Abstract
BackgroundControl of hookworm and other soil-transmitted helminth infections primarily relies on preventive chemotherapy using a single dose of albendazole/mebendazole drugs on high-risk groups. Herein, the efficacy of a single dose (400 mg) of albendazole (ALB) was investigated both in vivo and in vitro model in northwest Ethiopia.MethodsAn open-label, single-arm clinical trial was conducted to assess anti-hookworm effect of albendazole. Stool samples were collected and examined using McMaster and Harada-Mori filter paper culture. Eligible hookworm-infected patients were treated with a single dose of ALB. After 14–21 days post-treatment, stool samples were also taken again and re-examined using the abovementioned technique. Egg reduction rate (ERR) and larval motility were used as a therapeutic outcome measure. An independent t test was used to compare the mean difference in egg counts, and probit analysis was performed for calculating the lethal concentration dose of albendazole. P value < 0.05 at 95% CI was considered statistically significant.ResultsA total of 70 participants had completed the drug efficacy study. The efficacy of ALB against hookworm in terms of CR and ERR was 87% and 93%, respectively. Participants who had not eaten one or more hours prior to treatment had higher CR than those who had eaten within 1 h before treatment (97.4% vs 74.2%), while individuals with heavy infection intensity had a lower post-treatment ova clearing rate than those who were with light infection intensity (43% vs 94.6%). The in vitro larvicidal effect of ALB was 63–93% after applying 50–250 μg/ml concentration of ALB solution. The LC50 and LC99 were 152 μg/ml and 573 μg/ml, respectively.ConclusionA single dose of albendazole was found to be effective for treating hookworm infections according to WHO anthelminthic evaluation standard in the study area. Preventive chemotherapy might therefore be extended to risk groups, with proper continuous monitoring of its efficacy to strengthen and keep the ongoing control and prevention measures one step ahead.Trial registrationThis trial is retrospectively registered with www.pactr.org, number PACTR202010511829332 on October 26, 2020.
Highlights
Control of hookworm and other soil-transmitted helminth infections primarily relies on preventive chemotherapy using a single dose of albendazole/mebendazole drugs on high-risk groups
Our finding revealed lower efficacy status of albendazole against hookworm infections compared with a previous study conducted in Jimma, southwest Ethiopia [34]
The other interesting finding of this study is that the in vitro parasite cultivation may give us a green light to use it as an alternative diagnostic approach for estimating the outcomes of anthelminthic drugs
Summary
Control of hookworm and other soil-transmitted helminth infections primarily relies on preventive chemotherapy using a single dose of albendazole/mebendazole drugs on high-risk groups. Hookworms (Ancylostoma duodenale and Necator americanus) are the most important among the three big STHs and are responsible for 845, 000 disability-adjusted life years (DALYs) among the estimated 500 million infected people worldwide [3, 4]. It accounts for $7.5 billion to $138.9 billion productivity lost annually [3]. Hookworm infection is a recognized major cause of gastrointestinal blood loss and leads to iron, energy, protein, and zinc deficiency, pronounced in children and pregnant women [7, 8]. It causes more subtle chronic health problems such as growth retardation, as well as intellectual and cognitive impairment in children, and adverse maternal-fetal outcomes in pregnant women [9, 10]
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