The impact of ivermectin, diethylcarbamazine citrate, and albendazole mass drug administration on the prevalence of scabies and soil-transmitted helminths in school-aged children in three municipalities in Timor-Leste: a before–after assessment

Le, Brandon; Monteiro, Merita; Amaral, Salvador; Wand, Handan; Matthews, Alexander; Hii, Sze Fui; Clarke, Naomi E.; Arkell, Paul; Yan, Jennifer; Engelman, Daniel; Fancourt, Nicholas; Fernandes, José Luís; Steer, Andrew C.; Kaldor, John; Traub, Rebecca J.; Francis, Joshua; Nery, Susana Vaz

doi:10.1016/s2214-109x(23)00134-1

Cited by 8 publications

(14 citation statements)

References 26 publications

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“…A total of 21 papers (reporting 25 studies) met the inclusion criteria for the systematic review [ 17 – 25 , 34 – 45 ] and 15 of these papers (reporting 19 studies) were included in the meta-analysis [ 17 – 22 , 24 , 25 , 35 , 36 , 39 , 41 – 43 , 45 ] (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 lists individual studies included in the systematic review with their characteristics while Table 2 provides an aggregated summary of the study characteristics. Of the 25 studies included in the systematic review, 17 (68%) used ivermectin and albendazole as their PC regimen [ 20 – 25 , 34 , 36 , 38 – 41 , 43 , 45 ] and 8 (32%) used ivermectin with no other anthelminthic drugs [ 17 – 19 , 35 , 37 , 42 , 44 ]. Nine studies used additional drugs in addition to ivermectin and/or albendazole [ 19 , 34 , 36 , 38 – 41 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of the 25 studies included in the systematic review, 17 (68%) used ivermectin and albendazole as their PC regimen [ 20 – 25 , 34 , 36 , 38 – 41 , 43 , 45 ] and 8 (32%) used ivermectin with no other anthelminthic drugs [ 17 – 19 , 35 , 37 , 42 , 44 ]. Nine studies used additional drugs in addition to ivermectin and/or albendazole [ 19 , 34 , 36 , 38 – 41 , 44 ]. There was no head-to-head comparison of ivermectin versus ivermectin and albendazole.…”

Section: Resultsmentioning

confidence: 99%

“…Onchocerciasis ( n = 3) (17, 34, 37) and scabies ( n = 3) (18, 39, 43) were the primary diseases targeted for studies using ivermectin only. In studies using ivermectin and albendazole combined, albendazole was mostly distributed to entire communities through MDA together with ivermectin ( n = 13) [ 21 – 25 , 36 , 39 , 41 , 43 , 45 ], although four studies complemented MDA efforts with school-based targeted PC [ 20 , 34 , 38 , 40 ] with albendazole only on alternating timelines. Lymphatic filariasis was the most commonly targeted primary disease, representing 64% of these studies ( n = 16) (19, 21, 22, 33, 35, 36, 38, 40–42, 44, 46).…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of ivermectin mass drug administration in the control of soil-transmitted helminth infections in endemic populations: a systematic review and meta-analysis

Le,

Clarke,

Legrand

et al. 2024

Infect Dis Poverty

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Background Current soil-transmitted helminth (STH) control guidelines endorse the use of albendazole or mebendazole for school-based targeted preventive chemotherapy (PC), yet their reduced efficacy against Strongyloides stercoralis and Trichuris trichiura presents significant limitations. Emerging evidence indicates that community-wide PC [or mass drug administration (MDA)] using ivermectin, commonly used in other neglected tropical disease (NTD) control programs, may play an important role in controlling these parasites. We conducted a systematic review and meta-analysis to evaluate the effectiveness of ivermectin PC in reducing STH prevalence in endemic populations. Methods We searched Pubmed, EMBASE, and Web of Science on February 14, 2023, for studies that investigated the effectiveness of ivermectin PC, either alone or in combination with other anthelmintic drugs, on STH infections, and provided a measure of STH prevalence before and after PC. We calculated pooled prevalence reductions for each STH using random-effects meta-analyses. Our protocol is available on PROSPERO (registration number CRD42023401219). Results A total of 21 were eligible for the systematic review, of which 15 were eligible for meta-analysis. All studies delivered ivermectin through MDA. The pooled prevalence reduction of S. stercoralis following MDA with ivermectin alone was 84.49% (95% CI 54.96–94.66) across five studies and 81.37% (95% CI 61.62–90.96) across seven studies with or without albendazole. The prevalence reduction of T. trichiura was 49.93% (95% CI 18.23–69.34) across five studies with ivermectin alone, and 89.40% (95% CI 73.66–95.73) across three studies with the addition of albendazole. There was high heterogeneity for all syntheses (I2 > 65%). Conclusions This study underscores the key role of ivermectin-based MDA in addressing limitations in current global STH guidelines in terms of limited efficacy against S. stercoralis and T. trichiura. Based on these findings, revising international STH guidelines to include ivermectin is a promising option to progress the control and eventual elimination of STHs and other NTDs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effectiveness of ivermectin mass drug administration in the control of soil-transmitted helminth infections in endemic populations: a systematic review and meta-analysis

Le,

Clarke,

Legrand

et al. 2024

Infect Dis Poverty

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“…Ivermectin is known to act strongly against a wide variety of insects, nematodes, and acarine parasites, including lice and scabies (27, 28). A study to assess the impact of IDA-MDA for LF and STH control in Timor-Leste reported significant reduction in the prevalence of scabies, impetigo, and STH ( Trichuris trichiura and Ascaris lumbricoides ) among schoolchildren (29).…”

Section: Discussionmentioning

confidence: 99%

Triple-drug therapy with ivermectin, diethylcarbamazine and albendazole for the acceleration of lymphatic filariasis elimination in Kenya: Programmatic implementation and results of the first impact surveillance

Njenga,

Kanyi,

Okoyo

et al. 2024

Preprint

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The World Health Organization (WHO) endorsed the use of triple-drug mass drug administration (MDA) regimen with ivermectin, diethylcarbamazine (DEC) and albendazole (commonly abbreviated as IDA) to accelerate the elimination of lymphatic filariasis (LF) as a public health problem in settings where onchocerciasis is not co-endemic. The National Programme for Elimination of LF (NPELF) in Kenya was among the first adopters of the IDA-MDA and two annual rounds were provided in 2018 and 2019 to the residents of Lamu County and Jomvu sub-County in the coast region. There is a need to determine efficient sampling strategies, indicators, and the appropriate population groups that could be used for the monitoring and evaluation of LF programs using IDA-MDA for the elimination of the disease as a public health problem. Two cross-sectional surveys were conducted at baseline in 2018 before IDA-MDA and an impact assessment 17 months after the second round of IDA-MDA. The reported epidemiological treatment coverage was at least 80% in all implementation units during each round of IDA-MDA. Blood samples were tested for circulating filarial antigens using commercial Filariasis Test Strips (FTS) and any individual that was found to be positive was tested again at night for the presence of microfilariae in finger prick blood smears using microscopy. The overall prevalence of LF infection was relatively low at the baseline survey with Jomvu having 1.39% (95% CI: 0.91, 2.11) and Lamu having 0.48% (95% CI: 0.21, 1.13). Significant reductions in LF prevalence were observed during the impact assessment after two annual rounds of treatment. The overall relative risk reduction (%) in LF prevalence following the two rounds of MDA with IDA was significant in both Jomvu (52.45%, Z = –2.46, P < 0.02) and Lamu (52.71%, Z = –1.97, P < 0.05). Heterogeneity, however, was observed in the LF prevalence reduction between random and purposive clusters, as well as between adult and child populations. The results of the endline impact survey offered strong evidence that it was safe to stop the IDA-MDA in the two EUs because transmission appears to have been interrupted. It is also important to implement a post-treatment surveillance system which would enable efficient detection of any recrudescence of LF infection transmission at a sub-evaluation unit level. Our findings show that IDA-MDA may be considered for acceleration of LF elimination in other settings where onchocerciasis is not co-endemic.Author summaryPreventive chemotherapy with antifilarial drugs is currently the mainstay public health intervention recommended for the elimination of lymphatic filariasis in endemic countries. Two-drug regimen mass drug administration of albendazole plus either diethylcarbamazine or ivermectin has been used widely in most countries since the launch of the Global Programme to Eliminate Lymphatic Filariasis by the World Health Organization in 2000. Safety and efficacy clinical studies conducted in Papua New Guinea have shown that co-administration of three antifilarial drugs namely, ivermectin, diethylcarbamazine and albendazole is superior than the two-drug regimen diethylcarbamazine and albendazole in clearance of microfilariae from the bloodstream. Consequently, the triple-drug regimen was endorsed for accelerating efforts to eliminate lymphatic filariasis as a public health problem in areas where onchocerciasis is not co-endemic. The aim of this study was to assess the feasibility of delivering mass treatment with the triple-drug regimen under programmatic conditions. An operational research study was conducted to determine the optimal sampling strategies, indicator (or set of indicators), and study populations for monitoring and evaluation of lymphatic filariasis programs using the triple-drug regimen mass drug administration. Two rounds of mass treatment with the triple-drug regimen were given to the residents of Lamu County (comprising of Lamu East and Lamu West sub-counties) and Jomvu sub-County (in Mombasa) in November 2018 and November 2019. The programme epidemiological treatment coverage was at least 80% in each implementation unit during the two treatment rounds. The preventive treatment resulted in significant reductions in the prevalence of the disease with the number of positive cases being fewer than the threshold recommended for areas where transmission is likely to be no longer sustainable.

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Effectiveness of one and two doses of ivermectin mass drug administration in reducing the prevalence and intensity of soil-transmitted helminth (STH) infections in Western Province, Solomon Islands: a cluster-randomised, before-after analysis

Le,

Clarke,

Hii

et al. 2023

The Lancet Regional Health - Western Pacific

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The impact of ivermectin, diethylcarbamazine citrate, and albendazole mass drug administration on the prevalence of scabies and soil-transmitted helminths in school-aged children in three municipalities in Timor-Leste: a before–after assessment

Cited by 8 publications

References 26 publications

Effectiveness of ivermectin mass drug administration in the control of soil-transmitted helminth infections in endemic populations: a systematic review and meta-analysis

Effectiveness of ivermectin mass drug administration in the control of soil-transmitted helminth infections in endemic populations: a systematic review and meta-analysis

Triple-drug therapy with ivermectin, diethylcarbamazine and albendazole for the acceleration of lymphatic filariasis elimination in Kenya: Programmatic implementation and results of the first impact surveillance

Effectiveness of one and two doses of ivermectin mass drug administration in reducing the prevalence and intensity of soil-transmitted helminth (STH) infections in Western Province, Solomon Islands: a cluster-randomised, before-after analysis

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