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      Efficacy of Single-Dose and Triple-Dose Albendazole and Mebendazole against Soil-Transmitted Helminths and Taenia spp.: A Randomized Controlled Trial

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          Abstract

          Background

          The control of soil-transmitted helminth (STH) infections currently relies on the large-scale administration of single-dose oral albendazole or mebendazole. However, these treatment regimens have limited efficacy against hookworm and Trichuris trichiura in terms of cure rates (CR), whereas fecal egg reduction rates (ERR) are generally high for all common STH species. We compared the efficacy of single-dose versus triple-dose treatment against hookworm and other STHs in a community-based randomized controlled trial in the People's Republic of China.

          Methodology/Principal findings

          The hookworm CR and fecal ERR were assessed in 314 individuals aged ≥5 years who submitted two stool samples before and 3–4 weeks after administration of single-dose oral albendazole (400 mg) or mebendazole (500 mg) or triple-dose albendazole (3×400 mg over 3 consecutive days) or mebendazole (3×500 mg over 3 consecutive days). Efficacy against T. trichiura, Ascaris lumbricoides, and Taenia spp. was also assessed.

          Albendazole cured significantly more hookworm infections than mebendazole in both treatment regimens (single dose: respective CRs 69% (95% confidence interval [CI]: 55–81%) and 29% (95% CI: 20–45%); triple dose: respective CRs 92% (95% CI: 81–98%) and 54% (95% CI: 46–71%)). ERRs followed the same pattern (single dose: 97% versus 84%; triple dose: 99.7% versus 96%). Triple-dose regimens outperformed single doses against T. trichiura; three doses of mebendazole – the most efficacious treatment tested – cured 71% (95% CI: 57–82%). Both single and triple doses of either drug were highly efficacious against A. lumbricoides (CR: 93–97%; ERR: all >99.9%). Triple dose regimens cured all Taenia spp. infections, whereas single dose applications cured only half of them.

          Conclusions/Significance

          Single-dose oral albendazole is more efficacious against hookworm than mebendazole. To achieve high CRs against both hookworm and T. trichiura, triple-dose regimens are warranted.

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          Most cited references39

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          Control of neglected tropical diseases.

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            Soil-transmitted helminth infections: updating the global picture.

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              Taenia solium cysticercosis.

              The larval stage of the pork tapeworm (Taenia solium) infects the human nervous system, causing neurocysticercosis. This disease is one of the main causes of epileptic seizures in many less developed countries and is also increasingly seen in more developed countries because of immigration from endemic areas. Little information is available on the natural evolution of taeniasis or cysticercosis. Available therapeutic measures include steroids, treatments for symptoms, surgery, and, more controversially, antiparasitic drugs to kill brain parasites. Efforts to control and eliminate this disease are underway through antiparasitic treatment of endemic populations, development of pig vaccines, and other measures.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2011
                27 September 2011
                : 6
                : 9
                Affiliations
                [1 ]Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
                [2 ]University of Basel, Basel, Switzerland
                [3 ]National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
                [4 ]Helminthiasis Division, Yunnan Institute of Parasitic Diseases, Simao/Pu'er, People's Republic of China
                The George Washington University Medical Center, United States of America
                Author notes

                Conceived and designed the experiments: PS JU J-XC X-NZ. Performed the experiments: PS Z-WD J-YJ HZ. Analyzed the data: PS JU JH. Contributed reagents/materials/analysis tools: PS JU Z-WD J-YJ HZ JH. Wrote the paper: PS JU JH.

                Article
                PONE-D-11-07292
                10.1371/journal.pone.0025003
                3181256
                21980373
                bc61d8d3-cc76-4abf-84d8-fe544d6268db
                Steinmann et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                Page count
                Pages: 8
                Categories
                Research Article
                Medicine
                Clinical Research Design
                Clinical Trials
                Drugs and Devices
                Clinical Pharmacology
                Global Health
                Infectious Diseases
                Neglected Tropical Diseases
                Soil-Transmitted Helminths
                Parasitic Diseases
                Soil-Transmitted Helminths
                Taeniasis
                Infectious Disease Control

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                Uncategorized

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