scholarly journals Efficacy of a Single Dose versus Triple Dose Regimen of Mebendazole against Hookworm Infection among School Children: A Randomized, Single blinded Trial.

2019 ◽  
Author(s):  
Tegegne Eshetu ◽  
Mulugeta Aemero ◽  
Ayalew Jejaw
Keyword(s):  
Single Dose ◽  
Dose Regimen ◽  
Reduction Rate ◽  
Secondary Outcome ◽  
Hookworm Infection ◽  
Cure Rate ◽  
School Aged Children ◽  
Egg Reduction Rate ◽  
Triple Dose

Abstract Background: The current control efforts against soil transmitted helminthic infection focused on reducing morbidity and transmission potential through periodic anthelminthic chemotherapy of single dose of mebendazole and albendazole regimen. Single dose mebendazole is one of extensively applicable drug regimen as a preventive chemotherapy in hookworm endemic areas. However, nowadays, studies reveal single dose treatment regimen has poor and unsatisfactory efficacy status against hookworm infection. We evaluated the efficacy status of single dose (500mg) versus triple dose (100mg) of mebendazole against hookworm infection among school aged children.Methods: This randomized, single-blinded clinical trial took place in a primary school on Burie and Debre Elias towns, Northwest Ethiopia among school-aged children (6-14). Using simple randomization, eligible hookworm positive children were randomly allocated (1:1) to either a single dose or triple dose of mebendazole arm. Stool samples were collected at baseline and follow-up period (14-21 days after treatment) for McMaster analysis. The primary and secondary outcome measures in this study were cure rate (CR) and egg reduction rate (ERR), respectively. Results were displayed using tables and figure. Independent t test was used to compare group means, logistic regression was used to calculate odds ratio (OR), and P-value < 0.05 at 95% CI was considered for statistical significance.Result: 109 children were allocated for each treatment arm and 103 children were completed the drug efficacy follow up study. Cure rate against hookworm was significantly higher in triple dose (96.1%) than in single dose (30.8%) with (OR=55.125; 95% CI: 11.92-254.9; P < 0.001). Egg reduction rate against hookworm infection in triple dose (99.5%) was also significantly higher than single dose (68.9%) with difference t (101) =5.38; 95% CI 230.95-505.36; P < 0.001.Conclusion: Single dose regimen of mebendazole for the treatment of hookworm infection showed poor efficacy, while triple dose revealed satisfactory efficacy. Therefore, we recommend for giving special emphasis on current deworming program which implemented through single dose mebendazole for hookworm endemic area.

Efficacy of a Single dose versus a Multiple Dose Regimen of Mebendazole against Hookworm Infections among School Children: A Randomized Single-Blinded Trial

2020 ◽  
Author(s):  
Tegegne Eshetu ◽  
Mulugeta Aemero ◽  
Ayalew Jejaw
Keyword(s):  
Single Dose ◽  
Dose Regimen ◽  
Multiple Dose ◽  
Reduction Rate ◽  
Infection Intensity ◽  
Cure Rate ◽  
Preventive Chemotherapy ◽  
School Aged Children ◽  
Multiple Dose Regimen ◽  
Hookworm Infections

Abstract Background : Despite the existence of population-based control program using single dose albendazole or mebendazole as a preventive chemotherapy, Hookworm disease transmissions remains high. It causes a negative impact on the growth and school performance of children. In connection to this preventive chemotherapy, different studies produced conflicting results. This study evaluated the efficacy of single (500mg) versus multiple doses (100mg twice a day during three consecutive days) of mebendazole against Hookworm infections among school aged children. Methods : This randomized single-blinded clinical trial took place among school-aged children (6-14 years old) in Burie and Debre Elias towns, Northwest Ethiopia. Using simple randomization, eligible Hookworm positive children were allocated (1:1) to either a single or multiple doses treatment arm. Stool samples were collected and processed using McMaster method at baseline and follow-up period (14-21 days after treatment). Main outcome measures : The cure rate against Hookworm and egg reduction rate for determining the changes in infection intensity were the main outcome measures after 14-21 days following dosing. An independent t-test was used to compare group means, and logistic regression was used to calculate odds ratio (OR). P-value < 0.05 at 95% CI was considered statistically significant. Result: 109 children were participated in both treatment arms. Cure rate against Hookworm was significantly higher in the multiple dose (96.1%) than in the single dose (30.8%) with (OR=55.125; 95% CI: 11.92-254.9; P < 0.001). The egg reduction rate in the multiple dose treatment arm (99.5%) was also significantly higher than in the single dose arm (68.9%) with difference (t (101) =5.38; 95% CI 230.95-505.36; P < 0.001). Conclusion : The single dose regimen of mebendazole for the treatment of Hookworm infection showed poor efficacy, while the multiple dose revealed satisfactory efficacy. Moreover, infection intensity reduction was not achieved following single dosing. Therefore, we strongly recommend replacing the single dose mebendazole regimen with multiple dose regimen during deworming program in hookworm endemic areas. Trial registration : This trial is registered in www.pactr.org , # PACTR201911466695052

scholarly journals Efficacy of mebendazole and levamisole, alone or in combination, for soil-transmitted helminthiasis

2014 ◽  
Vol 54 (1) ◽  
pp. 9 ◽  
Author(s):  
Ifo Faujiah Sihite ◽  
Muhammad Ali ◽  
Ayodhia P. Pasaribu ◽  
Syahril Pasaribu ◽  
Chairuddin P. Lubis
Keyword(s):  
Single Dose ◽  
Controlled Trial ◽  
Reduction Rate ◽  
World Health ◽  
Cure Rate ◽  
Group Iii ◽  
School Aged Children ◽  
Group I ◽  
Health Organization ◽  
Egg Reduction Rate

BackgroundThe World Health Organization (WHO) recommends four, single-dose drugs (albendazole, levamisole, mebendazole, and pyrantel pamoate) for management of soil­transmitted helminthiasis (STH). Previous studies have shown varied and inconsistent outcomes of these STH treatments.ObjectiveTo compare the efficacy of mebendazole and levami­sole, alone or in combination, for the treatment of STH.MethodsAn open randomized controlled trial was conducted in Secanggang, North Sumatera from August to October 2009. School-aged children with STH infection were randomized into three groups. Group I received a single dose of mebendazole (500 mg); group II received a single dose of levamisole (2.5 mg/kg); and group III received a single dose of mebendazole-levamisole combined. Stool samples were collected at baseline, and the 1st, 2nd, 3rd, and 4th weeks after treatment and examined by the Kato-Katz technique. Statistical analyses were Kruskal-Wallis test for cure rate and Analysis of Variance (ANOVA) test for egg reduction rate. ResultsSTH was diagnosed in 197 children with the following parasite species: Ascariasis (96 children, 48.7%), Trichuriasis (58 children, 29.4%), and mixed infection (43 children, 21.8%). We found no hookworm infection in any of our subjects. Groups I and III had significantly higher efficacy (P=0.0001) against STH (egg reduction rate 99.3% and 99.9%; cure rate 92.2% and 98.4%, respectively) at 4th week of treatment.ConclusionA single dose of mebendazole alone and combined with levamisole have better efficacy compared to a single dose of levamisole for the treatment of STH. The highest efficacy of these treatments is noted at the 4th week after drug administration

scholarly journals Two or Three Consecutive Days Albendazole Treatment Has Better Efficacy than Single-Dose Albendazole Treatment for Trichuriasis

2020 ◽  
Vol 12 (1) ◽  
pp. 45-50
Author(s):  
Dina Evalina Gultom ◽  
Muhammad Ali ◽  
Ayodhia Pitaloka Pasaribu ◽  
Syahril Pasaribu
Keyword(s):  
Single Dose ◽  
Reduction Rate ◽  
Primary School Children ◽  
Repeated Dose ◽  
Hookworm Infection ◽  
Cure Rate ◽  
Chi Square ◽  
Group Iii ◽  
Group I ◽  
Stool Samples

BACKGROUND: Soil-transmitted helminth (STH) infection is endemic in Indonesia. Singledose albendazole is routinely used to control STH infections. Some studies found that repeated-dose of albendazole showed better efficacy. There is no study in Indonesia to compare single-dose and repeated-dose albendazole for against STH infections.METHODS: A randomized, open clinical trial was conducted in July-September 2018 among primary school children. Stool samples were collected before treatment and on day 7, 14, 21, and 28 after treatment then stained using the Kato-Katz method. Group I received three consecutive days, group II received two consecutive days, and Group III received single-dose of albendazole. Cure rate (CR) and egg reduction rate (ERR) were compared using Chi-square tests, and eggs per gram (EPG) was compared using the Kruskal Wallis test (p<0.05).RESULTS: One hundred ninety-five subjects enrolled and divided into 65 subjects in each group. The CR and ERR of trichuriasis after three consecutive days (79.5% and 97.4%) and two consecutive days regimen (70.3% and 91.9%) were higher than single-dose regimen (32.2% and 74.6%) with p<0.001, but not for ascariasis or hookworm infection. The highest efficacy was found in three consecutive days regimen group. Trichuris trichiura EPG was significantly different among the three groups on day 7, 14, 21, and 28 after treatment (p<0.001).CONCLUSION: Three and two consecutive days albendazole have better efficacy than single-dose of albendazole for trichuriasis, but not for ascariasis or hookworm infection. Two consecutive days albendazole is better choice for treating trichuriasis with more adherence and less side effect than three consecutive days regimen.KEYWORDS: soil-transmitted helminth infection, albendazole, single-dose, repeated-dose

Efficacy of a Single Dose versus a Multiple Dose Regimen of Mebendazole against Hookworm Infections among School Children: a Randomized Open-label Trial

2020 ◽  
Author(s):  
Tegegne Eshetu ◽  
Mulugeta Aemero ◽  
Ayalew Jejaw
Keyword(s):  
Single Dose ◽  
Dose Regimen ◽  
Multiple Dose ◽  
Open Label ◽  
Preventive Chemotherapy ◽  
Dose Treatment ◽  
School Aged Children ◽  
Multiple Dose Regimen ◽  
Hookworm Infections

Abstract Background: Despite the existence of a population-based control program using single dose albendazole or mebendazole as a preventive chemotherapy, hookworm transmission remains high. It causes a negative impact on the growth and school performance of children. In connection to this preventive chemotherapy, different studies produced conflicting results. This study aimed at evaluating the efficacy of single (500mg) versus multiple doses (100mg twice a day during three consecutive days) of mebendazole against hookworm infections among school-aged children. Methods: This randomized open-label clinical trial took place among school-aged children (6-14 years old) in Burie and Debre Elias towns, Northwest Ethiopia. Using simple randomization, eligible hookworm-positive children were allocated (1:1) to either a single or multiple dose treatment arms. Stool samples were collected and processed using McMaster method at baseline and follow-up period (14-21 days after treatment). Only laboratory technicians were blinded. The cure and egg reduction rates which were assessed after 14-21 days of treatment were the primary and secondary therapeutic outcome measures against hookworm infections, respectively. An independent t-test was used to compare group means, and logistic regression was used to calculate odds ratio (OR). P-value < 0.05 at 95% CI was considered statistically significant. Result: 108 children, 54 in each treatment arm had completed baseline data and received allocated treatment. 103 children had completed follow-up data records and included for the final efficacy analysis. Cure rate against hookworm was significantly higher in the multiple dose (96.1%) than in the single dose (30.8%) with OR=55.125; 95% CI: 11.92-254.9; P < 0.001. The egg reduction rate in the multiple dose treatment arm (99.5%) was also significantly higher than in the single dose arm (68.9%) with difference t (101) =5.38; 95% CI 230.95-505.36; P < 0.001. Conclusion: The single dose regimen of mebendazole for the treatment of hookworm infections showed poor cure and egg reduction rates, while the multiple dose revealed satisfactory. Although multiple dose regimen administration is a bit more complex than the single dose, we strongly encourage replacing it with multiple dose regimen during deworming programs in hookworm endemic areas. Trial registration: This trial is registered in www.pactr.org, # PACTR201911466695052.

scholarly journals Treatment of intestinal helminthiasis: mebendazole only or mebendazole-pyrantel pamoate?

2007 ◽  
Vol 47 (5) ◽  
pp. 216
Author(s):  
Wisman Dalimunthe ◽  
Charles Siregar ◽  
Munar Lubis ◽  
Syahril Pasaribu ◽  
Chairuddin P. Lubis
Keyword(s):  
Single Dose ◽  
Negative Impact ◽  
Reduction Rate ◽  
Multiple Infections ◽  
Cure Rate ◽  
School Students ◽  
Pyrantel Pamoate ◽  
Significant Difference ◽  
Chi Squared ◽  
Egg Reduction Rate

Background Although intestinal helminthiasis causes highmorbidity and has a negative impact on children’s growth anddevelopment, the efficacy of antihelmintics for multiplehelminthiasis in mass treatment is still doubtful.Objective To compare the efficacy of single dose mebendazoleand a combination of pyrantel pamoate and mebendazole for thetreatment of multiple infections due to Ascaris lumbricoides,hookworm, and Trichuris trichiura.Methods Subjects were elementary school students in Suka Village,Tiga Panah subdistrict, North Sumatera. They were randomizedto either receive mebendazole (M Group) or mebendazole-pyrantel pamoate group (MP Group). Stool examinations wereperfomed on each subjects on day 7, 14, 21, and 28 after treatment.Analyses were perfomed by using chi-squared and Mann-WhitneyU tests.Results The prevalence of intestinal helminthiasis was 95.4%. T.trichiura (88.7%) was the most common cause of infection followedby A. lumbricoides (79.5%), and hookworm (3.1%). Two hundredthirty nine (76.8%) children had multiple infections. Althoughthe egg reduction rate of intestinal helminthiasis in thecombination group was faster than that of the mebendazole group,there was no significant difference in the cure rate of both groups.Conclusion A single dose of mebendazole is preferred for masstreatment of multiple intestinal helminthiasis infections.

scholarly journals Efficacy of Mebendazole and Praziquantel against Soil-Transmitted Helminths and Schistosoma mansoni Infections among Schoolchildren in Northwest Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kefale Ejigu ◽  
Tadesse Hailu ◽  
Megbaru Alemu
Keyword(s):  
Single Dose ◽  
Schistosoma Mansoni ◽  
Reduction Rate ◽  
Northwest Ethiopia ◽  
Cure Rate ◽  
Soil Transmitted Helminths ◽  
Stool Samples ◽  
Periodic Evaluation ◽  
The Tropics ◽  
Egg Reduction Rate

Background. Soil-transmitted helminths (STHs) and Schistosoma mansoni are the main causes of morbidity among schoolchildren in the tropics. A school-based deworming program was launched to control and eliminate the infection in endemic countries including Ethiopia. Although periodic deworming is conducted in endemic areas, the prevalence of the infection is high in the country. In addition, periodic evaluation of the efficacy of the anthelminthic drug is limited. Objective. This study is aimed at checking the efficacy of mebendazole and praziquantel with the respective STHs and Schistosoma mansoni parasites. Methods. A longitudinal study was conducted from February to March 2018 among 422 schoolchildren. Stool samples were collected at baseline and at 2 and 4 weeks posttreatment and were processed using the Kato-Katz technique. Schoolchildren positive for STHs were treated with mebendazole and those positive for Schistosoma mansoni with praziquantel. After two weeks, a second round of stool was collected and examined, and then, single-dose redosing was given to each positive child. Lastly, the third stool sample was collected two weeks after the initiation of the redosing and checked for STHs and S. mansoni parasites. A close follow-up of students who were treated was done. All the data were entered and analyzed using SPSS version 20 for analysis. Descriptive statistics was used to compute the cure rate and egg reduction rate of mebendazole and praziquantel. Results. Among 422 participants, the prevalence of STHs, hookworm, Ascaris lumbricoides, and S. mansoni was 44.7%, 35.1%, 21.1%, and 13.9%, respectively. The cure rate of mebendazole against A. lumbricoides increased from 60% in the single dose to 100% in redosing after two weeks. The cure rate of mebendazole against hookworm also increased from 32.4% in the single dose to 91.0% in the redosing. The cure rate of praziquantel against S. mansoni-infected children was 91.5% in the first round and 100% in the redosing phase. There was a 98.6-100% egg reduction rate in the redosing regimen of both drugs. Conclusion. The cure and egg reduction rates of single-dose mebendazole in the treatment of hookworm and A. lumbricoides are lower at week two than at redosing, while cure and egg reduction rates of single-dose praziquantel are satisfactory to treat S. mansoni. Therefore, single-dose praziquantel to S. mansoni and redosing of single-dose mebendazole to A. lumbricoides and hookworm infections can be used for treatment purposes.

scholarly journals The Effectiveness of Triple Dose Albendazole in Treating Soil Transmitted Helminths Infection

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Saleha Sungkar ◽  
Kartika Q. Putri ◽  
Muhammad I. S. Taufik ◽  
Meutia N. Gozali ◽  
Pratiwi Sudarmono
Keyword(s):  
Reduction Rate ◽  
Wilcoxon Test ◽  
P Value ◽  
Cure Rate ◽  
Major Health Problem ◽  
Major Health ◽  
Soil Transmitted Helminths ◽  
Stool Samples ◽  
Egg Reduction Rate ◽  
Triple Dose

Soil transmitted helminths (STH) infection is a major health problem in tropical countries such as Indonesia. Albendazole is an effective and widely used anthelmintic agent to treat STH; however, it is not effective towards T. trichiura and its effectiveness varies between populations. Hence, we conducted a study to determine the effectiveness of triple dose albendazole in children of Perobatang village, Southwest Sumba, Indonesia. A pre-post study was carried out in Perobatang village on July 2016. Children aged 1-15 years old were enrolled in the study and asked to collect stool samples which were then examined using Kato-Katz method. The children infected with STH were given albendazole 400 mg for three consecutive days. From 246 subjects examined, 192 (78%) were positive for any STH consisting of T. trichiura (64%), A. lumbricoides (60%), and hookworms (10%). After treatment, the prevalence of STH decreased significantly (McNemar test, p<0.001) to 27%, T. trichiura 25%, A. lumbricoides 2%, and hookworm 0%. Cure rate for T. trichiura, A. lumbricoides, and hookworms was 61%, 97%, and 100%, respectively. Significant decrease of eggs per gram of feces was found in all STH (Wilcoxon test, p value <0.001 for A. lumbricoides and T. trichiura, p value = 0.027 for hookworms); egg reduction rate for T. trichiura was 91%, A. lumbricoides was 100%, and hookworms was 100%. In conclusion, triple dose albendazole is effective in controlling STH in children of Perobatang village, Southwest Sumba, Indonesia.

scholarly journals THE EFFECTIVENESS OF TRIPLE-DOSE ALBENDAZOLE IN COMPARISON WITH MEBENDAZOLE FOR THE TREATMENT OF TRICHURIASIS IN CHILDREN

2019 ◽  
pp. 104-107
Author(s):  
SALEHA SUNGKAR ◽  
FANNY P. IRMAWATI ◽  
ROSE A. HASWINZKY ◽  
YASMINE A. DWINASTITI ◽  
SRI WAHDINI ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Reduction Rate ◽  
Wilcoxon Test ◽  
Cure Rate ◽  
Exact Test ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Before And After ◽  
Egg Reduction Rate ◽  
Triple Dose

Objective: Trichuriasis is difficult to treat with single-dose anthelmintic. Although a higher cure rate (CR) can be achieved by treatment with triple-dose albendazole and mebendazole, the results of studies are inconsistent. This study aimed to evaluate the effectiveness of triple-dose albendazole and mebendazole in treating trichuriasis. Methods: A randomized controlled trial was conducted in a primary school in the Pandeglang District, Banten Province, Indonesia in July–August, 2018; 382 children were recruited. Stools were collected and examined microscopically using the Kato–Katz method to identify Trichuriasis eggs. Children positive for Trichuris trichiura were randomized and divided into two groups. One was given a triple dose of 400 mg albendazole and the other a triple dose of 500 mg mebendazole. On day 14 after treatment, stools were reexamined to calculate CR and the egg reduction rate (ERR). Data were analyzed using SPSS version 20. Results: The prevalence of soil-transmitted helminth infection was 42%, and that of trichuriasis and ascariasis was 25.1% and 29.8%. There was a significant difference (Wilcoxon test, P<0.01) in the intensity of infection before and after intervention. Both groups showed high values of CR (mebendazole: 95.2%, albendazole: 85.4%; Fisher’s exact test, P = 0.125) and ERR (mebendazole: 99%, albendazole: 96%; Mann–Whitney test, P = 0.110). There was no significant difference in CR and ERR between the two groups. Conclusion: Triple-dose albendazole was as effective as triple-dose mebendazole in treating trichuriasis.

Efficacy of single-dose 500 mg mebendazole in soil-transmitted helminth infections: a review

2017 ◽  
Vol 92 (3) ◽  
pp. 269-278 ◽  
Author(s):  
J. Mrus ◽  
B. Baeten ◽  
M. Engelen ◽  
S.A. Silber
Keyword(s):  
Single Dose ◽  
Substantial Reduction ◽  
Reduction Rate ◽  
Cure Rate ◽  
Preventive Chemotherapy ◽  
Efficacy Data ◽  
Phase 3 ◽  
Chewable Tablet ◽  
Ancylostoma Duodenale ◽  
Egg Reduction Rate

AbstractSoil-transmitted helminthiasis (STH) is caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), and Ancylostoma duodenale and Necator americanus (hookworms). Mebendazole is one of the recommended preventive chemotherapy agents for STH. This review summarizes the efficacy data from 29 studies with single-dose 500 mg mebendazole in STH treatment and compares the results with those of a recently conducted phase 3 study of a 500 mg mebendazole chewable tablet against A. lumbricoides and T. trichiura infections. Studies that reported efficacy results against at least one STH infection were selected from the literature and efficacy data by each STH type were abstracted and pooled. Single-dose 500 mg mebendazole treatment resulted in a cure rate of 92.6% (range: 72.5–100%) for A. lumbricoides, 27.6% (range: 8.4–100%) for T. trichiura and 25.5% (range: 2.9–91.1%) for hookworms. Egg reduction rate for A. lumbricoides was 97.9% (range: 89.8–100%), for T. trichiura it was 72.9% (range: 31.6–93.0%) and for hookworms it was 72.0% (range: −6.5% (denoting an increase in egg count) to 98.3%). Similar results were observed in the studies that were placebo-controlled. In the phase 3 study, the cure rate and egg reduction rate reported was 83.7% and 97.9%, respectively, for A. lumbricoides and 33.9% and 59.7%, respectively, for T. trichiura. In conclusion, single-dose 500 mg mebendazole showed a high cure rate against A. lumbricoides and a substantial reduction in faecal egg count for all STH types. These results are consistent with the recently conducted phase 3 study of a new 500 mg chewable mebendazole tablet.

scholarly journals The Efficacy of Single-Dose versus Double-Dose Praziquantel Treatments onSchistosoma mansoniInfections: Its Implication on Undernutrition and Anaemia among Primary Schoolchildren in Two On-Shore Communities, Northwestern Tanzania

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
David Z. Munisi ◽  
Joram Buza ◽  
Emmanuel A. Mpolya ◽  
Teckla Angelo ◽  
Safari M. Kinung’hi
Keyword(s):  
Single Dose ◽  
Geometric Mean ◽  
Reduction Rate ◽  
Repeated Dose ◽  
Cure Rate ◽  
Treatment Regimens ◽  
Northwestern Tanzania ◽  
Primary Schoolchildren ◽  
The Mean ◽  
To Receive

Administering more than one treatment may increase Praziquantel cure and egg reduction rates, thereby hastening achievement of schistosomiasis transmission control. A total of 431S. mansoni-infected schoolchildren were randomized to receive either a single or repeated 40 mg/kg Praziquantel dose. Heights, weights, and haemoglobin levels were determined using a stadiometer, weighing scale, and HemoCue, respectively. At 8 weeks, cure rate was higher on repeated dose (93.10%) compared to single dose (68.68%) (p<0.001). The egg reduction rate was higher on repeated dose (97.54%) compared to single dose (87.27%) (p=0.0062). Geometric mean egg intensity was lower among those on repeated dose (1.30 epg) compared to single dose (3.18 epg) (p=0.036) but not at 5 (p>0.05) and 8 (p>0.05) months with no difference in reinfection rate. No difference in the prevalence of stunting was observed between the two treatment regimens (p>0.05) at 8 months, but there was an increase in the prevalence of wasting among those on repeated dose (p<0.001). There was an increase in the mean haemoglobin levels at 8 months with no difference between the two arms (p>0.05). To achieve reduction of transmission intensity and disease control in highly endemic areas, repeated treatments alone may not be sufficient. This trial was registered withPACTR201601001416338.

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