Project Title

Alternative treatment strategies using anti-wolbachial drugs to accelerate elimination of onchocerciasis and lymphatic filariasis

EDCTP Project Call

Senior Fellowship (SF)

Project Objectives

The objectives of the ASTAWOL project include: to assess the efficacy of Rifampicin and Albendazole to shorten the time of treatment for onchocerciasis and lymphatic filariasis patients, to analyse the safety of the combination of Rifampicin plus Albendazole in the treatment of onchocerciasis and lymphatic filariasis, to build world-class capacity for the conduct of clinical trials and consolidate earlier gains in research capacity and to disseminate the research findings to scientists, stakeholders such as the Ministry of Health, National NTD programmes, Ghana Health Service, as well as the study communities and the participating volunteers.

Study Design

Prospective, randomized, controlled, monocentric, open-label, parallel-group, interventional phase II pilot trial

Project Summary

The World Health Organization (WHO) has targeted the elimination of onchocerciasis and Lymphatic filariasis (LF), in addition to the other Neglected Tropical Diseases, (NTDs), by the year 2030. However, the ambitious goal of WHO cannot be realized if it must depend on the current treatment of onchocerciasis and LF which remains the use of ivermectin (IVM) or diethylcarbamazine (DEC) and albendazole (ALB) through mass drug administration (MDA). Although onchocerciasis and LF infections have greatly been reduced through the current treatment strategies, elimination efforts remain problematic in the African regions where the prevalence of these infections is high. This is because the treatment drugs do not have enough effect on the adult worms, and neither can they permanently stop the production of the microfilaria. Moreover, there has been a report on the sub-optimal response of the parasites to IVM after more than 20 years of MDA. Additionally, either IVM or DEC cannot be administered as MDA in areas that are co-endemic to both Loa loa and onchocerciasis due to the occurrence of severe adverse reactions to these drugs. To assist in the elimination of these two diseases, the ASTAWOL project seeks to use alternative treatment strategies that depend on the action of anti-Wolbachial drugs that target the adult worm. The goal is to use existing approved drugs such as Rifampicin and Albendazole to treat individuals who live in communities endemic to these two NTDs and are also infected. The successful outcome of this study will contribute towards achieving WHO’s aim of eliminating these two diseases. The objectives of the ASTAWOL project include: to assess the efficacy of Rifampicin and Albendazole to shorten the time of treatment for onchocerciasis and lymphatic filariasis patients, to analyse the safety of the combination of Rifampicin plus Albendazole in the treatment of onchocerciasis and lymphatic filariasis, to build world-class capacity for the conduct of clinical trials and consolidate earlier gains in research capacity and to disseminate the research findings to scientists, stakeholders such as the Ministry of Health, National NTD programmes, Ghana Health Service, as well as the study communities and the participating volunteers. In 2023, the study team completed processing all the nodules extirpated from the participants that were enrolled into the WP1 part of the project. The 6- and 12-month follow-ups after treatment were successfully carried out on the study participants enrolled into the WP2 study. However, not all of the 120 participants were recruited for the LF study. The challenges encountered during recruitment included the lack of adequate infected participants for the LF study as result of the intensive mass drug administration (MDA) undertaken by the Ghana Health Service. Furthermore, it was impossible to continue with recruitment in the LF “hotspot” districts in the Upper East region due to social unrest in the districts. Also, it was alleged that the research team was administering COVID-19 medicine to the public and misleading people as screening for lymphatic filariasis infections. During this period, public knowledge and education on COVID-19 was little to none. Furthermore, it was difficult to carry out the recruitment because of the social turmoil in the Upper East region's LF "hotspot" regions. It is envisaged that through the successful execution of the ASTAWOL project, scientific staff and students from the sub-Saharan Africa will receive intensive training in the conduct of clinical trials in neglected tropical diseases (NTDs) through the transfer of knowledge and skills. The two manuscripts under review cover the disease prevalence aspects of the project. Mr. John Boateng, one of the master’s students has secured a German-West African Centre for Global Health and Pandemic Prevention (G-WAC) scholarship and currently pursuing a PhD at the KNUST. Mr. Prince Obeng, also a master’s student is currently working as a laboratory scientist in a private clinic in Accra, Ghana. The two PhD students are still on course without any significant delays.

Host Organisation

Current Organisation

Kwame Nkrumah University of Science and Technology

Current Job Title

Lecturer/Research scientist

Biography