Low Efficacy of Single-Dose Albendazole and Mebendazole against Hookworm and Effect on Concomitant Helminth Infection in Lao PDR

Title
Low Efficacy of Single-Dose Albendazole and Mebendazole against Hookworm and Effect on Concomitant Helminth Infection in Lao PDR
Authors
Soukhathammavong, PA; Sayasone, S; Phongluxa, K; Xayaseng, V; Utzinger, J; Vounatsou, P; Hatz, C; Akkhavong, K; Keiser, J; Odermatt, P
Keywords
OPISTHORCHIS-VIVERRINI; NEMATODE INFECTIONS; DRUG-RESISTANCE; RISK-FACTORS; CHEMOTHERAPY; COMMUNITY; DISTRICT; ANEMIA; SCALE
Issue Date
2012
Publisher
PLOS NEGLECT TROP D
Citation
Plos Neglect. Trop. Dis.;JAN;2012;6;1
Abstract
Background: Albendazole and mebendazole are increasingly deployed for preventive chemotherapy targeting soil-transmitted helminth (STH) infections. We assessed the efficacy of single oral doses of albendazole (400 mg) and mebendazole (500 mg) for the treatment of hookworm infection in school-aged children in Lao PDR. Since Opisthorchis viverrini is co-endemic in our study setting, the effect of the two drugs could also be determined against this liver fluke. Methodology: We conducted a randomized, open-label, two-arm trial. In total, 200 children infected with hookworm (determined by quadruplicate Kato-Katz thick smears derived from two stool samples) were randomly assigned to albendazole (n = 100) and mebendazole (n = 100). Cure rate (CR; percentage of children who became egg-negative after treatment), and egg reduction rate (ERR; reduction in the geometric mean fecal egg count at treatment follow-up compared to baseline) at 21-23 days posttreatment were used as primary outcome measures. Adverse events were monitored 3 hours post treatment. Principal Findings: Single-dose albendazole and mebendazole resulted in CRs of 36.0% and 17.6% (odds ratio: 0.4; 95% confidence interval: 0.2-0.8; P = 0.01), and ERRs of 86.7% and 76.3%, respectively. In children co-infected with O. viverrini, albendazole and mebendazole showed low CRs (33.3% and 24.2%, respectively) and moderate ERRs (82.1% and 78.2%, respectively). Conclusions/Significance: Both albendazole and mebendazole showed disappointing CRs against hookworm, but albendazole cured infection and reduced intensity of infection with a higher efficacy than mebendazole. Single-dose administrations showed an effect against O. viverrini, and hence it will be interesting to monitor potential ancillary benefits of a preventive chemotherapy strategy that targets STHs in areas where opisthorchiasis is co-endemic.
URI
http://hdl.handle.net/11267/2537
ISSN
1935-2727
Appears in Collections:
2.Ministry of Health > Journal articles
Files in This Item:

qrcode

Items in LAOSpace are protected by copyright, with all rights reserved, unless otherwise indicated.