Rapid Re-Infection with Soil-Transmitted Helminths after Triple-Dose Albendazole Treatment of School-Aged Children in Yunnan, People's Republic of China

Abstract

Abstract. Post-treatment soil-transmitted helminth re-infection patterns were studied as part of a randomized controlled trial among school-aged children from an ethnic minority group in Yunnan province, People's Republic of China. Children with a soil-transmitted helminth infection (N = 194) were randomly assigned to triple-dose albendazole or placebo and their infection status monitored over a 6-month period using the Kato-Katz and Baermann techniques. Baseline prevalence of Trichuris trichiura, Ascaris lumbricoides, hookworm, and Strongyloides stercoralis were 94.5%, 93.3%, 61.3%, and 3.1%, respectively, with more than half of the participants harboring triple-species infections. For the intervention group (N = 99), the 1-month post-treatment cure rates were 96.7%, 91.5%, and 19.6% for hookworm, A. lumbricoides, and T. trichiura, respectively. Egg reduction rates were above 88% for all three species. Rapid re-infection with A. lumbricoides was observed: the prevalence 4 and 6 months post-treatment was 75.8% and 83.8%, respectively. Re-infection with hookworm and T. trichiura was considerably slower.

Decreasing prevalence of Trichuris trichiura (whipworm) in the Northern Territory from 2002 to 2012

“…1,2 T. trichiura is the most prevalent helminth in many countries surveyed. [3][4][5] Heavy infections (> 10 000 eggs per gram of faeces) are associated with anaemia, malnutrition, the trichuris dysentery syndrome and rectal prolapse. [6][7][8] The Northern Territory has a population of about 232 000 in a geographic area of 1 200 000 km 2 .…”

The Impact of a School-Based Hygiene, Water Quality and Sanitation Intervention on Soil-Transmitted Helminth Reinfection: A Cluster-Randomized Trial

“…9,10 In the absence of control measures aimed at reducing exposure, treatment of STH infections is followed by re-infection, necessitating repeated treatments. 11,12 The benefits of such treatment can be sustained by efforts to reduce environmental exposure to infection through improved sanitation and hygiene behaviors. 13,14 Although household coverage of water and sanitation is measured by the United Nations Children's Fund (UNICEF)/World Health Organization (WHO) Joint Monitoring Program for Water and Sanitation, little is known about global access of water, sanitation, and hygiene (WASH) in schools.…”

A study of prevalence of intestinal worm infestation and efficacy of anthelminthic drugs

“…However, Soukhathammavong et al (2012) 15 in a trial to assess the efficacy of single-dose of albendazole and mebendazole against hookworm in school children in Lao PDR obtained a disappointingly low CR of 36.0% and 17.6% respectively. In a similar study to assess efficacy of ALB using triple dose therapy, Yap et al (2013) 16 in a study of school-age children in Fig. 1 e Relative prevalence of intestinal parasites in the study population.…”