Effect of length of albendazole treatment against Trichuris trichiura infection

  • Aridamuriany D Lubis Department of Child Health, University of North Sumatera Medical School/H. Adam Malik Hospital
  • Syahril Pasaribu Department of Child Health, University of North Sumatera Medical School/H. Adam Malik Hospital
  • Muhammad Ali Department of Child Health, University of North Sumatera Medical School/H. Adam Malik Hospital
  • Munar Lubis Department of Child Health, University of North Sumatera Medical School/H. Adam Malik Hospital
Keywords: albendazole, trichuriasis, single dose, repeated doses

Abstract

Background Trichuris trichiura is one of the most common soil-transmitted helminth that infects school-aged children. A single dose of albendazole has been shown to have wide variations in cure and egg reduction rates. Some studies have suggested that repeated doses of albendazole might increase its effectiveness.
Objective To compare the anti-trichuriasis effect of 400 mg albendazole taken daily for five consecutive days vs. seven consecutive days.
Methods A randomized open clinical trial was conducted from August to September 2009 on elementary school children at Jaring Halus in the North Sumatera Province. Stool specimens were collected before treatment and on days 7, 14, 21, and 28 after initiation of treatment, and examined by the Kato Katz method. Subjects were randomized into two groups. Group I received 400 mg albendazole daily for five consecutive days and Group II received 400 mg albendazole daily for seven consecutive days. Cure rates and egg reduction rates were compared using Chi-square and T-tests, respectively.
Results One hundred twenty-one children were enrolled, consisted of 61 children in Group I and 60 in Group II. For the first week after treatment ended, the cure rates in Group II was higher (86.7%) than in the Group I (39.3%) (P=0.001), as well as in the second week after treatment ended (88.3% vs 68.9%, P=0.017). However, after 3rd and 4th weeks, the cure rates were no longer significantly different. Egg reduction rate was also statistically higher in the Group II [20.3 (SD 23.77) %] compared to Group I [6.6 (SD 11.30) %].
Conclusions Albendazole for seven consecutive days is more effective in curing Trichuris trichiura infection in the 1st and 2nd weeks after treatment compared to that of five consecutive days, as well as in egg reduction rate, but the length of treatment does not influence the cure rate after the 3rd and 4th weeks.

References

1. Margono SS. Important human helminthiasis in Indonesia. In: Crompton DWT, Montresor A, Nesheim MC, Savioli L, editors. Controlling disease due to helminth infections. Geneva: WHO; 2003. p. 3-14.
2. Dewayani BS, Situmeang R, Sembiring T, Hamid ED, Pasaribu S, Lubis CP. Albendazole pada soil-transmitted helminthiasis. USU 2004. [cited 2009 August].Available from: http://library.usu.ac.id/download/fk/anal-cahiruddin12.pdf.?
3. Albonico M, Allen H, Chitsulo L, Engels D, Gabrielli AF, Savioli L. Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy. PloS Negl Trop Dis. 2008;2:e126.
4. Keiser J, Utzinger J. Efficacy of currrent drugs against soil-transmitted helminth infections, systematic review and meta-analysis. JAMA. 2008;299:1937-48.
5. O Olsen A, Namwanje H, Nejsum P, Roepstroff A, ThamsborgSM. Albendazole and mebendazole have low efficacy against Trichuris trichiura in school-age children in Kabale District, Uganda. Trans R Soc Trop Med Hyg. 2009;103:443-6.
6. Albonico M. Treatment of soil-transmitted helminth infection: prescribing information for disease control. In: Crompton DWT, Montresor A, Nesheim MC, Savioli L, editors. Controlling disease due to helminth infections. Geneva: WHO; 2003. p. 109-26.
7. Adams VJ, Lombard CJ, Dhansay MA, Markus MB, Fincham JE. Efficacy of albendazole against the whipworm Trichuris trichiura-a randomised, controlled trial. S Afr Med J. 2004;94:972-6.
8. Vercruysse J, Albonico M, Behnke J, Kotze A, McCarthy J, Prichard R, et al. Monitoring antihelminthics efficacy for soil-transmitted helminthes (STH). Geneva: WHO;2008. Available from: http://www.who.int/neglected_diseases/preventive_chemotherapy/Chemotherapy_anthelminthic_drug_WHO_WB_final.pdf
9. Sirivichayakul C, Pojjaroen-Anant C, Wisetsing P, Praevanit R, Chanthavanich P, Limkittikul K. The effectiveness of 3, 5 or 7 days of albendazole for the treatment of Trichuris trichiura infection. Ann Trop Med Parasitol. 2003;97:847-53.
10. Bethony J, Brooker S, Albonico M, Greiger SM, Loukas A, Diemert D, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367: 1521-32.
11. Stephenson LS, Holland CV, Cooper ES. The public significance of Trichuris trichiura. Parasitology. 2000;121: S73-95.
12. Sirivichayakul C, Pojjaroen-anant C, Wiseting P, Chanthavanich P, Praevanit R, Limkittikul K, et al. A comparative trial of albendazole alone versus combination of albendazole and praziquantel for treatment of Trichuris trichiura infection. Southeast Asian J Trop Med Public Health. 2001;32:297-301.
13. Awasthi S, Bundy DAP, Savioli L. Helminthic infections. BMJ. 2003;327:431-3.
14. Hall A, Hewitt G, Tuffrey V, de Silva N. A review and meta-analysis of the impact of intestinal worms on child growth and nutrition. Matern Child Nutr. 2008;4:118-236.
15. Hotez PJ, de Silva N, Brooker S, Bethony J. Soil transmitted helminth infection: the nature, causes and burden of the condition. Working Paper No.3, Disease Control Priorities Project. Maryland: Fogarty International Center, National Institutes of Health; 2003. Available from: http://www.dcp2.org/file/19/
16. Juan JO, Lopez-Chegne N, Gargala G, Favennec L. Comparative clinical studies of nitazoxanide, albendazole and praziquantel in the treatment of ascariasis, trichuriasis and hymenolepiasis in children from Peru. Trans R Soc Trop Med Hyg. 2002;96:193-6.
17. Oyewole F, Ariyo F, Oyibo WA, Sanyaolu A, Faweya T, Monye P, et al. Helminthic reduction with albendazole among school chidren in riverine communities of Nigeria. J Rural Trop Public Health. 2007;6:6-10.
18. Reddy M, Gill SS, Kalkar SR, Wu W, Anderson PJ, Rochon PA. Oral drug therapy for multiple neglected tropical diseases: a systematic review. JAMA. 2007;298:1911-24.
19. Horton J. The efficacy of antihelminthics: past, present, future. In: Crompton DWT, Montresor A, Nesheim MC, Savioli L, editors. Controlling disease due to helminth infections. Geneva: WHO; 2003. p. 143-55.
20. Horton J. Albendazole: a review of anthelminthic efficacy and safety in humans. Parasitology. 2000;121:113–32.
Published
2013-10-30
How to Cite
1.
Lubis A, Pasaribu S, Ali M, Lubis M. Effect of length of albendazole treatment against Trichuris trichiura infection. PI [Internet]. 30Oct.2013 [cited 19Apr.2024];53(5):245-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/299
Received 2016-08-21
Accepted 2016-08-21
Published 2013-10-30