FIBROSCHOT
FibroScHot
FibroScHot
Impact of increased praziquantel frequency on childhood fibrosis in persistent schistosomiasis morbidity hotspots.

About

ABOUT FIBROSCHOT

Severe schistosomiasis is a devastating neglected infectious disease (NID). Without control and disease management strategies, sufferers with the manifestion of periportal fibrosis can develop portal hypertension, in its severest form causing death through haematemasis. Mass Drug Administration (MDA) programmes are the corner-stone of international efforts to control schistosomiasis as a public health problem. Uganda was at the forefront of the treatment vanguard, first administering MDA in 2003. Amongst the communities first treated were those residing on the shores of Lake Albert, an area historically with high rates of periportal fibrosis. Our recent screens of school-children in these fishing communities show that despite concerted efforts and reported community treatment coverage rates of near 80%, infection intensities are very high and periportal fibrosis common place. There is a major need for alternative strategies for these hotspots if we are to meet the aims of Sustainable Development Goal 3: Ensure health lives and promote well being for all at all ages”. For rapid uptake into national and international policy these interventions need to be built upon existing control structures and be relatively easy to facilitate. In lower transmission areas MDA is targeted at school-children, combining the epidemiological knowledge that this age-group suffers the greatest burden of infection with easier implementation. We therefore propose that increasing praziquantel treatment frequency within the schoolstructure, in addition to annual community MDA, will be an effective disease control strategy in hotspots of schistosomiasis morbidity. At the core of this proposal is a superiority randomised intervention trial that asks the question:

Does increased treatment frequency reduce the prevalence of childhood periportal fibrosis in hotspots of persistant schistosomiasis?

To ascertain the causes of high morbidity, the trial focuses on the following four areas:

Clinical

A randomised superiority intervention trial of 2x and 4x annual PZQ treatment versus standard 1x annual treatment with the primary outcome – decreased prevalence of periportal fibrosis.

Anthropology

Anthropological investigations into perceptions of mass drug administration with praziquantel – the lived experience of standard annual MDA and the experience of multiple praziquantel treatments.

Immunology

Determination of schistosome egg specific cytokine responses, quantification of circulating regulatory immune cells, antibodies and their association with periportal fibrosis.

Genomics

In parallel with microsatellite genotyping, whole genome sequence analysis will identify loci associated with periportal fibrosis and praziquantel sub-optimal responses.

PEOPLE

The Fibroschot Consortium:

Shona
Dr Shona Wilson

Lead Investigator

Affiliation: University Of Cambridge

Project Coordinator

edridah
Dr Edridah Tukahebwa

Co-Principal Investigator

Affiliation: Vector Control Division, MoH

Trial Site Co-ordinator

moses
Moses Adriko

Programme Officer

Affiliation: Vector Control Division, MoH

Fieldwork Management

Simon
Dr Simon Bond

Co-Principal Investigator

Affiliation: Cambridge Clinical Trials Unit

Trial Statistician

Matt
Dr Matt Berriman

Co-Principal Investigator

Affiliation: Wellcome Trust Sanger Institute

Parasite Genomics

Stephen
Dr Stephen Cose

Co-Principal Investigator

Affiliation: Uganda Virus Research Institute, LSHTM

Host Immunopathology

James
Dr James Cotton

Student Mentor

Affiliation: Wellcome Trust Sanger Institute

Parasite Genomics

Elsa
Dr Elsa Leger

Senior Scientist

Affiliation: Royal Veterinary College

Parasite Genetics

Ruth
Ruth Munyambonera

PhD Student

Affiliation: Makerere University

Anthropology

stella
Prof Stella Neema

Co-Principal Investigator

Affiliation: Makerere University

Anthropology

fred
Prof Fred Nuwaha

Co-Principal Investigator

Affiliation: Makerere University

Trial Procedural Oversight

Benjamin
Benjamin Tinkitina

Database Manager

Affiliation: Vector Control Division, MoH

Data Management Uganda

birgitte
Prof Birgitte Vennervald

Co-Principal Investigator

Affiliation: University of Copenhagen

Clinical Oversight

Martin
Dr Martin Walker

Co-Principal Investigator

Affiliation: Royal Veterinary College

Mathematical Modelling

Jakub
Jakub Wawrzyniak

Data Manager

Affiliation: University of Cambridge

Data & Logistics

Joanne
Prof Joanne Webster

Co-Principal Investigator

Affiliation: Royal Veterinary College

Parasite Genetics

8
Partner Institutions
30+
Team Members
2018-22
Trial Timeframe
4k+
Praziquantel Treatments

FIELDWORK

A selection of images from the clinical trial site in Hoima region.

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NEWS

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CONTACT

Lets get in touch. Send us a message:

Email: info@fibroschot.eu


This project is part of the EDCTP2 programme supported by the European Union.

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