{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:38:44Z","timestamp":1789706324703,"version":"4.0.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2016,11,24]],"date-time":"2016-11-24T00:00:00Z","timestamp":1479945600000},"content-version":"vor","delay-in-days":119,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Schistosomiasis Control Initiative"},{"name":"UNICEF\/UNDP\/World Bank WHO Special Programme for Research"},{"name":"Training in Tropical Disease"},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Wellcome Trust Sanger Institute","award":["098051"],"award-info":[{"award-number":["098051"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background. \u2003Mass drug administration (MDA) with praziquantel is the cornerstone of schistosomiasis control in sub-Saharan Africa. The effectiveness of this strategy is dependent on the continued high efficacy of praziquantel; however, drug efficacy is rarely monitored using appropriate statistical approaches that can detect early signs of wane.<\/jats:p>\n                  <jats:p>Methods. \u2003We conducted a repeated cross-sectional study, examining children infected with Schistosoma mansoni from 6 schools in Uganda that had previously received between 1 and 9 rounds of MDA with praziquantel. We collected up to 12 S. mansoni egg counts from 414 children aged 6\u201312 years before and 25\u201327 days after treatment with praziquantel. We estimated individual patient egg reduction rates (ERRs) using a statistical model to explore the influence of covariates, including the number of prior MDA rounds.<\/jats:p>\n                  <jats:p>Results. \u2003The average ERR among children within schools that had received 8 or 9 previous rounds of MDA (95% Bayesian credible interval [BCI], 88.23%\u201393.64%) was statistically significantly lower than the average in schools that had received 5 rounds (95% BCI, 96.13%\u201399.08%) or 1 round (95% BCI, 95.51%\u201398.96%) of MDA. We estimate that 5.11%, 4.55%, and 16.42% of children from schools that had received 1, 5, and 8\u20139 rounds of MDA, respectively, had ERRs below the 90% threshold of optimal praziquantel efficacy set by the World Health Organization.<\/jats:p>\n                  <jats:p>Conclusions. \u2003The reduced efficacy of praziquantel in schools with a higher exposure to MDA may pose a threat to the effectiveness of schistosomiasis control programs. We call for the efficacy of anthelmintic drugs used in MDA to be closely monitored.<\/jats:p>","DOI":"10.1093\/cid\/ciw506","type":"journal-article","created":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T20:07:56Z","timestamp":1469736476000},"page":"1151-1159","source":"Crossref","is-referenced-by-count":149,"title":["Reduced Efficacy of Praziquantel Against\n                    <i>Schistosoma mansoni<\/i>\n                    Is Associated With Multiple Rounds of Mass Drug Administration"],"prefix":"10.1093","volume":"63","author":[{"given":"Thomas","family":"Crellen","sequence":"first","affiliation":[{"name":"Imperial College London, St Mary's Campus 1 Department of Infectious Disease Epidemiology and the London Centre for Neglected Tropical Disease Research ,"},{"name":"Wellcome Trust Sanger Institute 2 , Hinxton"},{"name":"Royal Veterinary College, University of London 3 Department of Pathology and Pathogen Biology , , Hertfordshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Walker","sequence":"additional","affiliation":[{"name":"Imperial College London, St Mary's Campus 1 Department of Infectious Disease Epidemiology and the London Centre for Neglected Tropical Disease Research ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poppy H. 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