keiser J AD - Swiss Tropical and Public Health Institute, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. FAU - King, Charles H AU - King CH AD - Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America. AD - Schistosomiasis Consortium for Operational Research and Evaluation, University of Georgia, Athens, Georgia, United States of America. FAU - Mutapi, Francisca AU - Mutapi F AD - NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), Ashworth Laboratories, University of Edinburgh, Edinburgh, United Kingdom. AD - Institute of Immunology and Infection Research, Centre for Immunity, Infection and Evolution, School of Biological Sciences, Ashworth Laboratories, University of Edinburgh, Edinburgh, United Kingdom. FAU - N'Goran, Eliezer K AU - N'Goran EK AD - Unite de Formation et de Recherche Biosciences, Universite Felix Houphouet-Boigny, Abidjan, Cote d'Ivoire. AD - Centre Suisse de Recherches Scientifiques en Cote d'Ivoire, Abidjan, Cote d'Ivoire. FAU - Raso, Giovanna AU - Raso G AD - Swiss Tropical and Public Health Institute, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. FAU - Scherrer, Alexandra U AU - Scherrer AU AD - Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Sousa-Figueiredo, Jose Carlos AU - Sousa-Figueiredo JC AD - Department of Life Sciences, Natural History Museum, Wolfson Wellcome Biomedical Laboratories, London, United Kingdom. AD - Centro de Investigacao em Saude de Angola, Hospital Provincial, Bengo, Angola. FAU - Stete, Katarina AU - Stete K AD - Division of Infectious Diseases, Department of Medicine II, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany. FAU - Utzinger, Jurg AU - Utzinger J AD - Swiss Tropical and Public Health Institute, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. FAU - Vaillant, Michel T AU - Vaillant MT AUID- ORCID: 0000-0003-4714-8128 AD - Centre of Competences for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg. LA - eng GR - 16/136/33/DH_/Department of Health/United Kingdom PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't DEP - 20200622 PL - United States TA - PLoS Negl Trop Dis JT - PLoS neglected tropical diseases JID - 101291488 RN - 0 (Anthelmintics) RN - 6490C9U457 (Praziquantel) SB - IM MH - Administration, Oral MH - Adolescent MH - Animals MH - Anthelmintics/*administration & dosage/adverse effects MH - Chemoprevention/*methods MH - Child MH - Child, Preschool MH - Feces/parasitology MH - Female MH - Humans MH - Linear Models MH - Male MH - Parasite Egg Count MH - Praziquantel/*administration & dosage/adverse effects MH - Randomized Controlled Trials as Topic MH - Schistosoma haematobium MH - Schistosoma mansoni MH - Schistosomiasis haematobia/drug therapy/*prevention & control MH - Schistosomiasis mansoni/drug therapy/*prevention & control MH - Treatment Outcome PMC - PMC7360067 COIS- The authors have declared that no competing interests exist. EDAT- 2020/06/23 06:00 MHDA- 2020/08/11 06:00 PMCR- 2020/06/22 CRDT- 2020/06/23 06:00 PHST- 2019/12/27 00:00 [received] PHST- 2020/04/08 00:00 [accepted] PHST- 2020/07/14 00:00 [revised] PHST- 2020/06/23 06:00 [pubmed] PHST- 2020/08/11 06:00 [medline] PHST- 2020/06/23 06:00 [entrez] PHST- 2020/06/22 00:00 [pmc-release] AID - PNTD-D-19-02157 [pii] AID - 10.1371/journal.pntd.0008277 [doi] PST - epublish SO - PLoS Negl Trop Dis. 2020 Jun 22;14(6):e0008277. doi: 10.1371/journal.pntd.0008277. eCollection 2020 Jun.