Efficacy of albendazole against the whipworm trichuris trichiura--a randomised, controlled trial.
OBJECTIVE
To test the efficacy of albendazole against the whipworm Trichuris trichiura for school-based deworming in the south-western Cape, South Africa. Children infected with Trichuris were randomised to 3 doses of albendazole (400, 800 or 1200 mg), each repeated 4 times. The boy/girl ratio was 1. A group not infected with worms was treated with placebo, creating a negative control.


METHODS
Pupils at a primary school serving a wine-producing area approximately 90 km east of Cape Town.


METHODS
Trichuris cure rates and reduction in the number of eggs/g in faeces, as well as the infection dynamics of Trichuris and Ascaris during treatment with placebo.


RESULTS
Albendazole treatment was associated with Trichuris cure rates of 23% (400 mg), 56% (800 mg) and 67% (1200 mg) after the final treatment. The corresponding reductions in the number of eggs/g of faeces were 96.8%, 99.3% and 99.7%. Environmental pollution by human faeces was confirmed because worm egg-negative children in the placebo group became egg-positive while the study was in progress.


CONCLUSIONS
The 400 mg stat dose had a low Trichuris cure rate. To repeat the dose on 2 or 3 days would increase cost, reduce compliance and complicate management. Albendazole cannot be used in deworming programmes in South Africa because it is a Schedule 4 prescription medicine. De-scheduling is needed urgently, particularly because of high efficacy against hookworm in KwaZulu-Natal and neighbouring countries.
Adams
V J
VJ
Medical Research Council, Cape Town.
Lombard
C J
CJ
Dhansay
M A
MA
Markus
M B
MB
Fincham
J E
JE
D000284:Administration, Oral; D000293:Adolescent; D015766:Albendazole / Q000008:administration & dosage* / Q000191:economics / Q000494:pharmacology; D000969:Antinematodal Agents / Q000008:administration & dosage* / Q000191:economics / Q000494:pharmacology; D002648:Child; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D016527:Drug Costs / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000191:economics; D004335:Drug and Narcotic Control / Q000191:economics / Q000331:legislation & jurisprudence; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D020380:Needs Assessment; D010270:Parasite Egg Count; D015995:Prevalence; D012572:School Health Services; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome; D014257:Trichuriasis / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology
D000969:Antinematodal Agents; D015766:Albendazole