title: Administration of triclabendazole is safe and effective in controlling fascioliasis in an endemic community of the Bolivian Altiplano.
abstract: BACKGROUND
  The Bolivian northern Altiplano is characterized by a high prevalence of Fasciola hepatica infection. In order to assess the feasibility, safety and efficacy of large-scale administration of triclabendazole as an appropriate public health measure to control morbidity associated with fascioliasis, a pilot intervention was implemented in 2008.
  
  
  METHODS
  Schoolchildren from an endemic community were screened for fascioliasis and treated with a single administration of triclabendazole (10 mg/kg). Interviews to assess the occurrence of adverse events were conducted on treatment day, one week later, and one month after treatment. Further parasitological screenings were performed three months after treatment and again two months later (following a further treatment) in order to evaluate the efficacy of the intervention.
  
  
  RESULTS
  Ninety infected children were administered triclabendazole. Adverse events were infrequent and mild. No serious adverse events were reported. Observed cure rates were 77.8% after one treatment and 97.8% after two treatments, while egg reduction rates ranged between 74% and 90.3% after one treatment, and between 84.2% and 99.9% after two treatments. The proportion of high-intensity infections (≥ 400 epg) decreased from 7.8% to 1.1% after one treatment and to 0% after two treatments.
  
  
  CONCLUSIONS
  Administration of triclabendazole is a feasible, safe and efficacious public health intervention in an endemic community in the Bolivian Altiplano, suggesting that preventive chemotherapy can be applied to control of fascioliasis. Further investigations are needed to define the most appropriate frequency of treatment.
authors.affiliation: Veterinary Public Health, Pan American Health Organization/World Health Organization, La Paz, Bolivia.
authors.forename: Fidel
authors.initials: F
authors.lastname: Villegas
authors.forename: René
authors.initials: R
authors.lastname: Angles
authors.forename: René
authors.initials: R
authors.lastname: Barrientos
authors.forename: Gary
authors.initials: G
authors.lastname: Barrios
authors.forename: María Adela
authors.initials: MA
authors.lastname: Valero
authors.forename: Kamal
authors.initials: K
authors.lastname: Hamed
authors.forename: Heiner
authors.initials: H
authors.lastname: Grueninger
authors.forename: Steven K
authors.initials: SK
authors.lastname: Ault
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
authors.forename: Dirk
authors.initials: D
authors.lastname: Engels
authors.forename: Santiago
authors.initials: S
authors.lastname: Mas-Coma
authors.forename: Albis Francesco
authors.initials: AF
authors.lastname: Gabrielli
mesh_terms: D000293:Adolescent; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage* / Q000009:adverse effects*; D001562:Benzimidazoles / Q000008:administration & dosage* / Q000009:adverse effects*; D001838:Bolivia / Q000453:epidemiology; D018890:Chemoprevention / Q000379:methods; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D019353:Endemic Diseases; D005210:Fasciola hepatica / Q000302:isolation & purification; D005211:Fascioliasis / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016896:Treatment Outcome; D000077682:Triclabendazole
chemical_list: D000871:Anthelmintics; D001562:Benzimidazoles; D000077682:Triclabendazole