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PubMed1994

Immunologic incrimination of Ancylostoma caninum as a human enteric pathogen.

In northeastern Australia, the incidence of human eosinophilic enteritis (EE) and unexplained abdominal pain with peripheral blood eosinophilia (PE) appear to be exceptionally high. Because adults of the common dog hookworm, Ancylostoma caninum, were found in situ in several cases, we compared specific antibody responses in patients with EE or PE with those of individuals from various control groups. Sera were obtained from three patients with confirmed dog hookworm infection, 25 patients with EE/PE, 42 with other diagnosed gastrointestinal disorders, eight with human hookworm infection, 27 with other diagnosed parasitic infections, and 100 blood donors from the State of Tasmania, where A. caninum does not occur. They were analyzed by enzyme-linked immunosorbent assay (ELISA) and Western blot for IgG and IgE antibodies to excretory-secretory (ES) antigens from adult A. caninum. In the ELISA, sera from 88% of EE/PE patients were positive for IgG and IgE antibodies to ES antigen. All eight patients infected with human hookworm (identified as A. duodenale in three) were also seropositive, while most of those with other parasitic infections, as well the blood donors, those with diagnosed gastrointestinal diseases, and the control subjects, were seronegative. In Western blots, sera from 92% of EE/PE patients demonstrated IgG and IgE antibodies to a component of ES antigen with a molecular weight of approximately 68 kD (Ac68), as did all sera from cases infected with human hookworms. Among the patients with other gastrointestinal disorders and parasitic infections, four of 42 (10%) and three of 27 (11%), respectively, reacted positively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1999

Parasitic infections. Treatment and developmental therapeutics. 1. Necatoriasis.

Necator americanus is a nematode hookworm of the family Ancylostomatidae, subfamily Necatorinae. This nematode parasite, which is distinguished by two chitinous cutting plates in the buccal cavity and fused male copulatory spicules, is the causative agent of necatoriasis, a hookworm disease prevalent in the Americas as well as in the tropical regions of Africa, southern Asia, and Polynesia. The adult parasites attached to the villi of the small intestines will suck blood causing abdominal discomfort, diarrhea and cramps, anorexia, wight loss, and in advanced disease, hypochromic microcytic anemia. Hookworm infections in man, especially in children, are one of the leading causes of iron-deficiency anemia resulting directly from intestinal capillary blood loss following the feeding activities of fourth-stage (L4) larva and adult worms. Another clinical manifestation often associated with hookworm infections is cutaneous larva migrans (CLM). It is a well recognized, usually self-limiting condition caused by the infectious larvae of nematodes. CLM is characterized by skin eruption and represents a clinical description rather than a definitive diagnosis. Of the hookworm parasites, the dog and cat worm Ancylostoma braziliense is the most common causing CLM, although many other species have been implicated. The major subject of this review article will be discussion of the evolution of therapies and treatment of human necatoriasis and the development of experimental infections with N. americanus. Difference in the clinical efficacies of mebendazole and albendazole will be discussed along with drug resistance of N. americanus.

Albendazole↗

PubMed2000

[Longitudinal observation on the control of intestinal helminthiasis].

OBJECTIVE: To search suitable measure for rapid control intestinal helminthiasis and long-term strengthen efficacy. METHODS: The treatment was taken in egg-positive population of intestinal helminthiasis in 1986-1988. The treatment was carried out only in the selected population in 1989-1992. No measure was taken in 1993-2000. RESULTS: (1) The prevalence rate of hookworm, Ascaris and Trichuris decreased to 3.2%, 37.3% and 3.5% respectively after administration of albendazole twice a year for 3 years. (2) The prevalence rate of hookworm continued to decrease to 0.5% after treatment on selected population. (3) The prevalence rate and the intensity of hookworm has been less than 1% and 10/LPG for 8 years. No hookworm larvae had been isolated from the soil. CONCLUSION: The hookworm transmission was effectively controlled in the study site.

Albendazole↗

PubMed2006

Morbidity indicators of Schistosoma mansoni: relationship between infection and anemia in Ugandan schoolchildren before and after praziquantel and albendazole chemotherapy.

The potential relationship between Schistosoma mansoni and anemia was examined using data obtained by the Schistosomiasis Control Initiative (SCI) before (baseline) and 1 year after (follow-up) a chemotherapeutic treatment program in Uganda. Changes in hemoglobin (Hb) levels in 2,788 children in relation to their schistosomiasis and/or hookworm infection intensity category and baseline anemia status were analyzed. At baseline, significant predictors of childhood anemia were intensities of S. mansoni and hookworm infection. At follow-up, moderate or heavy hookworm as well as heavy S. mansoni infections were important. Children heavily infected with S. mansoni or hookworm had significantly lower Hb counts at baseline compared with those not infected. Among anemic children at the baseline survey, a significant increase in Hb counts of 0.834 g/dL after treatment was found. Our results suggest that anemia is associated with schistosomiasis and hookworm in Ugandan children and that such anemia shows a significant improvement after chemotherapy.

Adolescent↗

PubMed1993

Intestinal parasitic infections in Campalagian district, south Sulawesi, Indonesia.

Intestinal parasitic infections were surveyed in the inhabitants of 3 coastal and 2 inland villages of Campalagian District, South Sulawesi, Indonesia, in July 1992. A total of 398 fecal samples were examined by using Kato-Katz thick smear, Harada-Mori culture and agar-plate culture techniques. Protozoan cysts were examined by formalin ether concentration technique on 380 fecal samples. Soil-transmitted helminth infections were highly prevalent with the overall positive rates as follows: Ascaris lumbricoides 25.3%, Trichuris trichiura 59.3%, hookworm 68.3% and Strongyloides stercoralis 2.3%. Eight species of protozoan were detected with the overall prevalence as follows: Entamoeba histolytica 10.9%, E. hartmanni 16.3%, E. coli 31.9%, Endolimax nana 12.5%, Iodamoeba buetschlii 5.4%, Giardia lamblia 4.6%, Chilomastix mesnili 0.8% and Blastocystis hominis 18.0%. In the inland villages, prevalence of hookworm infection was higher than Ascaris and Trichuris infections, while in the coastal villages Trichuris infection was predominant. Egg count revealed that the infection level was light in most of the hookworm and Trichuris carriers. Prevalence of lavatories among houses appeared to be inversely proportional to the prevalence of hookworm infection. Meanwhile, the incomplete structure of the lavatories might result in contamination of environment with Ascaris and Trichuris eggs. Harada-Mori culture was the most efficient method in the detection of hookworm infection compared to other techniques. Both Necator americanus and Ancylostoma duodenale were found in all villages, but the former was the predominant species. An adult pinworm was detected by agar-plate culture of feces. Two types of pinworm males, corresponding to Enterobius vermicularis and E. gregorii, were observed.

Adolescent↗

PubMed1996

Intestinal parasites among the Southeast Asian laborers in Taiwan during 1993-1994.

BACKGROUND: A large number of foreign laborers are now working in Taiwan, the majority coming from Southeast Asia where parasitic infections are common. Since 1992, monitoring the intestinal parasitic infections of these foreigners has been carried out, particularly to prevent the introduction of some of the parasites into Taiwan. This paper reports results obtained during the year 1993-1994. METHODS: The merthiolate-iodine-formalin (MIF) concentration method was used to detect intestinal parasites; and the data were analyzed by chi 2-test. RESULTS: Among the 3,020 persons examined, 526 (17.4%) were infected and 14 kinds of parasites were identified; i.e. Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, Enterobius vermicularis, hookworms, Taenia sp., Opisthorchis viverrini, Fasciolopsis buski, Schistosoma japonicum, an echinostome, Entamoeba histolytica. Entamoeba coli, Endolimax nana and Giardia lamblia. By nationality, those workers from Indonesia had the highest infection rate, at 32.3%; they were followed by the Filipinos (18.7%), the Thais (16.6%) and the Malaysians (8.0%). The three or four most prevalent parasites were T. Trichiura (21.8%), A. lumbricoides (5.6%) and hookworms (2.4%) for the Indonesians; T. Trichiura (9.1%), A. lumbricoides (3.7%), hookworms and E. histolytica (2.1% each) for the Filipinos; O. viverrini (8.4%), hookworms (3.3%) and E. histolytica (1.2%) for the Thais; T. trichiura (2.2%), A. lumbricoides and E. histolytica (1.8% each) and hookworms (1.4%) for the Malaysians. Among the 526 persons infected, 92.2% had 1 species, 7.2% had 2 species, 0.4% had 3 species and 0.2% had 4 species of parasites. CONCLUSIONS: The present result, a 17.4% infection rate, was significantly higher (p < 0.05) than the 12.3% obtained for the previous year (1992-1993). E. histolytica was found in 34 persons, 16 of whom were working as live-in housemaids. The epidemiological significance of some parasites is discussed here.

Adult↗

PubMed1994

Osmotic fragility of erythrocytes in clinically normal dogs and dogs infected with parasites.

The osmotic fragility of the erythrocytes was measured in blood samples collected from randomly selected healthy and infected dogs at a dogs' rescue shelter. The dogs were classified into six groups on the basis of the final diagnoses from clinical, post mortem and laboratory findings. The minimum (less than 5 per cent) and maximum (more than 90 per cent) haemolysis of the erythrocytes of the clinically normal dogs (group 1), occurred in 0.60 per cent and 0.30 per cent solutions of sodium chloride (NaCl). For the non-anaemic hookworm-infected dogs (group 2a) the respective values were 0.8 per cent and 0.4 per cent NaCl, and for the anaemic hookworm-infected dogs (group 2b) they were 0.85 per cent and 0.5 per cent NaCl, respectively. The erythrocytes from dogs with Babesia canis (group 3), concurrent hookworm and B canis (group 4) and Ehrlichia canis infections (group 5) had minimum haemolysis in 0.75 per cent NaCl and maximum haemolysis at between 0.20 per cent and 0.35 per cent NaCl solutions. The derivative fragiligrams for groups 2a, 2b, 3 and 4 were shifted to the left, whereas the fragiligram for group 5 was similar to that for the clinically normal dogs (group 1). The left shift for the hookworm-infected dogs was due to the increased osmotic fragility of a minor sub-population of the erythrocytes, but for the dogs infected with B canis major sub-populations of the erythrocytes had an increased osmotic fragility.

Anemia↗

PubMed1995

Time series analysis of the prevalence of endoparasitic infections in cats and dogs presented to a veterinary teaching hospital.

The apparent prevalence of endoparasitic infections of cats and dogs presented to the small animal Veterinary Hospital of the University of Pennsylvania was measured between 1984 and 1991. Two thousand feline and 8077 canine fecal samples were examined along with 6830 canine blood samples. The overall mean monthly prevalence of feline infections was 16% for ascarids, 0.9% for hookworms, 4.0% for tapeworms, 2.4% for Giardia spp. and 4.2% for coccidia. The overall mean monthly prevalence of canine infections was 5.7% for ascarids, 9.7% for hookworms, 9.7% for whipworms. 1.8% for tapeworms, 4.7% for Giardia spp. and 3.1% for coccidia. There was a significant downward trend in the prevalence of hookworms and heartworms in dogs (P < 0.001 in both cases). There was a significant upward trend in the prevalence of tapeworms in cats (P < 0.05). There were no significant long-term trends in any of the other time series. The smoothed data were analyzed for seasonal trends. None of the autocorrelation analyses gave incontrovertible evidence of seasonality. The repeated peaks at the 6, 12 and 24 month lags in the case of ascarid infections were suggestive of a 12 month seasonality with a peak prevalence in December, but the results were not statistically significant at the 5% level. Hookworms and whipworms in dogs occurred together more than would be expected by chance in 4 out of the 6 years for which data were available.

Aging↗

PubMed2006

Contrasting patterns in the small-scale heterogeneity of human helminth infections in urban and rural environments in Brazil.

Marked heterogeneity exists in the patterns of parasitic infection between individuals, households and communities. Analysis of parasite distributions within populations is complicated by the fact that parasite distributions are highly aggregated and few studies have explicitly incorporated this distribution when investigating small-scale spatial heterogeneities. This study aimed to quantify the small-scale (within- and between-household) heterogeneity of helminth infection in an area of Minas Gerais State, Brazil, with rural and urban sectors. Parasitological data from a cross-sectional survey of 1,249 individuals aged 0-86 years from 242 households were analysed. Within-household clustering of infection was assessed using random effect logistic regression models and between-household spatial heterogeneity was assessed using a Bayesian negative binomial spatial model. The overall prevalence of hookworm (Necator americanus) was 66.9%, the prevalence of Schistosoma mansoni was 44.9% and the prevalence of Ascaris lumbricoides was 48.8%. Statistical analysis indicated significant (within) household and (between household) spatial clustering of hookworm in both rural and urban areas and of S. mansoni in rural areas. There was no evidence of either household or spatial clustering of S. mansoni in urban areas. The spatial correlation of S. mansoni was estimated to reduce by half over a distance of 700 m in the rural area. Rural hookworm had a much smaller half-distance (28 m) and urban hookworm showed an even smaller half-distance (12 m). We suggest that such species-specific differences in patterns of infection by environment are primarily due to variation in exposure and parasite life cycle, although host genetic factors cannot be ruled out.

Adolescent↗

PubMed1997

Effects of chronic parasitosis on women's health.

Parasitic diseases are closely related to the lack of sanitation (unavailability of potable water, inadequate disposal of human waste, lack of latrines) or the absence of personal hygiene. They are also closely linked to warm and humid climates, and are therefore considered tropical diseases. This chapter addresses chronic hookworm parasitosis and malaria, and their effect on women's health. Of all Helminthes, hookworms cause the most severe anemia because of iron deficiency due to chronic blood loss. Worldwide, an estimated 51% of pregnant women suffer from anemia-almost twice as many as non-pregnant women. In severe cases (Hb < 70 g/l) the risk of perinatal maternal and child death increases up to 500-fold. Anemia due to maternal deficiency affects the fetus, causes retarded intrauterine growth, and reduces fetal ability to absorb iron provided by the mother. Hookworms are nematodes that infect roughly 1 billion people. Their preferred habitat is the jejunum, where they attach to the mucous tissue to feed, and secrete an anticoagulant causing bleeding. Hookworm infections often begin in childhood. The worm enters the body through the skin and reaches the highest number at the end of adolescence and young adulthood. Little attention has been given to the treatment of pregnant women because of unavailability of safe antiparasitic drugs and fear of teratogenesis. However, there are new treatments, and the anthelminthic drugs may be administered in schools and organized women's groups in communities. During pregnancy anthelminthic treatment can improve maternal, fetal and infant health. Treatment given every 4 months has been shown to interrupt the transmission cycle of the parasite and help to improve the iron status of all women. Therapeutic strategies should be linked to other measures, such as promoting the use of shoes, introduction of potable water, education and treatment of the population at large, especially the school-age population. An estimated 267 million people are annually infected by malaria, a parasitic disease caused by Protozoa of the genus Plasmodium. Malaria is transmitted by the Anopheles mosquito and is highly prevalent in tropical and subtropical regions located between 40 degrees latitude North and 30 degrees latitude South. It causes acute attacks that leave the human body in such a poor state that health problems resulting from these attacks become chronic. Due to the high mortality and morbidity associated with it, malaria is considered the most serious of tropical diseases and a major public-health dilemma. Pregnant women are at high risk of becoming infected, as well as children in their first years of life. In pregnant women, malaria can cause anemia which can be the major cause of maternal mortality, especially during the first pregnancy. Malaria can also cause fetal anemia which frequently results in retarded intrauterine growth and low birth weight. Prophylactic treatment with antimalarial drugs during pregnancy is recommended in areas where the disease is endemic. The prophylactic treatment should focus primarily on primiparous women who are most susceptible. Chloroquine is safe and effective for antimalarial prophylaxis, and is not teratogenic. Proguanil is also safe for prophylactic use during pregnancy, particularly in areas where P. falciparum is resistant to chloroquine. Mefloquine may be used during the third trimester of pregnancy, only if other antimalarial drugs are unavailable or ineffective.

Anthelmintics↗

PubMed2000

Gastrointestinal bleeding due to worm infestation, with negative upper gastrointestinal endoscopy findings: impact of enteroscopy.

BACKGROUND AND STUDY AIMS: In cases of hookworm and roundworm infestation, chronic occult bleeding is well known, but acute gastrointestinal bleeding is rarely described. We report five patients with worm infestation who presented with acute massive gastrointestinal bleeding. PATIENTS AND METHODS: Over 1 year, we have encountered 15 patients with obscure gastrointestinal bleeding. All the patients had normal findings on upper gastrointestinal endoscopy. Push enteroscopy was performed in each patient and evaluation of the proximal 40-50 cm of the jejunum was done. RESULTS: Five patients (four men, one woman; average age 50 yr, range 40-60) had worm infestation (two hookworm, three roundworm). All the patients had gastrointestinal bleeding (five had melena, one hematemesis, and two hematochezia) for a duration of 7-14 days. Hemoglobin ranged from 2.8 to 9 g/dl. Push enteroscopy revealed fresh blood in the jejunum, multiple erosions, and hookworms in two patients and roundworms in three patients. Hookworms were retrieved endoscopically in two patients whereas roundworms could be retrieved in only one patient. All the patients were treated with mebendazole (100 mg twice a day for 3 days), iron, and folic acid. Gastrointestinal bleeding subsided in all the patients. CONCLUSIONS: In developing countries, worm infestation should be considered an important cause of obscure acute gastrointestinal bleeding. Evaluation of the jejunum using an enteroscope will result in more frequent diagnosis of worms as a cause of acute gastrointestinal bleeding which might have been classified as obscure gastrointestinal bleeding.

Adult↗

PubMed1984

Human intestinal parasitism in three areas of Indonesia: a survey.

Stools from 1387 people were examined quantitatively for eggs of nematode parasites. The people were residents of Padangganting, near Sawahlunto, Sumatra (227 people), Sukamaju and Cibungur rubber plantations near Sukabumi, Java (831 people) and the villages of Mahima and Rabo near Reo, Manggarai, Flores (329 people). Ascaris lumbricoides, Trichuris trichiura and Necator americanus were common; Ancylostoma was not observed. Prevalence of parasitism was highest in Java and lowest in Flores. Egg counts were low, suggesting low worm burdens; intensity of infection with Ascaris and Trichuris was highest in Java, while hookworm was highest in Sumatra. Ascaris infections decreased and hookworm infections increased in prevalence and intensity with age; Trichuris was unaffected. A sex-related difference was observed only in Sumatra, where more females than males were infected with Ascaris. Village-to-village variation in prevalence of nematode infestation was observed in Flores and on the Sukamaju plantation; the topography of other areas did not allow for village comparisons. Ad hoc anthelmintic treatment of the residents of Cibungur plantation was reflected in reduced parasitism by Ascaris and Trichuris, but not hookworm, compared with neighbouring Sukamaju. Comparison of the patterns of disease in the three areas, in terms of the occurrence of single, double or triple infections, revealed marked differences. In Java most people with parasitism had triple infections. In Sumatra the most common expression of parasitism was single infection with hookworm. In Flores single infection with Ascaris prevailed. It is suggested that the clinical effects of intestinal parasitism might depend on the pattern of infection. Samples collected in Flores were also examined for protozoa which were found in about half the population; Entamoeba coli and E. histolytica were most common.

Adolescent↗

PubMed1992

Human Oesophagostomum infection in northern Togo and Ghana: epidemiological aspects.

Recently, it has been established that human infection with Oesophagostomum bifurcum is common in northern Togo and northeastern Ghana. Two surveys were conducted in this area. In a regional survey, O. bifurcum infection appeared to occur in 38 of 43 villages. The highest prevalences (up to 59%) occurred mostly in small isolated villages and were usually associated with high hookworm infection rates. The infection was relatively rare in children under five years of age (7% infected). In older individuals, females showed higher prevalences than males (30% vs. 24%). In a second survey, the entire population of two high-prevalence villages was examined. Infection rates were low in children under three years of age, but rose quickly thereafter, suggesting intense transmission. A stable level of infection was reached by 10 years of age. Oesophagostomum larvae were found more frequently in hookworm-positive than in hookworm-negative coprocultures, and possible explanations for the association between infection with Oesophagostomum and hookworm are discussed.

Adolescent↗

PubMed2006

Lack of risk of adverse birth outcomes after deworming in pregnant women.

BACKGROUND: Pregnant women who live in hookworm-endemic areas may benefit from deworming during their pregnancy. The benefit derives from reducing anemia, primarily iron-deficiency anemia caused by hookworm infection-attributable blood loss. Where the prevalence of hookworm is more than 20% to 30%, the World Health Organization recommends that pregnant women receive anthelminthic treatment (mebendazole, albendazole, levamisole or pyrantel) after their first trimester. The objective of this study is to report, describe and compare the occurrence of adverse birth outcomes in a large randomized, controlled trial of antenatal mebendazole (500 mg single dose) plus iron supplements versus placebo plus iron supplements conducted between April 2003 and June 2004 in the Amazon region of Peru. METHODS: Physician-recorded data on adverse birth outcomes occurring during the trial (N = 1042) were obtained. Proportions were compared using chi analysis. RESULTS: No statistically significant difference (P = 0.664) was found between the mebendazole group and the placebo group in terms of numbers of miscarriages, malformations, stillbirths, early neonatal deaths and premature babies (28 versus 31, respectively). CONCLUSIONS: The evidence provided by this large randomized, controlled trial of mebendazole administered during pregnancy indicates that deworming with mebendazole can be safely included in antenatal care programs in hookworm-endemic areas.

Animals↗

PubMed2004

Patterns of geohelminth infection, impact of albendazole treatment and re-infection after treatment in schoolchildren from rural KwaZulu-Natal/South-Africa.

BACKGROUND: Geohelminth infection is a major health problem of children from rural areas of developing countries. In an attempt to reduce this burden, the Department of Health of the province of KwaZulu-Natal (KZN) established in 1998 a programme for helminth control that aimed at regularly treating primary school children for schistosomiasis and intestinal helminths. This article describes the baseline situation and the effect of treatment on geohelminth infection in a rural part of the province. METHODS: Grade 3 schoolchildren from Maputaland in northern KZN were examined for infections with hookworm, Ascaris lumbricoides, and Trichuris trichiura, treated twice with 400 mg albendazole and re-examined several times over one year after the first treatment in order to assess the impact of treatment and patterns of infection and re-infection. RESULTS: The hookworm prevalence in the study population (83.2%) was considerably higher than in other parts of the province whereas T. trichiura and especially A. lumbricoides prevalences (57.2 and 19.4%, respectively) were much lower than elsewhere on the KZN coastal plain. Single dose treatment with albendazole was very effective against hookworm and A. lumbricoides with cure rates (CR) of 78.8 and 96.4% and egg reduction rates (ERR) of 93.2 and 97.7%, respectively. It was exceptionally ineffective against T. trichiura (CR = 12.7%, ERR = 24.8%). Re-infection with hookworm and A. lumbricoides over 29 weeks after treatment was considerable but still well below pre-treatment levels. CONCLUSION: High geohelminth prevalences and re-infection rates in the study population confirm the need for regular treatment of primary school children in the area. The low effectiveness of single course albendazole treatment against T. trichiura infection however demands consideration of alternative treatment approaches.

Albendazole↗

PubMed2005

A randomised controlled trial of the effects of albendazole in pregnancy on maternal responses to mycobacterial antigens and infant responses to Bacille Calmette-Guérin (BCG) immunisation [ISRCTN32849447].

BACKGROUND: Maternal schistosomiasis and filariasis have been shown to influence infant responses to neonatal bacille Calmette-Guérin (BCG) immunisation but the effects of maternal hookworm, and of de-worming in pregnancy, are unknown. METHODS: In Entebbe, Uganda, we conducted a randomised, double-blind, placebo-controlled trial of a single dose of 400 mg of albendazole in the second trimester of pregnancy. Neonates received BCG. Interferon-gamma (IFN-gamma) and interleukin (IL)-5 responses to a mycobacterial antigen (crude culture filtrate proteins (CFP) of Mycobacterium tuberculosis) were measured in a whole blood assay. We analysed results for binary variables using chi2 tests and logistic regression. We analysed continuous variables using Wilcoxon's tests. RESULTS: Maternal hookworm was associated with reduced maternal IFN-gamma responses to CFP (adjusted odds ratio for IFN-gamma > median response: 0.14 (95% confidence interval 0.02-0.83, p = 0.021). Conversely, maternal hookworm was associated with subsequent increased IFN-gamma responses in their one-year-old infants (adjusted OR 17.65 (1.20-258.66; p = 0.013)). Maternal albendazole tended to reduce these effects. CONCLUSION: Untreated hookworm infection in pregnancy was associated with reduced maternal IFN-gamma responses to mycobacterial antigens, but increased responses in their infants one year after BCG immunisation. The mechanisms of these effects, and their implications for protective immunity remain, to be determined.

Adult↗

PubMed1983

Albendazole, an effective single dose, broad spectrum anthelmintic drug.

Albendazole, a new anthelmintic drug was evaluated in Malaysia in 91 patients, with single or mixed infections of Ascaris, Trichuris, and hookworm. Albendazole was administered as a single dose of 400 mg, 600 mg, or 800 mg. The cure rate for Ascaris at all three doses was 100% at days 14 and 21 post-treatment; for hookworm it was 98.8%, 100% and 98%, respectively, at day 14 and 68.8%, 100% and 84%, respectively, at day 21; for Trichuris it was 31.2%, 57.1% and 42.3%, respectively, at day 14 and 27.3%, 60.9% and 48.0%, respectively, at day 21. The egg reduction rate at day 21 was 100% at all three doses for Ascaris, 94.5%, 100% and 96.1%, respectively, for hookworm; and 39.2%, 85.1% and 72.8%, respectively, for Trichuris. There were no side effects, and biochemical examination of blood and urine did not indicate any unfavourable changes. Based on this trial, the recommended dosage for Ascaris and hookworm is a 400 mg single dose, and for Trichuris is a 600 mg single dose. Albendazole appears to be more effective than other available anthelmintic drugs.

Adolescent↗

PubMed2001

The use of morbidity questionnaires to identify communities with high prevalence of geohelminth infections in Gondar region, Ethiopia.

In this preliminary study, a total of 8006 schoolchildren (aged 9-19 years) from 77 elementary schools was screened for infection with Ascaris lumbriocoides, Trichuris trichiura and hookworms using the Kato-Kata method. A. lumbriocoides was commonly encountered (35.4%) followed by the hookworms (16.3%) and T. trichiura (12.7%). The prevalence of "intestinal worms" (infection by A. lumbricoides, T. tirchiura and/or hookworms) accounted to 50.6%. The children were also asked about their recent experiences of the following: 'diarrhea', 'stomach ache', 'blood in stool', 'distended stomach'. and 'worms' using questionnaires and gave 24.0%, 64.9%, 18.6%. 37.0%, 38.1% 'yes' answers, respectively. At individual level reported 'worms' correlated with the prevalence of A. lumbricoides [OR 7.39 (95% CI: 6.65-8.20)] and 'intestinal worms' [OR 4.72 (95% CI: 4.27-5.22)]. Reported 'diarrhoea' was the best answer for T. trichiura [OR: 4.58 (95% CI: 3.98-5.27)]. Among schools, there were similar associations between prorated 'worms' and the prevalence of A. lumbricoides [OR 0.63 (95% CI: 0.47-0.75)] and 'intestinal worms' [OR 0.55 (95% CI: 0.37-0.69)]. No sign or symptom was significantly associated with hookworm infection. Reported 'worms' had the best though moderate diagnostic performance for 'intestinal worms' (sensitivity: 82.6%, specificity 51.6%, positive predictive value: 66.7%, negative predictive value: 71.7%) and A. lumbrocoides (sensitivity: 91.8%, specificity: 50.0%, positive predictive value: 75.5%, negative predictive value: 64.3%). These results indicate the potential of using reported 'worms' as a means of rapid assessment for identifying communities with a high prevalence of geohelminth infection.

Adolescent↗