Efficacy of triple dose albendazole treatment for soil-transmitted helminth infections.
Efficacy of triple dose albendazole treatment for soil-transmitted helminth infections.
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DOI：
10.1371/journal.pone.0272821
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
在马来西亚，土传蠕虫感染在土著社区中仍然存在。过去，本港的研究主要集中在性病感染的流行病学方面，而有关驱虫治疗成效的资料则相当缺乏。本研究包括两个阶段：一个是关于STH感染的流行病学现状和危险因素的横断面研究，另一个是关于三剂量阿苯达唑对STH感染的疗效的纵向研究，为期6周。在基线时共招募了253名参与者，并进行了预先测试的问卷调查，以获得有关社会人口统计学，环境和行为风险因素的信息。使用改良的Kato-Katz技术评价粪便样本。治疗3周后观察治愈率（CR）和减蛋率（ERR），治疗6周后再次观察感染情况。鞭虫、蛔虫和钩虫感染的基线阳性率分别为56.1%、11.9%和20.2%。多因素分析显示，年龄小于18岁（P = 0.004）、家中无厕所（P = 0.042）和随地大小便（P = 0.032）与STH感染有关。在纵向研究（N = 89）中，鞭虫的CR为64.6%，而蛔虫和钩虫的CR均为100%。所有三种STH物种的ERR均高于90%。第6周毛首鞭虫产卵量迅速增加。总之，性病感染在土著社区中非常普遍。儿童和青少年、不良的卫生条件和个人卫生行为是性传播疾病感染的决定因素。三倍剂量阿苯达唑对蛔虫和钩虫感染有效，但对T.鞭毛虫虽然三剂量阿苯达唑方案具有逻辑挑战性，可能不是常规选择，但在选择性社区中仍有必要考虑这种治疗方案，以降低T的高强度。鞭毛虫感染
In Malaysia, soil-transmitted helminth (STH) infections still persist among indigenous communities. In the past, local studies have focused mostly on epidemiologic aspects of STH infections with a scarcity of information on the efficacy of deworming treatment. The present study consisted of 2 phases: a cross-sectional phase on current epidemiological status and risk factors of STH infections and a longitudinal study over 6 weeks on triple dose albendazole efficacy against STH infections. A total of 253 participants were recruited at baseline and a pre-tested questionnaire was administered to obtain information on socio-demographics, environmental and behavioural risk factors. Stool samples were evaluated using a modified Kato-Katz technique. Cure rate (CR) and egg reduction rate (ERR) were assessed at 3 weeks following a 3-day course of 400mg albendazole treatment and infection status were observed again at 6 weeks. Baseline positivity of trichuriasis, ascariasis and hookworm infections were 56.1%, 11.9% and 20.2%, respectively. Multivariate analysis showed age below 18 years old (P = 0.004), without latrine in house (P = 0.042) and indiscriminate defecation (P = 0.032) were associated with STH infections. In the longitudinal study (N = 89), CR for trichuriasis was 64.6%, while CR of 100% was observed for both ascariasis and hookworm. ERR was above 90% for all three STH species. A rapid increased of Trichuris trichiura egg output was observed at 6 weeks. In conclusion, STH infections are highly prevalent among indigenous communities. Children and teenagers, poor sanitation and hygiene behaviour were determinants for STH infections. Triple dose albendazole is found to be efficacious against Ascaris lumbricoides and hookworm infections but has moderate curative effect with high ERR against T. trichiura. Although triple dose albendazole regimen has logistic challenges and may not be a routine option, consideration of this treatment regime may still be necessary in selective communities to reduce high intensity of T. trichiura infection.
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