title: Prevalence of intestinal protozoa infection among school-aged children on Pemba Island, Tanzania, and effect of single-dose albendazole, nitazoxanide and albendazole-nitazoxanide.
abstract: BACKGROUND
  Pathogenic intestinal protozoa infections are common in school-aged children in the developing world and they are frequently associated with malabsorption syndromes and gastrointestinal morbidity. Since diagnosis of these parasites is difficult, prevalence data on intestinal protozoa is scarce.
  
  
  METHODS
  We collected two stool samples from school-aged children on Pemba Island, Tanzania, as part of a randomized controlled trial before and 3 weeks after treatment with (i) single-dose albendazole (400 mg); (ii) single-dose nitazoxanide (1,000 mg); (iii) nitazoxanide-albendazole combination (1,000 mg-400 mg), with each drug given separately on two consecutive days; and (iv) placebo. Formalin-fixed stool samples were examined for the presence of intestinal protozoa using an ether-concentration method to determine the prevalence and estimate cure rates (CRs).
  
  
  RESULTS
  Almost half (48.7%) of the children were diagnosed with at least one of the (potentially) pathogenic protozoa Giardia intestinalis, Entamoeba histolytica/E. dispar and Blastocystis hominis. Observed CRs were high for all treatment arms, including placebo. Nitazoxanide showed a significant effect compared to placebo against the non-pathogenic protozoon Entamoeba coli.
  
  
  CONCLUSIONS
  Intestinal protozoa infections might be of substantial health relevance even in settings where they are not considered as a health problem. Examination of a single stool sample with the ether-concentration method lacks sensitivity for the diagnosis of intestinal protozoa, and hence, care is indicated when interpreting prevalence estimates and treatment effects.
authors.affiliation: Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, PO Box, CH-4002 Basel, Switzerland.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Speich
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Marti
authors.forename: Shaali M
authors.initials: SM
authors.lastname: Ame
authors.forename: Said M
authors.initials: SM
authors.lastname: Ali
authors.forename: Isaac I
authors.initials: II
authors.lastname: Bogoch
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: Marco
authors.initials: M
authors.lastname: Albonico
authors.forename: Jennifer
authors.initials: J
authors.lastname: Keiser
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000008:administration & dosage*; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D016845:Blastocystis hominis / Q000302:isolation & purification; D002648:Child; D004748:Entamoeba histolytica / Q000302:isolation & purification; D005243:Feces / Q000469:parasitology; D005767:Gastrointestinal Diseases / Q000188:drug therapy* / Q000453:epidemiology* / Q000469:parasitology; D016829:Giardia lamblia / Q000302:isolation & purification; D006801:Humans; D007195:Indian Ocean Islands / Q000453:epidemiology; D009574:Nitro Compounds; D010272:Parasitic Diseases / Q000188:drug therapy* / Q000453:epidemiology* / Q000469:parasitology; D010274:Parasitology / Q000379:methods; D010919:Placebos / Q000008:administration & dosage; D015995:Prevalence; D012574:Schools; D013844:Thiazoles / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents; D009574:Nitro Compounds; D010919:Placebos; D013844:Thiazoles; D015766:Albendazole; C041747:nitazoxanide