Ivermectin and albendazole coadministration: opportunities for strongyloidiasis control

Gandasegui, Javier; Onwuchekwa, Chukwuemeka; Krolewiecki, Alejandro; Doyle, Stephen R.; Pullan, Rachel L; Enbiale, Wendemagegn; Kepha, Stella; Hatherell, Hollie Ann; Lieshout, Lisette van; Cambra-Pellejà, María; Escola, Valdemiro; Muñóz, José

doi:10.1016/s1473-3099(22)00369-3

Cited by 9 publications

(4 citation statements)

References 58 publications

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“…Indeed, in light of the complexity of weight check in the field and of the good tolerability of ivermectin, some researchers are evaluating fixed-dose combinations of ivermectin and albendazole [ 18 ]. Should this represent an alternative to the current weight-dependent administration, the two methods for ivermectin administration, fixed dose or tablet pole, should be compared to see which one could be more feasible in the context of mass administration.…”

Section: Discussionmentioning

confidence: 99%

Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador

Buonfrate

Anselmi²,

Prandi³

et al. 2023

Infect Dis Poverty

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Background Establishment of efficient control programs for strongyloidiasis, the infection by Strongyloides stercoralis, is among the World Health Organization (WHO) targets for 2030. Ivermectin is a drug of choice for strongyloidiasis, but its weight-based administration can be unfeasible in remote areas. We evaluated a WHO tablet pole for administration of ivermectin in school-age children living in remote villages in Ecuador. Methods Children were enrolled in 16 villages in Esmeraldas Province of Ecuador, between July 2021 and June 2022. The pole identified four height intervals corresponding to ivermectin doses going from one to four tablets. For each child, we calculated the dose (µg/kg) administered with both weight-based and pole-based administration. Results were classified as follows: optimal dose, acceptable, overdose, underdose. Agreement between the two methods for estimating the number of tablets was assessed with Cohen’s kappa coefficient. Estimations were reported with 95% confidence intervals (CIs). Results Total of 778 children (47.3% female) were enrolled, with median age of 9.59 years (interquartile range: 7.42‒11.22). Optimal dose was achieved for a higher proportion of children when assessed with weight (37.9%) than with pole (25.7%). Underdose and overdose were more frequent with the pole (8.3% and 19.2% children, respectively) than with the weight-based (3.7% and 6.0%, respectively) administration. Agreement between weight-based and pole-based administration was moderate: 0.56 (95% CI 0.51, 0.61). The two methods indicated the same number of tablets in 71.6% (95% CI 0.684, 0.748) cases. Conclusions In our setting, the tablet pole could be a valid alternative. The tool needs further evaluation in different populations. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador

Buonfrate

Anselmi²,

Prandi³

et al. 2023

Infect Dis Poverty

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“…Although strongyloidiasis is considered a neglected tropical disease, it has also been described as a disease of disadvantage owing to its prevalence in low-resource communities with poor sanitation infrastructure [7]. Ivermectin and albendazole are generally effective for the treatment of strongyloidiasis [8][9][10][11]; however, these drugs do not prevent reinfection and repeated treatments are often required to eliminate the infection [12]. Moreover, drug resistance is already a major problem for the treatment of Strongyloides-infected livestock and is likely to soon become a problem for the treatment of human strongyloidiasis [7,13,14].…”

Section: Introductionmentioning

confidence: 99%

Invade or die: behaviours and biochemical mechanisms that drive skin penetration in Strongyloides and other skin-penetrating nematodes

McClure,

Patel,

Hallem

2023

Phil. Trans. R. Soc. B

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Skin-penetrating nematodes, including the human threadworm Strongyloides stercoralis and hookworms in the genera Necator and Ancylostoma , are gastrointestinal parasites that are a major cause of neglected tropical disease in low-resource settings worldwide. These parasites infect hosts as soil-dwelling infective larvae that navigate towards hosts using host-emitted sensory cues such as odorants and body heat. Upon host contact, they invade the host by penetrating through the skin. The process of skin penetration is critical for successful parasitism but remains poorly understood and understudied. Here, we review current knowledge of skin-penetration behaviour and its underlying mechanisms in the human parasite S. stercoralis , the closely related rat parasite Strongyloides ratti, and other skin-penetrating nematodes such as hookworms. We also highlight important directions for future investigations into this underexplored process and discuss how recent advances in molecular genetic and genomic tools for Strongyloides species will enable mechanistic investigations of skin penetration and other essential parasitic behaviours in future studies. This article is part of the Theo Murphy meeting issue ‘ Strongyloides : omics to worm-free populations’.

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“…Approaches to mitigate resistance may include combinatorial treatments that improve efficacy against a specific helminth. Anthelmintics administered in combination are recommended or being considered for the management of lymphatic filariasis [6,7], whipworm [8,9], and strongyloidiasis [10]. In the veterinary realm, combination anthelmintics are used to expand the spectrum of antiparasitic activity and to help delay or overcome single-drug resistance [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Mapping resistance-associated anthelmintic interactions in the model nematodeCaenorhabditis elegans

Rehborg

Wheeler

Zamanian

2023

Preprint

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Parasitic nematodes infect billions of people and are mainly controlled by anthelmintic mass drug administration (MDA). While there are growing efforts to better understand mechanisms of anthelmintic resistance in human and animal populations, it is unclear how resistance mechanisms that alter susceptibility to one drug affect the interactions and efficacy of drugs used in combination. Mutations that alter drug permeability across primary nematode barriers have been identified as potential resistance mechanisms using the model nematode Caenorhabditis elegans. We leveraged high-throughput assays in this model system to measure altered anthelmintic susceptibility in response to genetic perturbations of potential cuticular, amphidial, and alimentary routes of drug entry. Mutations in genes associated with these tissue barriers differentially altered susceptibility to the major anthelmintic classes (macrocyclic lactones, benzimidazoles, and nicotinic acetylcholine receptor agonists) as measured by animal development. We investigated two-way anthelmintic interactions across C. elegans genetic backgrounds that confer resistance or hypersensitivity to one or more drugs. We observe that genetic perturbations that alter susceptibility to a single drug can shift the drug interaction landscape and lead to the appearance of novel synergistic and antagonistic interactions. This work establishes a framework for investigating combinatorial therapies in model nematodes that can potentially be translated to amenable parasite species.

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Ivermectin and albendazole coadministration: opportunities for strongyloidiasis control

Cited by 9 publications

References 58 publications

Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador

Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador

Invade or die: behaviours and biochemical mechanisms that drive skin penetration in Strongyloides and other skin-penetrating nematodes

Mapping resistance-associated anthelmintic interactions in the model nematodeCaenorhabditis elegans

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