Mass administration of schistosomiasis drug can cut HIV

Copyright: Flickr/Yale Rosen, Pulmonary Pathology

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  • Women with genital schistosomiasis are more likely to get infected with HIV
  • Mass administration of the drug praziquantel can cut HIV and its prevention cost
  • But an expert says the approach fails to account for ethical and human rights

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[HARARE] Mass administration of praziquantel — a highly effective and low-cost drug for schistosomiasis treatment — targeting school-age children can reduce new HIV infections in young women, according to a modelling study that focused on Zimbabwe.
The researchers say in Sub-Saharan Africa around two-thirds of schistosomiasis — a neglected tropical disease transmitted by flatworm in dirty water — occur because of genital and urinary tract infections caused by Schistosoma haematobium.
Women with genital schistosomiasis are three to four times more likely than those without the disease to have HIV, according to the researchers. 
"We used cross-sectional and clinical data from Zimbabwe together with mathematical models to predict over a ten-year period the potential economic and health benefits of mass administration of praziquantel in school-age children for reducing HIV transmissions in women," says Martial Mbah, the study’s lead author and a public health expert at Yale University in the United States.
The study, published in PLoS Neglected Tropical Diseases last month (1 August), says that the intervention could save up to US$100 million in HIV/AIDS healthcare costs in that country in ten years.
It also shows that if the drug is assumed to be 30 per cent effective, then giving it yearly can prevent 41,500 HIV cases in women over ten years but if it is assumed to be 70 per cent effective, almost 97,000 HIV cases could be prevented over the same duration.
Mbah tells SciDev.Net that because genital schistosomiasis is very common among African girls and women the results of this study can be applied to other countries where S. haematobium and HIV are prevalent.
He adds that given the economic challenges faced by many African countries, for instance, Zimbabwe, major initiatives committed to HIV/AIDS prevention in Africa such as the US President's Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, TB and Malaria should embrace mass administration of the drug and support its expansion throughout the affected areas across Africa.
But an HIV/AIDS expert and a former executive director of Family AIDS Caring Trust in Zimbabwe, Jephias Mundondo, says that the research does not address the ethical and human rights issues surrounding the mass drug administration. He adds that there is a saving money motive and everything else is forgotten.
"While the idea is economically sound, the challenge lies in its ethicality and the acceptability of [mass application]," he says.
Link to full paper in PLoS Neglected Tropical Diseases
This article has been produced by SciDev.Net’s Sub-Saharan Africa desk.


PLoS Neglected Tropical Diseases doi:10.1371/journal.pntd.0002346 (2013)