Double‐Blind Placebo‐Controlled Study of Concurrent Administration of Albendazole and Praziquantel in Schoolchildren with Schistosomiasis and Geohelminths

Abstract

A double-blind placebo-controlled study of the concurrent administration of albendazole and praziquantel was conducted in>1500 children with high prevalences of geohelminths and schistosomiasis. The study sites were in China and the Philippines, including 2 strains of Schistosoma japonicum, and 2 different regions of Kenya, 1 each with endemic Schistosoma mansoni or Schistosoma haematobium. Neither medication affected the cure rate of the other. There was no difference between the side effect rate from albendazole or the double placebo. Praziquantel-treated children had more nausea, abdominal pain, and headache but these side effects were statistically more common in children with schistosomiasis, suggesting a strong influence of dying parasites. The subjects were followed for 6 months for changes in infection status, growth parameters, hemoglobin, and schistosomiasis morbidity. In all 4 sites, a significant 6-month increase in serum hemoglobin was observed in children who received praziquantel, strongly supporting population-based mass treatment.

Evidence for an improvement in cognitive function following treatment of Schistosoma japonicum infection in Chinese primary schoolchildren.

“…Neither drug affected the cure rate of the other drug. 27 Albendazole treatment did not result in any significant reduction in the prevalence of either T. trichiura or A. lumbricoides infections or in any significant reduction in the intensity (epg) of T. trichiura infection. However, albendazole treatment did lead to a significant reduction in the intensity of infection with A. lumbricoides (P Ͻ 0.001; Table TABLE 2 The effect of albendazole and praziquantel treatment on the prevalence and intensity of helminth infection* * IDA ϭ iron deficiency anemia; NCHS ϭ National Center for Health Statistics.…”

“…The likelihood of finding an effect of treating S. japonicum infection on cognitive function in this study was considered to be low because of the low intensity of S. japonicum infection 43 and because, owing to a combination of poor cure rates and reinfection over the 90-day period of follow-up, 27 children were still infected post-treatment with T. trichiura and less so with A. lumbricoides. Therefore, it is possible that the same study design in a higher transmission area with more efficacious treatment would show stronger effects.…”

“…27 The study was conducted in Meishan County, Sichuan Province, approximately 50 miles southwest of Chengdu, China in 1993. A total of 181 children were recruited to the cognition component of the study.…”

Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

“…Though both stunting and wasting were prevalent in our study, we did not find the associations with schistosomiasis that other investigators have shown. [50][51][52] Our inability to reproduce the association is likely caused by residual confounding from unmeasured variables. The overwhelming support from other studies argues that anthropometry should remain in the toolkit for morbidity assessments.…”

Reduction in Hookworm Infection after Praziquantel Treatment among Children and Young Adults in Leyte, the Philippines

“…In a previous four-arm randomized controlled trial of albendazole and praziquantel, there was a fall in the prevalence of hookworm infection 45 days posttreatment in the placebo group, which did not reach statistical significance. 28 No data were provided with respect to change in intensity of hookworm infection in that time. Thus, it is possible that the observed decreases in hookworm infection were caused by changes in the ecology of transmission, improvements of sanitation and hygiene, or unmeasured treatment with albendazole.…”