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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Oxantel pamoate-albendazole for trichuris trichiura infection
New England Journal of Medicine, Volume 370, No. 7, Year 2014
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Description
BACKGROUND: Infections with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) are widespread and often occur concomitantly. These parasitic-worm infections are typically treated with albendazole or mebendazole, but both drugs show low efficacy against T. trichiura. Albendazole is the drug of choice against hookworm. METHODS In this double-blind trial conducted on Pemba Island, Tanzania, we randomly assigned children, 6 to 14 years of age, to receive one of four treatments: oxantel pamoate at a dose of 20 mg per kilogram of body weight, plus 400 mg of albendazole, administered on consecutive days; oxantel pamoate at a single dose of 20 mg per kilogram; albendazole at a single dose of 400 mg; or mebendazole at a single dose of 500 mg. We assessed the efficacy and safety profile of oxantel pamoate-albendazole when used in the treatment of T. trichiura infection (primary outcome) and concomitant soil-transmitted helminth infection (secondary outcome). Efficacy was determined by means of assessment of the cure rate and egg-reduction rate. Adverse events were assessed four times after treatment. RESULTS: Complete data were available for 458 children, of whom 450 were infected with T. trichiura, 443 with hookworm, and 293 with A. lumbricoides. The cure rate of T. trichiura infection was significantly higher with oxantel pamoate-albendazole than with mebendazole (31.2% vs. 11.8%, P = 0.001), as was the egg-reduction rate (96.0% [95% confidence interval {CI}, 93.5 to 97.6] vs. 75.0% [95% CI, 64.2 to 82.0]). The cure rate with albendazole (2.6%) and the egg-reduction rate with albendazole (45.0%; 95% CI, 32.0 to 56.4) were significantly lower than the rates with mebendazole (P = 0.02 for the comparison of cure rates). Oxantel pamoate had low efficacy against hookworm and A. lumbricoides. Adverse events (mainly mild) were reported by 30.9% of all children. CONCLUSIONS: Treatment with oxantel pamoate-albendazole resulted in higher cure and egg-reduction rates for T. trichiura infection than the rates with standard therapy. Copyright © 2014 Massachusetts Medical Society.
Authors & Co-Authors
Speich, Benjamin
Switzerland, Basel
Universitat Basel
Ame, Shaali Makame
Tanzania, Mkokotoni, Zanzibar
Public Health Laboratory-ivo de Carneri
Ali, Said Mohammed
Tanzania, Mkokotoni, Zanzibar
Public Health Laboratory-ivo de Carneri
Alles, Rainer
Unknown Affiliation
Huwyler, J.
Unknown Affiliation
Hattendorf, Jan
Switzerland, Basel
Universitat Basel
Utzinger, Jürg
Switzerland, Basel
Universitat Basel
Albonico, Marco
Italy, Milan
Ivo de Carneri Foundation
Keiser, Jennifer
Switzerland, Basel
Universitat Basel
Statistics
Citations: 61
Authors: 9
Affiliations: 3
Identifiers
Doi:
10.1056/NEJMoa1301956
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Disability
Maternal And Child Health
Study Locations
Tanzania