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Albendazole and Mebendazole Administered Alone or in Combination with Ivermectin against Trichuris trichiura: A Randomized Controlled Trial

Knopp, Stefanie ; Mohammed, Khalfan A. ; Speich, Benjamin ; Hattendorf, Jan ; Khamis, I. Simba ; Khamis, Alipo N. ; Stothard, J. Russell ; Rollinson, David ; Marti, Hanspeter ; Utzinger, Jürg

In: Clinical Infectious Diseases, 2010, vol. 51, no. 12, p. 1420-1428

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    Titel
    • Albendazole and Mebendazole Administered Alone or in Combination with Ivermectin against Trichuris trichiura: A Randomized Controlled Trial
    Autor
    • Knopp, Stefanie. Departments of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
    • Mohammed, Khalfan A.. Helminth Control Laboratory Unguja, Ministry of Health and Social Welfare, Zanzibar, Tanzania
    • Speich, Benjamin. Departments of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
    • Hattendorf, Jan. Departments of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
    • Khamis, I. Simba. Helminth Control Laboratory Unguja, Ministry of Health and Social Welfare, Zanzibar, Tanzania
    • Khamis, Alipo N.. Helminth Control Laboratory Unguja, Ministry of Health and Social Welfare, Zanzibar, Tanzania
    • Stothard, J. Russell. Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, London, United Kingdom
    • Rollinson, David. Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, London, United Kingdom
    • Marti, Hanspeter. Medical Diagnostic Services, Swiss Tropical and Public Health Institute, Basel, SwitzerlandBasel, Switzerland
    • Utzinger, Jürg. Departments of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Clinical Infectious Diseases, 2010, vol. 51, no. 12, p. 1420-1428. The University of Chicago Press
    Andere elektronische Ausgabe
    Klassifikation
    • Gesundheit
    OAI-PMH-ID
    • oai:doc.rero.ch:294749
    Summary
    Background. Single-dose albendazole and mebendazole show limited efficacy in the treatment of trichuriasis. The combination of albendazole with ivermectin improves efficacy, but a mebendazole-ivermectin combination has not been previously investigated. Methods. We performed a randomized controlled trial in 2 schools in Zanzibar, Tanzania, to assess the efficacy and safety of albendazole (400 mg) plus placebo, albendazole plus ivermectin (200 µg/kg), mebendazole (500 mg) plus placebo, and mebendazole plus ivermectin in children with a parasitologically confirmed Trichuris trichiura infection. Cure rate (CR) and egg reduction rate were assessed by intent-to-treat analysis. Adverse events were monitored within 48 h after treatment. Results. Complete data records were available for 548 children. The highest CR against T. trichiura was achieved with a mebendazole-ivermectin combination (55%). Low CRs were observed with albendazole-ivermectin (38%), mebendazole (19%), and albendazole (10%). Compared with placebo, the use of ivermectin statistically significantly increased the CRs from 14% to 47% (odds ratio, 0.19; 95% confidence interval [CI], 0.12-0.28). The highest egg reduction rate (97%; 95% CI, 95%-98%) was observed using the mebendazole-ivermectin combination, followed by albendazole-ivermectin (91%; 95% CI, 87%-94%), mebendazole (67%; 95% CI, 52%-77%), and albendazole (40%; 95% CI, 22%-56%). The adverse events, reported by 136 children, were generally mild, with no significant difference between the treatment arms. Conclusions. Addition of ivermectin improves the therapeutic outcomes of both albendazole and mebendazole against T. trichiura and may be considered for use in soil-transmitted helminth control programs and individual patient management. Trial registration. isrctn.org Identifier: ISRCTN08336605