Therapeutic effect of once and twice doses of albendazole for soil-transmitted helminth infection

doi:10.12140/j.issn.1000-7423.2024.02.011

Abstract

Abstract:

Objective To evaluate the efficacy of once and twice doses of albendazole in treating human soil-transmitted helminth infections. Methods From October 2015 to January 2016, school students of grades 2-6 in 5 primary schools were selected to participate baseline survey (in Blang Mountain Township, Menghai County, Xishuangbanna Prefecture, Yunnan Province. Fecal samples were collected for two consecutive days (one sample per day), each of which was used to prepare three slides and examined using Kato-Katz method by microscopy. Students with fecal egg-positive finding (Ascaris, hookworm, Trichuris single or mixed infections) are treated with albendazole (400 mg single dose). Three days after treatment, fecal samples were collected in consecutive 2 days. After 4 weeks, the same group of students received additional single dose of 400 mg albendazole and their fecal samples were collected 3 days after dosing and examined. A questionnaire survey was conducted at the same time of two medications to assess the adverse reactions. Students who were still egg-positive after twice dosing were treated with albendazole once more. The examinees of the five primary schools were summarized according to administrative villages to evaluste the therapeutic effect on Trichuris infection in different villages. The comparison of rates is conducted using χ² test. Results A total of 438 people from 5 schools were investigated, and the infection rate of soil-derived nematodes was 82.19% (360/438). The infection rate was 79.19% (175/221) in boys and 85.25% (185/217) in girls, with no significant difference (χ² = 2.754, P > 0.05). The infection rates of soil-transmitted helminth were 89.79% (299/333), 90.57% (48/53), 21.43% (9/42), 4/10 (χ² = 133.781, P < 0.05) among the Blang, Lahu, Hani and other ethnological populations, respectively. The infection rates were 73.97% (54/73), 90.38% (94/104), 73.56% (64/87), 87.50% (28/32), 84.51% (120/142), respectively (χ² = 13.700, P < 0.05). The infection rates of Ascaris, hookworm and Trichuris were 52.51% (230/438), 35.39% (155/438) and 73.29% (321/438), respectively. The cure rates of Ascaris, hookworm and Trichuris infection after the first dose were 94.24% (180/191), 63.64% (77/121) and 2.64% (7/265), respectively. The cure rates of Ascaris, hookworm and Trichuris infection after the second dose were 98.77% (161/163), 91% (91/100) and 6.33% (14/221), respectively. There was a significant difference in the cure rates of patients with Ascaris, hookworm and Trichuris who took albendazole once and twice (χ² = 5.107, 22.487, 3.976, P < 0.05). There was no significant difference in the cure rates of mild, moderate and severe patients with Ascaris, hookworm and Trichuris after two doses (the first treatment χ² = 3.218, 3.930, 4.050, P > 0.05; the second treatment χ² = 1.745, 1.902, 0.329, P > 0.05). The incidence of adverse reactions such as difficulty swallowing pills, dizziness, nausea, diarrhea and vomiting after the first dose was 11.47% (39/340), 10.88% (37/340), 16.76% (57/340), 7.65% (26/340) and 1.47% (5/340), respectively. The incidence of adverse reactions in the second dose was close to that in the first dose, and there was no statistical significance in the incidence of adverse reactions between the two doses. According to the analysis of the village where the school was located, the cure rate of the students infected with Trichuris was 12.68% (9/71) in Kira Primary School after the second dose, which was higher than that in Mannian Primary School (3.60%, 4/111) (χ² = 5.374, P < 0.05). Conclusion Albendazole single therapy showed good effect on Ascaris infection, while double therapy presented a better deworming effect on Ascaris and hookworm infection without increasing the frequency of adverse reactions. It is unnecessary to increase the dosage of albendazole for treating moderate and severe Ascaris and hookworm infections. Albendazole is not effective for treating Trichuris, thus it is not advisable to use albendazole alone for treatment of Trichuris infection.

Key words: Albendazole, Soil-transmitted helminth, Efficacy observation, Adverse reaction, Drug resistance

CLC Number:

R532.1

YAN Xinliu, DU Zunwei, YANG Yaming, WANG Libo, WU Fangwei, LI Benfu, LI Hongbin, CHEN Ran, ZI Jinrong, PENG Jia, CAI Xuan, BAO Xueying, TANG Xiaoying, YANG Henglin. Therapeutic effect of once and twice doses of albendazole for soil-transmitted helminth infection[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2024, 42(2): 204-210.

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不良反应类型 Type of adverse reaction	不良反应发生人数（发生率/%） No. adverse reaction (incidence rate/%)		χ²值 χ² value	P值 P value
不良反应类型 Type of adverse reaction	第1次服药后 After the first dose	第2次服药后 After the second dose	χ²值 χ² value	P值 P value
吞药片困难 Difficulty swallowing pills
是 Yes	39（11.47）	29（10.47）	1.094	> 0.05
否 No	260（76.47）	221（79.78）
不知道 Unknown	41（12.06）	27（9.75）
头晕 Dizziness
是 Yes	37（10.88）	43（15.52）	2.914	> 0.05
否 No	303（89.12）	234（84.48）
恶心 Feel sick
是 Yes	57（16.76）	45（16.25）	0.03	> 0.05
否 No	283（83.24）	232（83.75）
腹泻 Diarrhea
是 Yes	26（7.65）	24（8.66）	0.212	> 0.05
否 No	314（92.35）	253（91.34）
呕吐 Emesis
是 Yes	5（1.47）	9（3.25）	2.177	> 0.05
否 No	335（98.53）	268（96.75）

学校名称 School name	行政村 Administrative Village	第1次服药 The first dose			第2次服药 The second dose			χ²值 χ²value	P值 P value
学校名称 School name	行政村 Administrative Village	检查人数 No. inspected	治愈人数No. cured	治愈率/% Cure rate/%	检查人数 No. inspected	治愈人数 No. cured	治愈率/% Cure rate/%	χ²值 χ²value	P值 P value
吉良小学 Jiliang Elementary School	吉良 Jiliang	77	4	5.19	71	9	12.68	5.374^a	0.02
曼囡小学 Mannan Elementary School	曼囡 Mannan	148	3	2.03	111	4	3.60	2.011^b	0.156
章家小学（3个校点） Zhangjia Elementary School (3 campuses)	章家 Zhangjia	40	0	0	39	1	2.56	0.000^c	1
合计 Total		265	7	2.64	221	14	6.33