Efficacy of triple dose albendazole treatment for soil-transmitted helminth infections

Abstract

In Malaysia, soil-transmitted helminth (STH) infections still persist among indigenous communities. In the past, local studies have focused mostly on epidemiologic aspects of STH infections with a scarcity of information on the efficacy of deworming treatment. The present study consisted of 2 phases: a cross-sectional phase on current epidemiological status and risk factors of STH infections and a longitudinal study over 6 weeks on triple dose albendazole efficacy against STH infections. A total of 253 participants were recruited at baseline and a pre-tested questionnaire was administered to obtain information on socio-demographics, environmental and behavioural risk factors. Stool samples were evaluated using a modified Kato-Katz technique. Cure rate (CR) and egg reduction rate (ERR) were assessed at 3 weeks following a 3-day course of 400mg albendazole treatment and infection status were observed again at 6 weeks. Baseline positivity of trichuriasis, ascariasis and hookworm infections were 56.1%, 11.9% and 20.2%, respectively. Multivariate analysis showed age below 18 years old (P = 0.004), without latrine in house (P = 0.042) and indiscriminate defecation (P = 0.032) were associated with STH infections. In the longitudinal study (N = 89), CR for trichuriasis was 64.6%, while CR of 100% was observed for both ascariasis and hookworm. ERR was above 90% for all three STH species. A rapid increased of Trichuris trichiura egg output was observed at 6 weeks. In conclusion, STH infections are highly prevalent among indigenous communities. Children and teenagers, poor sanitation and hygiene behaviour were determinants for STH infections. Triple dose albendazole is found to be efficacious against Ascaris lumbricoides and hookworm infections but has moderate curative effect with high ERR against T. trichiura. Although triple dose albendazole regimen has logistic challenges and may not be a routine option, consideration of this treatment regime may still be necessary in selective communities to reduce high intensity of T. trichiura infection.

Soil-Transmitted Helminth Infections among Antenatal Women in Primary Care Settings in Southern India: Prevalence, Associated Factors and Effect of Anti-Helminthic Treatment

“…A study among Rwandan children showed an overall cure rate of 88.6% and an ERR of 75.4% by wet mount microscopy, and in our study the CR was 90.7% [ 22 ].The cure rates depend on the individual parasitic load and the presence of parasites in the environment, which could cause reinfection. In addition, the cure rate depends on the number of doses, quality of the drug, and dosage [ 36 , 37 ].…”

Zinc status or supplementation and its relation to soil‐transmitted helminthiasis in children: A systematic review

“…In this regard, gut microbiota helps in metabolising albendazole and influence drug bioavailability and efficacy on infected individuals. 35,36 However, a huge diversity and functional capacity of human gut microbiome perform in various ways regarding the protection against pathogen overgrowth, inflammation, influence host-cell proliferation, biosynthesis of vitamins, and react differently to drugs and their metabolism. 37 Similarly, anthelmintic treatment could affect the gut microbiome through acting on intestinal protozoa, which have close interaction with gut microbiome, thus leading to improvement in the nutritional status of the children and to combat the multi-micronutrient deficiencies including zinc.…”

“…For example, Albendazole restrains the helminths glucose uptake and energy production, and ultimately exerts a spastic or paralytic effect on the worm. In this regard, gut microbiota helps in metabolising albendazole and influence drug bioavailability and efficacy on infected individuals 35,36 . However, a huge diversity and functional capacity of human gut microbiome perform in various ways regarding the protection against pathogen overgrowth, inflammation, influence host‐cell proliferation, biosynthesis of vitamins, and react differently to drugs and their metabolism 37 .…”

Status of Soil-Transmitted Helminthiasis Among Adolescents in Anaocha Local Government Area, Anambra State, Nigeria: Prevalence, Associated Factors, and Future Directions After a Decade of Ongoing Mass Administration of Medicines

“…It is important to note that anthelmintic drugs have varying levels of effectiveness against different species of STH, and they are particularly ineffective against Trichuris trichiura when using single-dose treatments [50]. Previous comparative studies have shown that a triple-dose regimen is more effective in treating STH than a single or double-dose regimen, particularly in co-endemic areas where all three STH species are prevalent [51][52][53]. Additionally, a study found that the combination therapy of ivermectinalbendazole had good tolerability and higher efficacy against T. trichiura compared to the current standard single-dose albendazole treatment, supporting its use in PC programs [54].…”