A randomized controlled trial comparing mebendazole and albendazole against Ascaris, Trichuris and hookworm infections

Albonico, Marco; Smith, P. G.; Hall, Andrew; Chwaya, Hababu M.; Alawi, K. S.; Savioli, Lorenzo

doi:10.1016/0035-9203(94)90174-0

Cited by 125 publications

(75 citation statements)

References 4 publications

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“…294 In endemic areas, hookworm infestation is known to be a major contributing factor in development of anemia in women of reproductive age. 295 Although the current recommendation during pregnancy is to use a single-dose regimen of either mebendazole or albendazole for treating hookworm infestation, 296 in combination with iron-folate supplements, there have been almost no systematic studies of the impact of this intervention on pregnancy outcomes.…”

Section: Malaria Prevention Using Itnsmentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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Section: Malaria Prevention Using Itnsmentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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“…A previous randomized trial conducted in Pemba had compared the efficacy of a single dose of 500 mg generic mebendazole with a single dose of 400 mg albendazole. Compared with that of albendazole, the efficacy of mebendazole was somewhat less against hookworms, very similar against Ascaris lumbricoides, and somewhat better against T. trichiura (17). The cost of generic mebendazole, US$0.027 per dose, was one-tenth of that of albendazole at that time (L Savioli, personal communication, 1993).…”

Section: The School-based Deworming Programmentioning

confidence: 99%

“…The generic mebendazole tablet is chewable and orange flavored. It was palatable to the children and produced few and mild side effects (17).…”

Section: Figurementioning

confidence: 99%

Effects of the Zanzibar school-based deworming program on iron status of children

Stoltzfus

Albonico

Chwaya

et al. 1998

The American Journal of Clinical Nutrition

119

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We evaluated the effects of the Zanzibar school-based deworming program on the iron status of primary school children. Parasitologic and nutritional assessments were carried out at baseline, 6 mo, and 12 mo in 4 nonprogram schools (n = 1002), 4 schools in which students received twice-yearly deworming (n = 952), and 4 schools in which students received thrice-yearly deworming (n = 970) with 500 mg generic mebendazole. Schools were randomly selected for evaluation and allocated to program groups. Relative to no treatment, thrice-yearly deworming caused significant decreases in protoporphyrin concentrations and both deworming regimens caused marginally significant increases in serum ferritin concentrations. The average annual changes in protoporphyrin concentrations were Ϫ5.9 and Ϫ23.5 mol/mol heme in the control and thrice-yearly deworming groups, respectively (P < 0.001). The average changes in ferritin concentration were 2.8 and 4.5 g/L, respectively (P = 0.07). Deworming had no effect on annual hemoglobin change or prevalence of anemia. However, the relative risk of severe anemia (hemoglobin < 70 g/L) was 0.77 (95% confidence limits: 0.39, 1.51) in the twice-yearly deworming group and 0.45 (0.19, 1.08) in the thrice-yearly deworming group. The effects on prevalence of high protoporphyrin values and incidence of moderate-to-severe anemia (hemoglobin < 90 g/L) were significantly greater in children with > 2000 hookworm eggs/g feces at baseline. We estimate that this deworming program prevented 1260 cases of moderate-to-severe anemia and 276 cases of severe anemia in a population of 30 000 schoolchildren in 1 y. Where hookworm is heavily endemic, deworming programs can improve iron status and prevent moderate and severe anemia, but deworming may be needed at least twice yearly.Am J Clin Nutr 1998;68:179-86.

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“…Albendazole is a benzimidazole derivative developed more than 25 years ago; it acts by binding to parasite b-tubulin, inhibiting its polymerization and impairing glucose uptake. Albendazole is used in the treatment of intestinal helminthiasis and is also a useful drug to treat a number of other parasitic diseases including cystic echinococcosis, ascariasis, enterobiasis, and cestode parasitosis [Njorge et al, 2005;Albonico et al, 1994;Horton, 2000]. Albendazole is presently considered the drug of choice for the treatment of human intestinal capillariasis because it is effective against eggs, larvae, and adult worms [Cross, 1992;Andersib et al, 1984].…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic evaluation and studies on the clinical efficacy of guar gum‐–based oral drug delivery systems of albendazole and albendazole‐β‐cyclodextrin for colon‐targeting in human volunteers

Shyale¹,

Chowdary²,

Krishnaiah³

et al. 2006

Drug Development Research

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The present investigation assessed the in vivo properties of the guar gum-based colontargeted matrix tablets of albendazole-b-cyclodextrin (KA), albendazole matrix tablet (GA), and an immediate-release albendazole tablet (CA) in humans. A single oral dose was administered in healthy human volunteers and a completely randomized, two-way, three-period crossover design was adopted. The data were statistically analyzed and a value of Po0.05 was considered statistically significant. In healthy human volunteers, guar gum colon-targeted tablets showed delayed t max and absorption time, decreased absorption rate constant, and unaltered t 1/2 indicating that albendazole is not released in stomach and small intestine, but is delivered to the colon, resulting in a slow absorption of the drug and making the drug available for local action in the colon. The increase in C max and AUC 0-N of KA shows that the bioavailability of albendazole in humans could be definitely improved by complexing the drug with b-cyclodextrin. Furthermore, an open, parallel, single-blind clinical study was conducted in patient volunteers who had helminthiasis. Clinical studies showed that the guar gum colon-targeted tablets could reduce eggs per gram faster than conventional tablets could, resulting in improved clinical symptoms, Hb content, and decreased total count as compared to conventional tablets of albendazole. The investigation shows that albendazole, when complexed with b-cyclodextrin, improves in vivo bioavailability of the drug and colon targeting using guar gum ensures drug delivery in the colonic fluids, and therefore improves clinical efficacy in human beings with helminthiasis. Drug Dev. Res. 67:154-165, 2006.

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A randomized controlled trial comparing mebendazole and albendazole against Ascaris, Trichuris and hookworm infections

Cited by 125 publications

References 4 publications

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Effects of the Zanzibar school-based deworming program on iron status of children

Pharmacokinetic evaluation and studies on the clinical efficacy of guar gum‐–based oral drug delivery systems of albendazole and albendazole‐β‐cyclodextrin for colon‐targeting in human volunteers

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