The optimal timing of post-treatment sampling for the assessment of anthelminthic drug efficacy against Ascaris infections in humans
The optimal timing of post-treatment sampling for the assessment of anthelminthic drug efficacy against Ascaris infections in humans
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DOI：
10.1016/j.ijpddr.2017.12.004
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发表时间：
2018-04-01
影响因子：
4
通讯作者：
Vercruysse, Jozef
中科院分区：
文献类型：
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作者：
Levecke, Bruno;Easton, Alice V.;Vercruysse, Jozef
减卵率（ERR）是目前评估药物对人类土壤传播蠕虫（STH;蛔虫、鞭虫和钩虫）有效性的标准平均值。虽然治疗后采样的时间对于药物疗效的容易解释至关重要，但缺乏经验数据可以推荐随访卵子计数的最佳时间点。在本研究中，我们重新分析了在肯尼亚社区进行的一系列研究中，单次口服阿苯达唑后蛔虫的驱虫和产卵动力学。结果表明，处理后需要长达10天才能完成成虫雄性和雌性蠕虫的排出，大约20%的蠕虫在处理后第7天和第10天之间排出。产蛋量的序贯分析表明，在处理后第7天的ERR较差（89.4%），但在处理后第14天和第21天的ERR为100%。根据我们的研究结果，我们建议在阿苯达唑治疗后至少等待14天，然后再进行后续鸡蛋计数。由于濒死或退化蠕虫释放残留虫卵，在此时间点之前的任何采样均可能导致ERR估计值偏倚。
The egg reduction rate (ERR) is the current standard mean to assess the efficacy of drugs against human soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura and hookworm). Although the timing of post-treatment sampling is pivotal for a readily interpretation of drug efficacy, there is lack empirical data that allows recommending the optimal time point for a follow-up egg counting. In the present study, we re-analyzed both the kinetics of worm expulsion and egg output for Ascaris lumbricoides following a single oral dose of albendazole in a series of studies previously conducted in Kenyan communities. The results indicate that it takes up to 10 days post-treatment before the expulsion of both adult male and female Ascaris worms is completed, approximately 20% of the worms being expelled between day 7 and 10 post-treatment. The sequential analysis of the egg out put, indicated a poor ERR (89.4%) at day 7 post-treatment, but a 100% ERR at day 14 and 21 post-treatment. Based on our findings we recommend to wait at least 14 days after an albendazole treatment before conducting the follow-up egg count. Any sampling before this time point may result in biased ERR estimates, due the release of residual eggs from moribund or degenerating worms.