Cure rate is not a valid indicator for assessing drug efficacy and impact of preventive chemotherapy interventions against schistosomiasis and soil-transmitted helminthiasis - PubMed (original) (raw)

Editorial

Cure rate is not a valid indicator for assessing drug efficacy and impact of preventive chemotherapy interventions against schistosomiasis and soil-transmitted helminthiasis

Antonio Montresor. Trans R Soc Trop Med Hyg. 2011 Jul.

Abstract

Every year in endemic countries, several million individuals are given anthelminthic drugs in the context of preventive chemotherapy programmes for morbidity control of schistosomiasis and soil-transmitted helminthiasis. The capacity to evaluate accurately the efficacy of the drugs used as well as the health impact produced by treatment is of utmost importance for appropriate planning and implementation of these interventions. Cure rate is an indicator of drug efficacy that was originally developed for assessing the clinical efficacy of antibiotics on selected bacterial diseases. Over time, this indicator has also been widely applied to anthelminthic drugs and consequently used to monitor and evaluate preventive chemotherapy interventions. In the author's opinion, however, measurement of cure rate provides information of limited usefulness in the context of helminth control programmes. The present article analyses the peculiarities of helminth infections and those of the drugs used in preventive chemotherapy, explaining the reasons why the cure rate is not an adequate indicator in this specific public health context.

Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

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Conflict of interest statement

Conflict of interests The author has no conflicts of interest concerning the work reported in this paper.

Figures

Figure 1

Figure 1

Reduction of total prevalence of hookworm infections and prevalence of infection light and high intensity during the one year implementation of a preventive chemotherapy campaign in Yen Bai Province, Vietnam.

Figure 2

Figure 2

Reduction of prevalence of Schistosoma mekongi infections during the preventive chemotherapy campaign conducted for 10 years in Stung Treng and Kratie provinces, Cambodia.

References

    1. Keiser J, Utzinger J. Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. JAMA. 2008;299:1937–48. - PubMed
    1. Saconato H, Atallah A. Interventions for treating schistosomiasis mansoni. Cochrane Database Syst Rev. 2000 CD000528. - PubMed
    1. Crompton DW, Savioli L. Handbook of helminthiasis for public health. Boca Raton, London, NewYork: 2006.
    1. Anderson RM, May RM. Infectious diseases of humans Dynamics and control. Oxford University Press; Oxford, New York, London: 1991.
    1. Flohr C, Tuyen LN, Lewis S, et al. Low efficacy of mebendazole against hookworm in Vietnam: two randomized controlled trials. Am J Trop Med Hyg. 2007;76:732–6. - PubMed

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