title: Simultaneous administration of praziquantel, ivermectin and albendazole, in a community in rural northern Ghana endemic for schistosomiasis, onchocerciasis and lymphatic filariasis.
abstract: OBJECTIVE
  To compare (i) side effects associated with the simultaneous adminstration of praziquantel, albendazole and ivermectin with side affects associated with albendazole and ivermectin only and (ii) coverage by volunteers distributing three or two drugs.
  
  
  METHODS
  Two-arm comparative study in northern Ghana integrated praziquantel distribution into an existing lymphatic filariasis and onchocerciasis control programme using Community Directed Distributors. The control arm continued to distribute only ivermectin and albendazole. Dosages of ivermectin and praziquantel were based on height. Treatment was directly observed, and all two/three drugs were co-administered. Adverse effects were recorded based on passive surveillance. Parasitological, anthropometric and haematological data were collected at baseline.
  
  
  RESULTS
  Prevalence of Schistosoma haematobium infection among 1001 (boys: 47.9% girls: 52.1%) school-age children (6-15 years) [intervention: 30.0% (CI: 23.1-34.2); control: 23.0% (CI: 18.9-27.0)], mean haemoglobin, weight and age were similar among the intervention and control groups. While 1676 (99.1%) compounds in the control area were visited and 15,020 (96.58%) people were treated, only 1375 (88.5%) compounds in the intervention area were visited and 8454 (80.97%) people treated (P < 0.001). The numbers of adverse effects were similar (intervention: 50/6896; control: 130/15,020). The most reported adverse effects was headache (intervention: 14/50; control: 13/130), followed by body weakness, which was reported more from the intervention group (intervention: 13/50, 95% CI: 14.6-40.3; control: 6/130, 95% CI: 1.7-9.8]. Sixty-six per cent (6896/10,441) of the eligible population received praziquantel.
  
  
  CONCLUSIONS
  Reported adverse events were mild and managed at the subdistrict level with no cases of hospitalization; intensive health education will, however, be required to improve coverage.
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana.
authors.forename: Francis
authors.initials: F
authors.lastname: Anto
authors.forename: Victor
authors.initials: V
authors.lastname: Asoala
authors.forename: Thomas
authors.initials: T
authors.lastname: Anyorigiya
authors.forename: Abraham
authors.initials: A
authors.lastname: Oduro
authors.forename: Martin
authors.initials: M
authors.lastname: Adjuik
authors.forename: Patricia
authors.initials: P
authors.lastname: Akweongo
authors.forename: Raymond
authors.initials: R
authors.lastname: Aborigo
authors.forename: Langbong
authors.initials: L
authors.lastname: Bimi
authors.forename: Joseph
authors.initials: J
authors.lastname: Amankwa
authors.forename: Abraham
authors.initials: A
authors.lastname: Hodgson
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000453:epidemiology; D019353:Endemic Diseases / Q000517:prevention & control; D005260:Female; D005369:Filaricides / Q000009:adverse effects / Q000627:therapeutic use*; D005869:Ghana; D006266:Health Education; D006801:Humans; D007559:Ivermectin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D009855:Onchocerciasis / Q000188:drug therapy* / Q000453:epidemiology; D011223:Praziquantel / Q000008:administration & dosage / Q000627:therapeutic use; D012424:Rural Population; D012552:Schistosomiasis / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D005369:Filaricides; D011223:Praziquantel; D007559:Ivermectin; D015766:Albendazole