OBJECTIVE: To evaluate the efficacy of and resistance to mebendazole (500 mg) and levamisole (40 or 80 mg), alone or in combination, for the treatment of Ascaris lumbricoides, Trichuris trichiura and hookworm infections on Pemba Island - an area exposed to periodic school-based mebendazole treatment since 1994. METHODS: A randomized, placebo-controlled trial was carried out in 914 children enrolled from the first and fifth grades of primary schools. Stool samples collected at baseline and 21 days after treatment were examined by the Kato-Katz technique to assess the prevalence and intensity of helminth infection. FINDINGS: Efficacies of mebendazole and levamisole as single treatments against intestinal nematode infections were comparable with those in previous trials, but mebendazole treatment of hookworm infections gave significantly lower cure (7.6%) and egg reduction (52.1%) rates than reported in a study undertaken before the beginning of periodic chemotherapy (cure rate, 22.4%; egg reduction rate, 82.4%). Combined treatment with mebendazole and levamisole had a significantly higher efficacy against hookworm infections (cure rate, 26.1%; egg reduction rate, 88.7%) than either drug given alone. No difference in mebendazole efficacy was found in children who had been treated repeatedly compared with those who had not been treated previously. CONCLUSION: The overall efficacy of mebendazole against hookworm infections after periodic chemotherapy is reduced. The efficacy of benzimidazoles in chemotherapy-based control programmes should be monitored closely. Combined treatment with mebendazole and levamisole may be useful as a tool to delay the development of benzimidazole resistance.
RCT Entities:
OBJECTIVE: To evaluate the efficacy of and resistance to mebendazole (500 mg) and levamisole (40 or 80 mg), alone or in combination, for the treatment of Ascaris lumbricoides, Trichuris trichiura and hookworm infections on Pemba Island - an area exposed to periodic school-based mebendazole treatment since 1994. METHODS: A randomized, placebo-controlled trial was carried out in 914 children enrolled from the first and fifth grades of primary schools. Stool samples collected at baseline and 21 days after treatment were examined by the Kato-Katz technique to assess the prevalence and intensity of helminth infection. FINDINGS: Efficacies of mebendazole and levamisole as single treatments against intestinal nematode infections were comparable with those in previous trials, but mebendazole treatment of hookworm infections gave significantly lower cure (7.6%) and egg reduction (52.1%) rates than reported in a study undertaken before the beginning of periodic chemotherapy (cure rate, 22.4%; egg reduction rate, 82.4%). Combined treatment with mebendazole and levamisole had a significantly higher efficacy against hookworm infections (cure rate, 26.1%; egg reduction rate, 88.7%) than either drug given alone. No difference in mebendazole efficacy was found in children who had been treated repeatedly compared with those who had not been treated previously. CONCLUSION: The overall efficacy of mebendazole against hookworm infections after periodic chemotherapy is reduced. The efficacy of benzimidazoles in chemotherapy-based control programmes should be monitored closely. Combined treatment with mebendazole and levamisole may be useful as a tool to delay the development of benzimidazole resistance.
Authors: Luciano Gualdieri; Monica Piemonte; Settimia Alfano; Rita Maffei; Maria Elena Della Pepa; Laura Rinaldi; Marilena Galdiero; Massimiliano Galdiero; Giuseppe Cringoli Journal: Parasitol Res Date: 2015-12-28 Impact factor: 2.289
Authors: Thomas S Churcher; Sébastien D S Pion; Mike Y Osei-Atweneboana; Roger K Prichard; Kwablah Awadzi; Michel Boussinesq; Richard C Collins; James A Whitworth; María-Gloria Basáñez Journal: Proc Natl Acad Sci U S A Date: 2009-09-17 Impact factor: 11.205
Authors: Debbie Humphries; Emily Mosites; Joseph Otchere; Welbeck Amoani Twum; Lauren Woo; Hinckley Jones-Sanpei; Lisa M Harrison; Richard D Bungiro; Blair Benham-Pyle; Langbong Bimi; Dominic Edoh; Kwabena Bosompem; Michael Wilson; Michael Cappello Journal: Am J Trop Med Hyg Date: 2011-05 Impact factor: 2.345
Authors: Victoria J Wright; Shaali Makame Ame; Haji Said Haji; Rosemary E Weir; David Goodman; David I Pritchard; Mahdi Ramsan Mohamed; Hamad Juma Haji; James M Tielsch; Rebecca J Stoltzfus; Quentin D Bickle Journal: PLoS Negl Trop Dis Date: 2009-05-19