Insights gained from conducting a randomised controlled trial on Ivermectin-Albendazole against Trichuris trichiura in Côte d'Ivoire, Lao PDR and Pemba Island

Keller, Ladina; Hürlimann, Eveline; Patel, Chandni; Welsche, Sophie; Sayasone, Somphou; Ali, Said M.; Shaali, M.; Coulibaly, Jean T.; Keiser, Jennifer

doi:10.1016/bs.apar.2020.11.001

Cited by 4 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Apparent reinfection rates with T. trichiura in Lao PDR at six and 12 months were considerably lower compared to Pemba Island, regardless of the treatment received. Even though open defecation practices might be a contributing factor to these high reinfection rates, it is unlikely to drive the discrepancy in our two study settings as self-reported open defaecation practices were high in both countries (S1 Fig) . A likely explanation might be the high population density on Pemba as well as that STH and particularly T. trichiura prevalence on Pemba Island is considerably higher compared to Lao PDR, where we found a highly focal distribution of STH prevalence [36]. Consequently, the overall environmental contamination is presumably much higher on Pemba Island, leading to a higher risk of reinfection.…”

Section: Discussionmentioning

confidence: 65%

“…A likely explanation might be the high population density on Pemba as well as that STH and particularly T . trichiura prevalence on Pemba Island is considerably higher compared to Lao PDR, where we found a highly focal distribution of STH prevalence [ 36 ]. Consequently, the overall environmental contamination is presumably much higher on Pemba Island, leading to a higher risk of reinfection.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term outcomes of ivermectin-albendazole versus albendazole alone against soil-transmitted helminths: Results from randomized controlled trials in Lao PDR and Pemba Island, Tanzania

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Preventive chemotherapy is the cornerstone of soil-transmitted helminth (STH) control. Long-term outcomes and adequate treatment frequency of the recently recommended albendazole-ivermectin have not been studied to date. Methodology/principal findings Double-blind randomized controlled trials were conducted in Lao PDR, Pemba Island, Tanzania and Côte d’Ivoire between 2018 and 2020 to evaluate the efficacy and safety of ivermectin-albendazole versus albendazole-placebo in Trichuris trichiura-infected individuals aged 6 to 60. In the framework of this study, in Lao PDR 466 and 413 participants and on Pemba Island, 558 and 515 participants were followed-up six and 12 months post-treatment, respectively. From each participant at least one stool sample was processed for Kato-Katz diagnosis and cure rates (CRs), egg reduction rates (ERRs) and apparent reinfection rates were calculated. If found helminth-positive at 6-months, participants were re-treated according to their allocated treatment. Long-term outcomes against T. trichiura based on CRs and ERRs of ivermectin-albendazole compared to albendazole were significantly higher at six months in Lao PDR (CR, 65.8% vs 13.4%, difference; 52.4; 95% CI 45.0–60.0; ERRs: 99.0% vs 79.6, difference 19.4; 95% CI 14.4–24.4) and Pemba Island (CR: 17.8 vs 1.4%, difference; 16.4%; 95% CI 11.6–21.0; ERRs: 84.9 vs 21.2, difference 63.8; 95% CI 50.6–76.9) and also at 12 months in Lao PDR (CR, 74.0 vs 23.4%, difference; 50.6; 95% CI 42.6–61.0; ERRs: 99.6 vs 91.3, difference 8.3; 95% CI 5.7–10.8) and Pemba Island (CR, 19.5 vs 3.4%, difference; 16.1; 95% CI 10.7–21.5; ERRs: 92.9 vs 53.6, difference 39.3; 95% CI 31.2–47.4) respectively. Apparent reinfection rates with T. trichiura were considerably higher on Pemba Island (100.0%, 95% CI, 29.2–100.0) than in Lao PDR (10.0%, 95% CI, 0.2–44.5) at 12 months post-treatment for participants treated with albendazole alone. Conclusions/significance The long-term outcomes against T. trichiura of ivermectin-albendazole are superior to albendazole in terms of CRs and ERRs and in reducing infection intensities. Our results will help to guide decisions on how to best use ivermectin-albendazole in the context of large-scale PC programs tailored to the local context to sustainably control STH infections. Trial registration ClinicalTrials.gov registered with clinicaltrials.gov, reference: NCT03527732, date assigned: 17 May 2018.

show abstract

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of ivermectin-albendazole versus albendazole alone against soil-transmitted helminths: Results from randomized controlled trials in Lao PDR and Pemba Island, Tanzania

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…For Ascaris lumbricoides and hookworm, albendazole 400 mg was administered as a single oral dose. For Trichuris trichiura , both ivermectin 600 µ g/kg with albendazole 400 mg were administered together, 11 , 16 and for Strongyloides stercolaralis , ivermectin 200 µ g/kg/day for 2 days was administered 10 , 17 , 18 (see Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Single-Dose Albendazole and Albendazole Plus Ivermectin for Soil-Transmitted Helminth Infection in Children in the Peruvian Amazon

Curico,

Garcia Bardales,

Pinedo Vasquez

et al. 2024

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

In countries where soil-transmitted helminth (STH) infections are endemic, deworming programs are recommended to reduce morbidity; however, increasing levels of resistance to benzimidazoles are of concern. In an observational study in Peru, we studied the clinical efficacy of 400 mg of albendazole 20 days after treatment among children aged 2–11 years. Of 426 participants who provided samples, 52.3% were infected with a STH, 144 (33.8%) were positive for Ascaris (41.8% light, 50.8% moderate, and 7.4% heavy infections), 147 (34.5%) were positive for Trichuris (75.2% light, 22.5% moderate, and 2.3% heavy infections), and 1.1% were positive for hookworm species (100% light infections). Additional stool samples were examined at 20, 90, and 130 days after the initial treatment. At 20 days post-administration of albendazole, the cure rate (CR) of Ascaris infection was 80.1% (95% CI: 73.5–86.7), and the egg reduction rate (ERR) was 70.8% (95% CI: 57.8–88.7); the CR for Trichuris infection was 27.1% (95% CI: 20.0–34.3), and the ERR was 29.8% (95% CI: –1.40 to 57.5). Among participants with persistent or recurrent infections with Trichuris, the combined therapy of albendazole (400 mg) and ivermectin at 600 µg/dose increased overall CR for Trichuris infection to 75.2% (95% CI: 67.3–83.2%) with an ERR of 84.2% (95% CI: 61.3–93.8%). Albendazole administration alone for the control of STH was associated with high rates of treatment failure, especially for Trichuris. Combined single doses of albendazole and ivermectin was observed to have improved efficacy.

show abstract

“…For Trichuris trichiura , ivermectin 600 µg/kg/day will be administered with albendazole 400 mg, both as single oral doses [ 20 , 21 ]. For Strongyloides stercolaris , Ivermectin 200 µg/kg/day for 2 days will be administered [ 22 – 24 ].…”

Section: Data and Specimen Collection (See Fig 1 F...mentioning

confidence: 99%

Resistance to single dose albendazole and reinfection with intestinal helminths among children ages 2 to 11 years from the Peruvian Amazon region: a study protocol

et al. 2022

View full text Add to dashboard Cite

Background Deworming programs aimed at reducing morbidity and mortality from geohelminth infections are common in many countries where these infections are endemic, but data demonstrating increasing levels of resistance to albendazole and mebendazole are causes for concern. Studies to evaluate the clinical efficacy of deworming programs are critical to maintain high infection control goals. Methods We propose to assess the clinical efficacy of Peruvian national guidelines for deworming programs in a prospective observational study conducted in the Amazon River basin area near Iquitos, Peru. Major outcomes to be evaluated include (1) albendazole resistance of intestinal helminths (trichuriasis, ascariasis, hookworm), and (2) frequency of reinfection with intestinal helminths 4 months after treatment with albendazole. Children ages 2–11 years from the Belén District of Iquitos will be identified based on a community census. Following parental informed consent, demographic data, weight, and height will be recorded and a stool specimen for parasitological exam by direct observation and Kato-Katz concentration method, and helminthic egg counts will be collected prior to administration of albendazole, following Peruvian national guidelines. Follow-up stool specimens examined in the same manner will be collected at 20 days, 90 days, and 100 days following initial administration of albendazole, and based on parasites found repeat treatment will be administered in accordance with national guidelines. Real-time multiplex qPCR will be performed on helminth positive samples collected prior to initial deworming and on helminth-positive specimens detected on day 15–20. A total sample size of 380 participants was calculated based on total population in the target group and prevalence estimates of helminth infections and clinical resistance based on recent data. Discussion Data from observational clinical efficacy studies are important to guide geohelminth infection control programs. Trial registrationhttps://www.researchregistry.com/. Identification number: researchregistry7736; Registered retrospectively March 13, 2022; https://www.researchregistry.com/browse-the-registry#home/registrationdetails/622e024cf06132001e3327bf/

show abstract

Insights gained from conducting a randomised controlled trial on Ivermectin-Albendazole against Trichuris trichiura in Côte d'Ivoire, Lao PDR and Pemba Island

Cited by 4 publications

References 25 publications

Long-term outcomes of ivermectin-albendazole versus albendazole alone against soil-transmitted helminths: Results from randomized controlled trials in Lao PDR and Pemba Island, Tanzania

Long-term outcomes of ivermectin-albendazole versus albendazole alone against soil-transmitted helminths: Results from randomized controlled trials in Lao PDR and Pemba Island, Tanzania

Efficacy of Single-Dose Albendazole and Albendazole Plus Ivermectin for Soil-Transmitted Helminth Infection in Children in the Peruvian Amazon

Resistance to single dose albendazole and reinfection with intestinal helminths among children ages 2 to 11 years from the Peruvian Amazon region: a study protocol

Contact Info

Product

Resources

About