title: Comparison of three copromicroscopic methods to assess albendazole efficacy against soil-transmitted helminth infections in school-aged children on Pemba Island.
abstract: BACKGROUND
  The diagnostic accuracy of three faecal egg count techniques (Kato-Katz, McMaster and FLOTAC) to assess albendazole efficacy against soil-transmitted helminth (STH) infections was compared.
  
  
  METHODS
  The study is registered with Current Controlled Trials [identifier: ISRCTN90088840]. During September-November 2009, 304 school-aged children on Pemba Island, Tanzania, were screened and those infected with Ascaris lumbricoides, hookworm or Trichuris trichiura were treated with a single dose of albendazole (400 mg). Twenty-one days post-treatment, children provided a single stool sample which was examined using the same diagnostic methods. All stool samples were divided into two aliquots and one was fixed in 5% formalin and examined using FLOTAC and McMaster approximately 6 months after collection.
  
  
  RESULTS
  Using fresh stool samples, comparable prevalences were demonstrated for the three methods at baseline (90-92.2% for T. trichiura, 41.1-52.8% for hookworm, 32.9-37.2% for A. lumbricoides); FLOTAC was the most sensitive method at baseline and follow-up. Albendazole showed high cure rate (CR) against A. lumbricoides (90-97%), moderate CR against hookworm (63-72%) and very low CR against T. trichiura (6-9%), regardless of the technique used. Egg counts (eggs per gram) at baseline were similar for A. lumbricoides and for hookworm among the three methods, and higher using McMaster and Kato-Katz compared with FLOTAC for T. trichiura. All methods were similar for hookworm and A. lumbricoides egg reduction rate (ERR) estimation, but Kato-Katz indicated a significantly higher ERR than McMaster and FLOTAC for T. trichiura. Preserved stool samples revealed consistently lower FECs at baseline and follow-up for all STHs.
  
  
  CONCLUSIONS
  Further development and validation of standard protocols for anthelminthic drug efficacy evaluation must be pursued.
authors.affiliation: Department of Biology, University of Torino, 10122 Torino, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Albonico
authors.forename: Laura
authors.initials: L
authors.lastname: Rinaldi
authors.forename: Sonia
authors.initials: S
authors.lastname: Sciascia
authors.forename: Maria E
authors.initials: ME
authors.lastname: Morgoglione
authors.forename: Monica
authors.initials: M
authors.lastname: Piemonte
authors.forename: Maria P
authors.initials: MP
authors.lastname: Maurelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Musella
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: Said M
authors.initials: SM
authors.lastname: Ali
authors.forename: Shaali M
authors.initials: SM
authors.lastname: Ame
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cringoli
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000627:therapeutic use*; D000871:Anthelmintics / Q000627:therapeutic use*; D002648:Child; D005243:Feces / Q000469:parasitology; D005260:Female; D006373:Helminthiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007195:Indian Ocean Islands / Q000453:epidemiology; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D010270:Parasite Egg Count; D012987:Soil / Q000469:parasitology; D013636:Tanzania / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000871:Anthelmintics; D012987:Soil; D015766:Albendazole
keywords: Diagnostic accuracy; Drug efficacy; FLOTAC; Kato–Katz; McMaster; Soil-transmitted helminths