Triple co-administration of ivermectin, albendazole and praziquantel in zanzibar: a safety study.
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.
Mohammed
Khalfan A
KA
Programme for Lymphatic Filariasis, Schistosomiasis and Soil-Transmitted Helminthiasis, Ministry of Health and Social Welfare, Zanzibar, United Republic of Tanzania.
Haji
Hamad J
HJ
Gabrielli
Albis-Francesco
AF
Mubila
Likezo
L
Biswas
Gautam
G
Chitsulo
Lester
L
Bradley
Mark H
MH
Engels
Dirk
D
Savioli
Lorenzo
L
Molyneux
David H
DH
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
D000871:Anthelmintics; D011223:Praziquantel; D007559:Ivermectin; D015766:Albendazole