Authors
J B Halder1; A M Julé3; M Vaillant2; M G Basáñez1; P L Olliaro4; M Walker1; 1 Imperial College London; 2 Luxembourg Institute of Health; 3 University of Oxford ; 4 University of Oxford and World Health Organization Discussion
In 2014, over 271 million schoolchildren were treated with benzimidazoles as part of the World Health Organization’s plan to scale up mass drug administration (MDA) programmes targeting soil-transmitted helminths (STHs). There is consensus that drug efficacies should be monitored for signs of decline that could jeopardise long-term effectiveness of MDA strategies. Efficacies are mostly calculated and reported as averages in groups of patients. However, heterogeneities in trial design and reporting inhibit straightforward meta-analysis of these data which could otherwise be used to explore varying efficacy among populations with different MDA histories. These issues are avoided if individual participant data are accessed directly and subjected to standardized analyses. Such data would also allow examination of the distributions of individual responses to drugs, offering a more sensitive means to identify reduced efficacies potentially caused by emerging drug resistance. To assess the trial landscape, we searched the STH literature for published anthelmintic trials, and collated locations, study sizes, methodologies, reported drug efficacies and other aspects of the reported data. We quantify these characteristics and create an overview of the variety therein. The results indicate the volume of individual patient data that may exist and that could be used to create a database on the efficacy of the anthelmintics that are the cornerstone of MDA targeting STH infections. 
