title: Triple co-administration of ivermectin, albendazole and praziquantel in zanzibar: a safety study.
abstract: BACKGROUND
  Public health interventions based on distribution of anthelminthic drugs against lymphatic filariasis (LF), onchocerciasis, soil-transmitted helminthiasis (STH) and schistosomiasis have been implemented separately to date. A better use of available resources might be facilitated by a more coordinated approach to control such infections, including the possibility of co-administering the three recommended anthelminthic drugs through a single, large-scale intervention.
  
  
  RESULTS
  Ivermectin, albendazole and praziquantel were co-administered to 5,055 children and adults living in areas endemic for LF, STH and schistosomiasis in Zanzibar, United Republic of Tanzania, during a pilot intervention aimed at elucidating and quantifying possible side-effects. Subsequently, these drugs were co-administered to about 700,000 individuals during a countrywide intervention targeting a large part of the total population of Zanzibar. Passive and active surveillance measures carried out during both interventions showed that side-effects attributable to the three drugs given at the same time were mild and self-limiting events.
  
  
  CONCLUSIONS
  Our data suggest that co-administration of ivermectin, albendazole and praziquantel is safe in areas where lymphatic filariasis, soil-transmitted helminthiasis and schistosomiasis are co-endemic and where several rounds of treatment with one or two drugs have been implemented in the past. Passive surveillance measures, however, should be continued and detection, management and reporting of possible side-effects should be considered a key component of any health intervention administering drugs.
authors.affiliation: Programme for Lymphatic Filariasis, Schistosomiasis and Soil-Transmitted Helminthiasis, Ministry of Health and Social Welfare, Zanzibar, United Republic of Tanzania.
authors.forename: Khalfan A
authors.initials: KA
authors.lastname: Mohammed
authors.forename: Hamad J
authors.initials: HJ
authors.lastname: Haji
authors.forename: Albis-Francesco
authors.initials: AF
authors.lastname: Gabrielli
authors.forename: Likezo
authors.initials: L
authors.lastname: Mubila
authors.forename: Gautam
authors.initials: G
authors.lastname: Biswas
authors.forename: Lester
authors.initials: L
authors.lastname: Chitsulo
authors.forename: Mark H
authors.initials: MH
authors.lastname: Bradley
authors.forename: Dirk
authors.initials: D
authors.lastname: Engels
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Savioli
authors.forename: David H
authors.initials: DH
authors.lastname: Molyneux
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000871:Anthelmintics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004605:Elephantiasis, Filarial / Q000188:drug therapy; D005260:Female; D006373:Helminthiasis / Q000188:drug therapy; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009855:Onchocerciasis / Q000188:drug therapy; D011223:Praziquantel / Q000627:therapeutic use*; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D011223:Praziquantel; D007559:Ivermectin; D015766:Albendazole