Effect of Mass Drug Administration with a Single Dose of Albendazole on Ascaris lumbricoides and Trichuris trichiura Infection among Schoolchildren in Yangon Region, Myanmar

Abstract

Soil-transmitted helminths, including <i>Ascaris lumbricoides</i> and <i>Trichuris trichiura</i>, are important intestinal parasites mostly affecting younger people in developing countries. In 2014-2015, we performed mass fecal examinations targeting a total of 2,227 schoolchildren in 3 districts (South Dagon, North Dagon, and Hlaing-thar-yar) of Yangon Region, Myanmar, using the Kato-Katz thick smear technique. The egg positive children were subjected to a mass drug administration (MDA) using a single oral dose of 400 mg albendazole. The pre-treatment egg positive rate (EPG/person) of <i>A. lumbricoides</i> averaged 17.2% (15,532); it was 25.2% (21,796), 14.2% (11,816), and 12.8% (12,983) in 3 districts, respectively, and that of <i>T. trichiura</i> averaged 19.4% (1,074), and was 24.1% (1,040), 12.3% (852), and 21.2% (1,330) in 3 districts, respectively. Follow-up fecal examinations performed 4 months post-MDA revealed considerable decreases of <i>A. lumbricoides</i> prevalence (EPG/person) to av. 8.3% (12,429), and 13.7% (17,640), 8.0% (7,797), and 4.5% (11,849) in 3 districts, respectively. However, <i>T. trichiura</i> did not show any recognizable decrease in the prevalence (EPG/person) remaining at av. 18.2% (862), and 18.5% (888), 11.5% (812), and 23.3% (887) in 3 districts, respectively. The results demonstrated difficulty in short-term control of <i>T. trichiura</i> by MDA using albendazole and suggested necessity of either a long-term MDA (>10 years) or changing the albendazole regimen into 2~3-day course (total 800 or 1,200 mg), or using an alternative drug/drug combination.

Albendazole and Mebendazole as Anti-Parasitic and Anti-Cancer Agents: an Update

“…The therapeutic efficacy of albendazole against A. lumbricoides seems unchanged until recently (2017); it was reported to be 95.7–96.5% in CR and 98.5–99.7% in ERR [ 42 , 43 ]. Albendazole (400 mg single dose) was shown to be useful for short-term control (4 months) of ascariasis using mass drug administration (MDA) in schoolchildren in Yangon Region, Myanmar [ 46 ].…”

“…Moser et al [ 42 , 43 ] put an emphasis on a temporal decrease of ERR which was 72.6% in 1995 and 43.4% in 2015 and considered this temporal decrease of albendazole efficacy against T. trichiura to be in part due to an emergence of drug resistance. Chai et al [ 46 ] tried to control A. lumbricoides and T. trichiura infections among schoolchildren in Myanmar by MDA using a 400 mg single dose of albendazole but difficulties were experienced in short-term control of trichuriasis seemingly because of limited drug efficacy against T. trichiura.…”

“…In case of mebendazole, its efficacy (500 mg single dose) for T. trichiura infection was 42.1–44.4% in CR and 66.0–80.7% in ERR [ 42 ]. For a short-term control (4 months) of trichuriasis in schoolchildren, Myanmar, a single dose of albendazole (400 mg) appeared to be not enough, and a long-term MDA (>10 years), increasing albendazole dosage-regimen into 3-day course, or using an alternative drug or drug combination was recommended [ 46 ].…”

Larval Gnathostomes and Zoonotic Trematode Metacercariae in Fish from a Local Market in Yangon City, Myanmar

“…Epidemiological studies on helminthic infections have not been actively performed in the Republic of the Union of Myanmar (Myanmar). Most studies if any were surveys on soil-transmitted helminthiases [10][11][12][13][14]. However, Aung et al [15] and Sohn et al [16] reported the endemic status of opisthorchiasis in Myanmar.…”

“…We purchased a total of 486 fish of 13 species in a local market in North Dagon District [ 14 ], Yangon City, Myanmar, 8 times (December 2015, August and November 2016, November 2017, June and December 2018, 2019). All collected fish were transported with ice to the laboratory of Department of Parasitology and Tropical Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.…”