The rapeutic effect of once and twice doses of albendazole for soil-transmitted helminth infection
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,Xishuang-banna 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 x2 test.Results A to-tal 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(x2=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(x2=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(x2=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(x2=5.107,22.487,3.976,P＜0.05).There was no significant difference in the cure rates of mild,mod-erate and severe patients with Ascaris,hookworm and Trichuris after two doses(the first treatmentx2=3.218,3.930,4.050,P＞0.05;the second treatment x2=1.745,1.902,0.329,P＞0.05).The incidence of adverse reactions such as dif-ficulty 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 stu-dents 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)(x2=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 in-fection 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.
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