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

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 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 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 Single Versus Multiple Dose Regimen of Prophylactic Antibiotic in Cesarean Section

2014 ◽  
Vol 8 (2) ◽  
pp. 50-53 ◽  
Author(s):  
K Bhattachan ◽  
GN Baral ◽  
L Gauchan
Keyword(s):  
Single Dose ◽  
Hospital Stay ◽  
Dose Regimen ◽  
Multiple Dose ◽  
Prophylactic Antibiotic ◽  
Cesarean Deliveries ◽  
Cord Clamping ◽  
Group I ◽  
Significant Difference ◽  
Multiple Dose Regimen

Aims: The purpose of this study was to compare the efficacy of single combined dose of Cefotaxime and Metronidazole against conventional regimen of Ampicllin and Metronidazole for five days for the prevention of infectious morbidities in cesarean deliveries. Methods: This study was carried out at Paropakar Maternity and Women’s Hospital, Kathmandu from April to August 2011. Hundred patients, who had cesarean deliveries for various indications, were divided into two groups with fifty on each arm. Patients in group I were treated with intravenous single dose of Cefotaxime and Metronidazole after cord clamping, whereas those patients in group II were treated with Ampicillin and Metronidazole for five days. Efficacy of the treatment was compared in terms of postoperative infectious morbidities, duration of hospital stay and cost of antibiotics. Results: Overall ten cases (10%) had post-operative complications in which eight (8%) had infectious and two (2%) had thrombophlebitis. The infectious morbidities were febrile morbidities in four cases (4%) followed by urinary tract infection in three cases (3%) and wound infection in one case (1%). There was no statistically significant difference among distribution of these morbidities and in the mean duration hospital stay. The cost of single dose regimen was one-eighth of the multiple dose regimens which was statistically significant (p=0.000). Conclusions: Single dose of Cefotaxime and Metronidazole was equally effective as multiple doses of Ampicllin and Metronidazole for five days in prevention of infectious morbidities with benefit of cost.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 50-53 DOI: http://dx.doi.org/10.3126/njog.v8i2.9771  

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 A comparative interventional study on the efficacy of single and multiple dose combination drug regimen of leucorrhea among women in reproductive age group

2017 ◽  
Vol 4 (4) ◽  
pp. 1230
Author(s):  
Sivakumar K. ◽  
Ajay Raj S. ◽  
Sujatha K.
Keyword(s):  
Single Dose ◽  
Dose Regimen ◽  
Multiple Dose ◽  
Vaginal Discharge ◽  
Drug Regimen ◽  
Reproductive Age ◽  
Age Group ◽  
Cure Rate ◽  
Abnormal Vaginal Discharge ◽  
Reproductive Age Group

Background: Reproductive tract infections (RTIs) in women are becoming major public health problem not only in India but also over the world. Syndromic approach is advocated by World Health Organization (WHO) to manage common RTIs using clinical flow charts based on identifying a syndrome that cause the symptoms reported by patients. The most commonly reported among the women with RTIs is abnormal vaginal discharge or Leucorrhea. Single dose regimen is not preventing the recurrence of infections. A second course of treatment is required followed by standard single dose regimen for achieving better cure rate in chronic vaginal discharge. Objective of the study was to compare the efficacy of single dose drug combination regimen with multiple dose regimens in the treatment of leucorrhoea. Methods: Quasi-experimental study was done in Urban field service area, RMMCH – Chidambaram among Married women in the reproductive age group (15-49 years) with complaints of abnormal vaginal discharge for ≥15 days coupled with any one of the symptoms suggestive of RTI. The study subjects were categorized into two groups – one with single dose regimen and the other with multiple dose regimen. Follow up was done on day 7, 15 and after 6 months of therapy. Results: A total of 113 subjects were recruited with 57 participants in single dose group and 56 in multiple dose groups. The subjects who received single dose had a better cure rate as compared to multiple dose group on day 7(87.7% & 85.7%), day 15 (94.7% & 89.3%) and after six months (84.2% & 76.8%) assessment respectively. Recurrence rate was found to be equal in both the groups. Our study indicates that variables such as age of the study subjects and type of flow had significant association with the outcome. Conclusions: Single-dose therapy is as effective as multiple- dose in the management of vaginal discharge based solely on symptoms. The multiple drug regimens can be given if the symptoms persist after single drug regimen as the chances of developing complications due to chronic vaginal discharge are high. 

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

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