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HOUSEHOLD CLUSTERING SUPPORTS A NOVEL CHEMOPROPHYLAXIS TRIAL DESIGN FOR A MOSQUITO-BORNE VIRAL DISEASE
Author
Affilliation
Evotec ID. Antiviral Research Unit. Lyon, France / Aarhus University. Departments of Clinical Pharmacology, Hepatology and Gastroenterology. Aarhus, Denmark.
Pasteur Network. Institut Pasteur du Cambodge. Virology Unit. Phnom Penh, Cambodia.
Pasteur Network. Institut Pasteur du Cambodge. Epidemiology and Public Health Unit. Phnom Penh, Cambodia.
Evotec ID. Clinical Development. Lyon, France.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. School of Medicine. Salvador, BA, Brazil.
Pasteur Network. Institut Pasteur du Cambodge. Virology Unit. Phnom Penh, Cambodia.
Pasteur Network. Institut Pasteur du Cambodge. Epidemiology and Public Health Unit. Phnom Penh, Cambodia.
Evotec ID. Clinical Development. Lyon, France.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. School of Medicine. Salvador, BA, Brazil.
Abstract
Infections because of chikungunya and other mosquito-borne viruses, such as dengue and Zika, represent an area of significant unmet medical need. There are currently no approved medicines for prophylaxis or treatment of these diseases, and the development and implementation of vaccines against these viruses have proved problematic. Although antiviral molecules with treatment and prophylactic potential against the chikungunya virus have been identified, no successful field trials have been reported. Chemoprophylaxis may be attractive for unvaccinated at-risk populations; however, performing a successful chemoprophylaxis trial during a chikungunya outbreak will require a clearly identifiable at-risk population. We propose the application of a household transmission model as used in testing drugs against respiratory viruses. Current evidence on household clustering of chikungunya and other Aedes mosquito-borne viral infections is supportive. We suggest that this model may improve prophylaxis trial feasibility and focus research and future treatment on a population likely to benefit.
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