Understanding Praziquantel: the schistosomiasis lifeline drug

Have you ever heard of Praziquantel? Well, for people suffering from schistosomiasis this drug can be a lifeline.  At the SCI we support governments in sub-Saharan Africa to deliver treatment programmes against schistosomiasis using Praziquantel, and work hard to ensure that as many people as possible receive treatment.

Where do the drugs come from?

Thanks to generous donations every year from the pharmaceutical company Merck, millions of much-needed treatments are not only possible but cost effective too. However, when there are shortages of Praziquantel, the SCI purchases the amount needed to cover the difference, to ensure that all those who need treatment receive it.

How do we know how many drugs are needed?

The World Health Organisation will allocate drugs to different countries based on need, and the country’s ability to use the drugs given. They can calculate the number of people who need treatment through disease mapping. If school-aged children are being treated, for example, it is assumed that approximately 2.5 tablets per child will be needed, to find the total number of drugs needed.

How do we ensure that no one is left behind?

Countries provide treatment via schools in areas with high attendance to ensure high coverage. In most countries kids between 5-14 years old attend school, so treatment can reach the majority. Large communication campaigns are also run at the same time to inform people that treatment programmes are about to start, to come and receive treatment.

What are the biggest challenges faced?

There can be many challenges with making sure people are receiving treatment, including:

●       Bad weather – during rainy season, flooding often blocks roads making areas inaccessible.

●       Terrain – there may be areas where roads have become inaccessible, or don’t exist at all. This means that drugs will need to be carried by health workers into areas to distribute treatment. In cases where there are islands, boats will need to be hired so that island communities can be visited. If boats aren’t available, or weather makes water travel a danger, treatments can be delayed.

●       Conflict – civil unrest or tribal disputes can make treatment tricky. Thankfully, in places like Yemen, we have dedicated workers who’ve found ways to get to conflict zones, distribute treatments and still conduct surveys. Issues with government trust can also be a challenge as it means that local communities won’t accept treatments by government workers or a health worker from a different tribe.

●       Migration – in some countries, people will migrate during the seasons, either due to the weather or for their herds. This makes it hard to ensure that everyone who should receive treatments do. We have to make sure that treatments happen at the right time of the year to avoid this.

●       Social convention (i.e., gendered roles) – in some countries, female health workers might have issues distributing treatments to males in their community and vice versa.

●       Children not enrolled at school – while many children attend school, there are still some who have to tend herds, farm, assist with a family business or just choose not to attend classes.

We collaborate with governments in the countries to discuss these issues and find suitable solutions. We can often find ways to help through training, or monitoring treatment programmes to ensure that everyone is doing their part and that drugs are being distributed fairly.

If you’d like to learn more about our treatment programmes, follow us on social media for our updates.

Author 

Elizabeth Hollenberg, Programme Advisor