Table 3. Results for soil-transmitted helminths (n = 7).
Study ID, references & country | Study type | Participants: number, age, specific characteristics |
Intervention, drug and dose | Results |
---|---|---|---|---|
Diaz Camacho 1991 [39] Mexico |
BA | n = 339; all ages > 5 years; pregnant women and persons with liver cirrhosis or neurologic symptoms excluded. | Selective chemotherapy of cases: NICL 2g for taeniasis, ALB 400 mg per day for three consecutive days for Hymenolepis nana; ALB 400 mg for ascaris, enterobius, and Trichuris MDA—PZQ 10 mg/kg |
Significant decreases in prevalences from baseline to follow-up were found for T. trichiura (prevalence decrease from 8.6% to 3.7%). Antihelminthic treatment decreased the overall prevalence of intestinal parasites from 69.2% at baseline to 37.5% at 1-year follow-up (n = 283 stool samples at follow-up). Relative reduction in prevalence = 45.8%. |
Kumar 2014 [43] India |
BA | n = 2732; all ages (mostly adult males, 76 females, including 6 children); persons suffering from diarrhea/dysentery excluded. | Selective chemotherapy plus education: PZQ 10 mg/kg for taeniasis, ALB (400mg) for A. lumbricoides and T. trichiura. Hymenolepis nana– 25 mg/kg body weight of PZQ, and the dose was repeated after one week. | The overall prevalence of intestinal parasitosis was found to be 49.38% (1349/2732). The prevalence of Ascaris lumbricoides was found to be the highest (46.88%), followed by H. nana (0.21%). The cure rate after one-time administration of recommended doses of anthelminthic drugs was found to be 66% for Ascaris lumbricoides and 100% for other parasites (n = 1349 positive at baseline). |
Okello 2016 [14, 46, 54] Lao People's Democratic Republic |
BA | n = 298; all ages > 6 years; persons with acute illness, pregnant and lactating women excluded. | MDA with ALB 400 mg per day for three consecutive days—twice 6 months apart (plus education and intervention in pigs—three times 6 months apart). | Relative reduction in prevalence of hookworm was 83.4% (after MDA1, n = 58 stool samples) and 84.5% (after MDA2, n = 48 stool samples), A. lumbricoides was 95.6% and 93.5% and T. trichiura was 69.2% and 61% after MDA1 and MDA2, respectively. The intensity of infection within the sampled population also decreased, with egg reduction rates of 94.4% (MDA1) and 97.8% (MDA2) for hookworm, 99.4% and 99.3% for A. lumbricoides and 77.2% and 88.5% for T. trichiura. During the 5-month inter-treatment interval between MDA1 and MDA2, an increase in STH prevalence was detected, with the overall prevalence reaching 62.1% of pre-MDA1 levels. Among the individual parasite species detected A. lumbricoides had the greatest increase in prevalence, reaching 74.8% of pre-MDA1 levels followed by 70.6% for T. trichiura and 48.4% for hookworm. |
Steinmann 2008 [51] China |
RCT | n = 66 ALB, n = 57 Tribendimidine; all ages (range 5–87 years); persons with acute illness, pregnant, or who had drunk alcohol on the day of treatment excluded. Area co-endemic for soil transmitted helminths. | Int—MDA with ALB 400 mg (≥ 15 years), 200 mg (5 to 14 years); Cont—MDA with Tribendimidine 400 mg (≥ 15 years), 200 mg (5 to 14 years) |
ALB—Cure rate = 100% (50/50) for A. lumbricoides, 69.6% (32/46) for hookworm, 11.7% (7/60) for T. trichiura, and 30.8% (4/13) for S. stercoralis, respectively. TRB—Cure rate = 92.3% (36/39), 52.2% (24/46), 0% (0/48), and 46.2% (6/13), respectively. |
Steinmann 2011 [49, 64] China |
RCT | n = 314; all ages ≥ 5 years; persons with chronic disease or other conditions likely to interfere with treatment, pregnant women, recent anthelminthic treatment excluded. Area co-endemic for soil transmitted helminths. | MDA IntA—single dose ALB 400 mg IntB—triple dose ALB 400 mg given over 3 consecutive days ContA—single dose mebendazole 500 mg ContB—triple dose mebendazole 500 mg given over 3 consecutive days |
ALB—Single dose: Cure rate = 69.1% (95% CI: 55.2–80.9%), (17/55) for hookworm; 96.1% (95% CI: 89.1–99.2%), (75/78) for A. lumbricoides; 33.8% (95% CI: 22.6–46.6%), (22/65) for T. trichiura. ALB—Triple dose: cure rate = 92.0% (95% CI: 80.8–97.8%), (46/50) for hookworm; 96.8% (95% CI: 89.0–99.6%), (61/63) for A. lumbricoides; 56.2% (95% CI: 41.2–70.5%), (27/48) for T. trichiura. The efficacies of ALB and mebendazole were comparable. Triple dose treatment was significantly more efficacious than single dose treatment for hookworm and T. trichiura but not for A. lumbricoides: difference between cure rate for triple vs single dose for ALB was 22.9% for hookworm, p<0.01, 22.4% for T. trichiura, p<0.05, and 0.7% for A. lumbricoides, NS. |
Steinmann 2015 [50] China |
CBA | n = 760, 100 samples per village; all ages ≥ 2years; persons with acute or chronic illness, pregnant women excluded. Area co-endemic for soil transmitted helminths. | MDA—ALB 400mg IntA—Annual MDA; IntB—6-monthly MDA; IntC—6-monthly MDA + latrine construction + regular health education (all over a 3-year period). Then annual MDA by local village doctors for another 2-year period. |
N≈100 in each group at each time point. Relative reduction in prevalence after 2 years: Hookworm—A) 93.3%, B) 84.3%, C) 72.7%; A. lumbricoides—A) 4.0%, B) 50.1%, C) 75.0%; T. trichiura—A) 27.7%, B) 19.7%, C) 41.5%; S. stercoralis—A) 33.1%, B) 59.0%, C) 5.4%. All three interventions significantly reduced the prevalence of T. trichiura and hookworm after 2 years and 5 years but not S. stercoralis. B and C significantly reduced the prevalence of A. lumbricoides after 2 years, while both A and C significantly reduced the prevalence of A. lumbricoides after 5 years. |
Taylor 1995 [52] South Africa |
BA | n = 200; children 4–6 years (mean 4.81, SD 0.34 years); 77% of study population had multiple parasite infestations. | Selective chemotherapy PZQ 40 mg/kg for taeniasis; ALB 400mg for soil transmitted helminths |
Cure rate: A. lumbricoides—91.9% (113/123) after first treatment, 96.4% (27/28) after second treatment; T. trichiura—22.4% (28/125) after first treatment, 14.1% (12/85) after second treatment; N. americanus—89% (40/45) after first treatment, 100% (3/3) after second treatment. |
Abbreviations: ALB—albendazole; CI—confidence interval; MDA—mass drug administration; NICL—niclosamide; NS—not significant; PZQ—praziquantel; SD—standard deviation