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Low efficacy of single-dose albendazole and mebendazole against hookworm and effect on concomitant helminth infection in Lao PDR.
PLoS Negl Trop Dis. 2012 Jan; 6(1):e1417.PN

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.

CLINICAL TRIAL REGISTRATION

Current Controlled Trials ISRCTN29126001.

Authors+Show Affiliations

National Institute of Public Health, Ministry of Health, Vientiane, Lao People's Democratic Republic.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22235353

Citation

Soukhathammavong, Phonepasong Ayé, et al. "Low Efficacy of Single-dose Albendazole and Mebendazole Against Hookworm and Effect On Concomitant Helminth Infection in Lao PDR." PLoS Neglected Tropical Diseases, vol. 6, no. 1, 2012, pp. e1417.
Soukhathammavong PA, Sayasone S, Phongluxa K, et al. Low efficacy of single-dose albendazole and mebendazole against hookworm and effect on concomitant helminth infection in Lao PDR. PLoS Negl Trop Dis. 2012;6(1):e1417.
Soukhathammavong, P. A., Sayasone, S., Phongluxa, K., Xayaseng, V., Utzinger, J., Vounatsou, P., Hatz, C., Akkhavong, K., Keiser, J., & Odermatt, P. (2012). Low efficacy of single-dose albendazole and mebendazole against hookworm and effect on concomitant helminth infection in Lao PDR. PLoS Neglected Tropical Diseases, 6(1), e1417. https://doi.org/10.1371/journal.pntd.0001417
Soukhathammavong PA, et al. Low Efficacy of Single-dose Albendazole and Mebendazole Against Hookworm and Effect On Concomitant Helminth Infection in Lao PDR. PLoS Negl Trop Dis. 2012;6(1):e1417. PubMed PMID: 22235353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low efficacy of single-dose albendazole and mebendazole against hookworm and effect on concomitant helminth infection in Lao PDR. AU - Soukhathammavong,Phonepasong Ayé, AU - Sayasone,Somphou, AU - Phongluxa,Khampheng, AU - Xayaseng,Vilavanh, AU - Utzinger,Jürg, AU - Vounatsou,Penelope, AU - Hatz,Christoph, AU - Akkhavong,Kongsap, AU - Keiser,Jennifer, AU - Odermatt,Peter, Y1 - 2012/01/03/ PY - 2011/04/06/received PY - 2011/10/22/accepted PY - 2012/1/12/entrez PY - 2012/1/12/pubmed PY - 2012/5/1/medline SP - e1417 EP - e1417 JF - PLoS neglected tropical diseases JO - PLoS Negl Trop Dis VL - 6 IS - 1 N2 - 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. CLINICAL TRIAL REGISTRATION: Current Controlled Trials ISRCTN29126001. SN - 1935-2735 UR - https://www.unboundmedicine.com/medline/citation/22235353/Low_efficacy_of_single_dose_albendazole_and_mebendazole_against_hookworm_and_effect_on_concomitant_helminth_infection_in_Lao_PDR_ L2 - http://dx.plos.org/10.1371/journal.pntd.0001417 DB - PRIME DP - Unbound Medicine ER -