title: Mass treatment with albendazole reduces the prevalence and severity of Oesophagostomum-induced nodular pathology in northern Ghana.
abstract: Previous surveys conducted in northern Ghana where Oesophagostomum bifurcum is endemic showed that O. bifurcum-induced nodular pathology could be detected in up to 50% of the inhabitants. The impact of albendazole-based mass treatment to control both infection and morbidity is assessed and compared with the situation in a control area where no mass treatment has taken place. A significant reduction in the prevalence of infection based on stool cultures was achieved following two rounds of mass treatment in one year: from 52.6% (361/686) pre treatment to 5.2% (22/421) 1 year later (chi(1)(2)=210.1; P<0.001). At the same time, the morbidity marker of ultrasound-detectable nodules declined from 38.2% to 6.2% (chi(1)(2)=138.1; P<0.001). There was a shift from multinodular pathology, often seen in heavy infections, to uninodular lesions. In the control villages where no treatment took place, O. bifurcum infection increased from 17.8% (43/242) to 32.2% (39/121) (chi(1)(2)=9.6; P<0.001). Nodular pathology decreased slightly from 21.5% to 19.0%, but a higher proportion of these subjects developed multinodular pathology compared with baseline (chi(1)(2)=5.5; P=0.019). It is concluded that repeated albendazole treatment significantly reduces O. bifurcum-induced morbidity.
authors.affiliation: Leiden University Medical Centre, Department of Parasitology, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: J B
authors.initials: JB
authors.lastname: Ziem
authors.forename: N
authors.initials: N
authors.lastname: Spannbrucker
authors.forename: A
authors.initials: A
authors.lastname: Olsen
authors.forename: P
authors.initials: P
authors.lastname: Magnussen
authors.forename: B M W
authors.initials: BM
authors.lastname: Diederen
authors.forename: J
authors.initials: J
authors.lastname: Horton
authors.forename: A M
authors.initials: AM
authors.lastname: Polderman
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019353:Endemic Diseases / Q000517:prevention & control*; D005243:Feces / Q000469:parasitology; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D009814:Oesophagostomiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D009815:Oesophagostomum / Q000302:isolation & purification; D015995:Prevalence
chemical_list: D000871:Anthelmintics; D015766:Albendazole