GHES LMIC Fellow 2017-2018
Home Institution: University of Zimbabwe
U.S. Institution: Stanford University
Project Title: Pharmacokinetics of praziquantel in pediatric dose formulation development and its safe and efficacious use in mass drug administration (MDA) treatment of schistosomiasis programs in sub-Saharan Africa.
This project aims to conduct research into the metabolism and pharmacokinetics of praziquantel. This will contribute to current efforts to develop a pediatric formulation of the drug and to optimise deployment of annual mass drug administration programs aimed at reducing the burden of schistosomasis.
Praziquantel remains the only effective and recommended drug by WHO for the treatment against all species of schistosomiasis, which is a helminthic infection that affects 700 million people with 90% of people requiring treatment residing in Africa. The disease has been identified as one of the major neglected tropical diseases (NTDs) targeted for eradication for which WHO has made a resolution to treat 75% of the 779 million at-risk populations.
In developing the pediatric formulation there is need to understand how the under 4 years children metabolize and dispose PZQ since such data does not exist and cannot be easily extrapolated from data on adults. Schistosomiasis is also endemic in regions where diseases such as HIV, TB and other infections are also prevalent. This presents a risk of co-infections, which will, in turn, be associated with co-treatment. Polypharmacy is associated with high risk for drug-drug interactions, which can affect the safety and efficacy of PZQ. In this project, we will evaluate the effects of various anti-retroviral drugs on the pharmacokinetics of PZQ. The findings will help optimize the MDA programs for efficacy and safety.
The successful development of a new formulation of PZQ will result in a treatment solution for the more than 20 million children infected with schistosomiasis. Understanding the risk for drug-drug interactions in the use of PZQ will result in treatment guidelines, which will make MDA programs more effective and safe.