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https://www.arca.fiocruz.br/handle/icict/9804
ASSESSMENT OF ANTHELMINTIC EFFICACY OF MEBENDAZOLE IN SCHOOL CHILDREN IN SIX COUNTRIES WHERE SOIL-TRANSMITTED HELMINTHS ARE ENDEMIC
Author
Levecke, Bruno
Montresor, Antonio
Albonico, Marco
Ame, Shaali M.
Behnke, Jerzy M.
Bethony, Jeffrey Michael
Noumedem, Calvine D.
Engels, Dirk
Guillard, Bertrand
Kotze, Andrew C.
Krolewiecki, Alejandro J.
McCarthy, James S.
Mekonnen, Zeleke
Periago, Maria Vitoria
Sopheak, Hem
Tchuem-Tchuente, Louis-Albert
Duong, Tran Thanh
Huong, Nguyen Thu
Zeynudin, Ahmed
Vercruysse, Jozef
Montresor, Antonio
Albonico, Marco
Ame, Shaali M.
Behnke, Jerzy M.
Bethony, Jeffrey Michael
Noumedem, Calvine D.
Engels, Dirk
Guillard, Bertrand
Kotze, Andrew C.
Krolewiecki, Alejandro J.
McCarthy, James S.
Mekonnen, Zeleke
Periago, Maria Vitoria
Sopheak, Hem
Tchuem-Tchuente, Louis-Albert
Duong, Tran Thanh
Huong, Nguyen Thu
Zeynudin, Ahmed
Vercruysse, Jozef
Affilliation
Ghent University. Department of Virology, Parasitology and Immunology. Merelbeke, Belgium
World Health Organization. Department of Control of Neglected Tropical Diseases. Geneva, Switzerland
Fondazione Ivo de Carneri. Milan, Italy
Public Health Laboratory-Ivo de Carneri, Chake Chake, United Republic of Tanzania
University of Nottingham. School of Life Sciences. Nottingham, United Kingdom
George Washington University Medical Center. Microbiology, Immunology, and Tropical Medicine. Washington, D.C., United States of America
University of Yaounde. Centre for Schistosomiasis and Parasitology. Yaounde, Cameroon
World Health Organization. Department of Control of Neglected Tropical Diseases. Geneva, Switzerland
Pasteur Institute. Clinical Laboratory. Phnom Penh, Cambodia
Commonwealth Scientific and Industrial Research Organisation. Division of Animal, Food and Health Sciences. St. Lucia, Australia
Universidad Nacional de Salta. Instituto de Investigaciones en Enfermedades Tropicales. Argentina
University of Queensland. Queensland Institute for Medical Research. Brisbane, Australia
Jimma University. Department of Medical Laboratory Sciences and Pathology. Jimma, Ethiopia
Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Belo Horizonte, MG, Brazil
Pasteur Institute. Clinical Laboratory. Phnom Penh, Cambodia
University of Yaounde. Centre for Schistosomiasis and Parasitology. Yaounde, Cameroon
National Institute of Malariology, Parasitology and Entomology. Department of Parasitology. Ha Noi, Vietnam
National Institute of Malariology, Parasitology and Entomology. Department of Parasitology. Ha Noi, Vietnam
Jimma University. Department of Medical Laboratory Sciences and Pathology. Jimma, Ethiopia
Ghent University. Department of Virology, Parasitology and Immunology. Merelbeke, Belgium
World Health Organization. Department of Control of Neglected Tropical Diseases. Geneva, Switzerland
Fondazione Ivo de Carneri. Milan, Italy
Public Health Laboratory-Ivo de Carneri, Chake Chake, United Republic of Tanzania
University of Nottingham. School of Life Sciences. Nottingham, United Kingdom
George Washington University Medical Center. Microbiology, Immunology, and Tropical Medicine. Washington, D.C., United States of America
University of Yaounde. Centre for Schistosomiasis and Parasitology. Yaounde, Cameroon
World Health Organization. Department of Control of Neglected Tropical Diseases. Geneva, Switzerland
Pasteur Institute. Clinical Laboratory. Phnom Penh, Cambodia
Commonwealth Scientific and Industrial Research Organisation. Division of Animal, Food and Health Sciences. St. Lucia, Australia
Universidad Nacional de Salta. Instituto de Investigaciones en Enfermedades Tropicales. Argentina
University of Queensland. Queensland Institute for Medical Research. Brisbane, Australia
Jimma University. Department of Medical Laboratory Sciences and Pathology. Jimma, Ethiopia
Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Belo Horizonte, MG, Brazil
Pasteur Institute. Clinical Laboratory. Phnom Penh, Cambodia
University of Yaounde. Centre for Schistosomiasis and Parasitology. Yaounde, Cameroon
National Institute of Malariology, Parasitology and Entomology. Department of Parasitology. Ha Noi, Vietnam
National Institute of Malariology, Parasitology and Entomology. Department of Parasitology. Ha Noi, Vietnam
Jimma University. Department of Medical Laboratory Sciences and Pathology. Jimma, Ethiopia
Ghent University. Department of Virology, Parasitology and Immunology. Merelbeke, Belgium
Abstract
BACKGROUND: Robust reference values for fecal egg count reduction (FECR) rates of the most widely used anthelmintic drugs in preventive chemotherapy (PC) programs for controlling soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and hookworm) are still lacking. However, they are urgently needed to ensure detection of reduced efficacies that are predicted to occur due to growing drug pressure. Here, using a standardized methodology, we assessed the FECR rate of a single oral dose of mebendazole (MEB; 500 mg) against STHs in six trials in school children in different locations around the world. Our results are compared with those previously obtained for similarly conducted trials of a single oral dose of albendazole (ALB; 400 mg).
METHODOLOGY: The efficacy of MEB, as assessed by FECR, was determined in six trials involving 5,830 school children in Brazil, Cambodia, Cameroon, Ethiopia, United Republic of Tanzania, and Vietnam. The efficacy of MEB was compared to that of ALB as previously assessed in 8,841 school children in India and all the above-mentioned study sites, using identical methodologies.
PRINCIPAL FINDINGS: The estimated FECR rate [95% confidence interval] of MEB was highest for A. lumbricoides (97.6% [95.8; 99.5]), followed by hookworm (79.6% [71.0; 88.3]). For T. trichiura, the estimated FECR rate was 63.1% [51.6; 74.6]. Compared to MEB, ALB was significantly more efficacious against hookworm (96.2% [91.1; 100], p<0.001) and only marginally, although significantly, better against A. lumbricoides infections (99.9% [99.0; 100], p = 0.012), but equally efficacious for T. trichiura infections (64.5% [44.4; 84.7], p = 0.906).
CONCLUSIONS/SIGNIFICANCE: A minimum FECR rate of 95% for A. lumbricoides, 70% for hookworm, and 50% for T. trichiura is expected in MEB-dependent PC programs. Lower FECR results may indicate the development of potential drug resistance.
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