title: Randomized, controlled, assessor-blind clinical trial to assess the efficacy of single- versus repeated-dose albendazole to treat ascaris lumbricoides, trichuris trichiura, and hookworm infection.
abstract: In many regions where soil-transmitted helminth infections are endemic, single-dose albendazole is used in mass drug administration programs to control infections. There are little data on the efficacy of the standard single-dose administration compared to that of alternative regimens. We conducted a randomized, controlled, assessor-blinded clinical trial to determine the efficacies of standard and extended albendazole treatment against soil-transmitted helminth infection in Gabon. A total of 175 children were included. Adequate cure rates and egg reduction rates above 85% were found with a single dose of albendazole for Ascaris infection, 85% (95% confidence interval [CI], 73, 96) and 93.8% (CI, 87.6, 100), respectively, while two doses were necessary for hookworm infestation (92% [CI, 78, 100] and 92% [CI, 78, 100], respectively). However, while a 3-day regimen was not sufficient to cure Trichuris (cure rate, 83% [CI, 73, 93]), this regimen reduced the number of eggs up to 90.6% (CI, 83.1, 100). The rate ratios of two- and three-dose regimens compared to a single-dose treatment were 1.7 (CI, 1.1, 2.5) and 2.1 (CI, 1.5, 2.9) for Trichuris and 1.7 (CI, 1.0, 2.9) and 1.7 (CI, 1.0, 2.9) for hookworm. Albendazole was safe and well tolerated in all regimens. A single-dose albendazole treatment considerably reduces Ascaris infection but has only a moderate effect on hookworm and Trichuris infections. The single-dose option may still be the preferred regimen because it balances efficacy, safety, and compliance during mass drug administration, keeping in mind that asymptomatic low-level helminth carriage may also have beneficial effects. (This study has been registered at ClinicalTrials.gov under registration number NCT01192802.).
authors.affiliation: Centre de Recherches Médicales de Lambaréné (CERMEL), Hôpital Albert Schweitzer, Lambaréné, Gabon.
authors.forename: Ayola A
authors.initials: AA
authors.lastname: Adegnika
authors.forename: Jeannot F
authors.initials: JF
authors.lastname: Zinsou
authors.forename: Saadou
authors.initials: S
authors.lastname: Issifou
authors.forename: Ulysse
authors.initials: U
authors.lastname: Ateba-Ngoa
authors.forename: Roland F
authors.initials: RF
authors.lastname: Kassa
authors.forename: Eliane N
authors.initials: EN
authors.lastname: Feugap
authors.forename: Yabo J
authors.initials: YJ
authors.lastname: Honkpehedji
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Dejon Agobe
authors.forename: Hilaire M
authors.initials: HM
authors.lastname: Kenguele
authors.forename: Marguerite
authors.initials: M
authors.lastname: Massinga-Loembe
authors.forename: Selidji T
authors.initials: ST
authors.lastname: Agnandji
authors.forename: Benjamin
authors.initials: B
authors.lastname: Mordmüller
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
authors.forename: Maria
authors.initials: M
authors.lastname: Yazdanbakhsh
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lell
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D000723:Ancylostomatoidea / Q000187:drug effects / Q000472:pathogenicity; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D001196:Ascariasis / Q000188:drug therapy*; D017164:Ascaris lumbricoides / Q000187:drug effects / Q000472:pathogenicity; D002648:Child; D002675:Child, Preschool; D005260:Female; D006725:Hookworm Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D014257:Trichuriasis / Q000188:drug therapy*; D014258:Trichuris / Q000187:drug effects / Q000472:pathogenicity
chemical_list: D000871:Anthelmintics; D015766:Albendazole