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 haematemesis. Mass Drug Administration (MDA) programmes are the cornerstone 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 with historically 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 commonplace. 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 school structure, 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

Kelsilandia
Dr Kelsilandia Aguiar-Martins

Scientist

Affiliation: Royal Veterinary College

Parasite Genetics

Shallon
Shallon Akampurira

Trial Data Clerk

Affiliation: Makerere University

Data Uganda

Matt
Dr Matt Berriman

Co-Principal Investigator

Affiliation: Wellcome Trust Sanger Institute (now University of Glasgow)

Parasite Genomics

Fred
Fred Besigye

MSc Student/Technician

Affiliation: Makerere University

Parasitology

Simon
Dr Simon Bond

Co-Principal Investigator

Affiliation: Cambridge Clinical Trials Unit

Trial Statistician

Stephen
Dr Stephen Cose

Co-Principal Investigator

Affiliation: Uganda Research Institute, LSHTM

Host Immunopathology

James
Dr James Cotton

Student Mentor

Affiliation: Wellcome Trust Sanger Institute (now University of Glasgow)

Parasite Genomics

Rachel
Rachel Donegan

Statistician

Affiliation: Cambridge Clinical Trials Unit

Analysis Plan Statistician

Katrina
Dr Katrina Gately

Senior Trial Co-ordinator

Affiliation: Cambridge Clinical Trials Unit

Sponsor Oversight

Eliot
Eliot Kanyesigye

Trial Nurse

Affiliation: Makerere University

Fieldwork Manager

Patrice
Dr Patrice Mawa

Immunologist

Affiliation: Uganda Research Institute, LSHTM

Host Immunopathology

Gregory
Dr Gregory Milne

Scientist

Affiliation: Royal Veterinary College

Mathematical modelling

Stella
Prof Stella Neema

Co-Principal Investigator

Affiliation: Makerere University

Anthropology

Fred
Prof Fred Nuwaha

Co-Principal Investigator

Affiliation: Makerere University

Trial Procedural Oversight

Andrew
Andrew Nuwamanya

Research Nurse

Affiliation: Vector Control Division, MoH

Fieldwork

Paskari
Paskari Odoi

PhD Student

Affiliation: Makerere University

Anthropology

Rebecca
Dr Rebecca Oettle

Scientist

Affiliation: University of Cambridge

Mathematical modelling, Immunology & Logistics

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

Joanne
Prof Joanne Webster

Co-Principal Investigator

Affiliation: Royal Veterinary College

Parasite Genetics

Previous Consortium Members

Julien
Dr Julien Kincaid-Smith

Scientist

Affiliation: Royal Veterinary College

Parasite Genetics

Sebastien
Dr Sebastien Lambert

Scientist

Affiliation: Royal Veterinary College

Mathematical modelling

Ruth
Ruth Munyambonera

PhD Student

Affiliation: Makerere University

Anthropology

Ritah
Ritah Nabunje

MSc Student

Affiliation: Makerere University

Bioinformatics

James
Dr James Ssenfuka

Medical Officer

Affiliation: Makerere University

Fieldwork Clinician/Manager

Jakub
Jakub Wawrzyniak

Data Manager

Affiliation: University of Cambridge

Data & Logistics

8
Partner Institutions
30+
Team Members
2018-24
Trial Timeframe
4k+
Planned Praziquantel Treatments

PUBLICATIONS & REPORTS

Mawa PA, Kincaid-Smith J, Tukahebwa EM, Webster JP, Wilson S. Schistosomiasis Morbidity Hotspots: Roles of the Human Host, the Parasite and Their Interface in the Development of Severe Morbidity. Front Immunolo. 2021 Mar 12; 12:635869. doi: 10.3389/fimmu.2021.635869.

Fall CB, Lambert S, Léger E, Yasenev L, Garba AD, Diop SD, Borlase A, Catalano S, Faye B, Walker M, Sene M, Webster JP. Hybridized Zoonotic Schistosoma Infections Result in Hybridized Morbidity Profiles: A Clinical Morbidity Study amongst Co-Infected Human Populations of Senegal. Microorganisms. 2021 Aug 20;9(8):1776. doi: 10.3390/microorganisms9081776.

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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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