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[噻苯达唑用于秘鲁高流行地区控制粪类圆线虫感染]

[Thiabendazole for the control of Strongyloides stercoralis infection in a hyperendemic area in Peru].

作者信息

Marcos Luis, Terashima Angélica, Samalvides Frine, Alvarez Héctor, Lindo Felipe, Tello Raúl, Canales Marco, Demarini Julio, Gotuzzo Eduardo

机构信息

Instituto de Medicina Tropical Alexander von Humbolt, IMTAvH, Universidad Peruana Cayetano Heredia, UPCH, Lima.

出版信息

Rev Gastroenterol Peru. 2005 Oct-Dec;25(4):341-8.

Abstract

Strongyloides stercoralis infection is a disease caused by an intestinal parasite. This helminth is highly prevalent in tropical and subtropical areas. The preferred treatment is ivermectin, and thiabendazole as a second option available in certain Peruvian institutions. The purpose of the study was to assess the efficacy and tolerability of thiabendazole (25 mg/kg/day) administered twice a day (after meals) for three days in individuals with S. stercoralis chronic infection. The study was conducted at Hospital de La Merced, Province of Chanchamayo, Peru (endemic area), during a 90 day period. The study included 32 individuals (22 female and 10 male, average age +/- SD = 9.31 +/- 8.11 years) with a diagnosed S. stercoralis infection. Follow up tests were eosinophil count, hematocrit, agar plate feces culture, and Baermann technique modified by Lumbreras. Healing rate was 90.6%. The average eosinophil count in healed patients significantly decreased (1168 to 665 eosinophils/cc, p=0.006) as compared to the treatment failure group, which showed a slight increase (618 to 897 eosinophils/cc, p=0.125). Hematocrit increased in both groups (2% and 3%, respectively). Adverse effects were headache, dizziness, and epigastralgia in 6.2% of individuals. It was concluded that the studied scheme showed a high effectiveness rate and was well tolerated. Therefore this scheme may be taken into account for control programs of this parasite in hyperendemic areas.

摘要

粪类圆线虫感染是一种由肠道寄生虫引起的疾病。这种蠕虫在热带和亚热带地区高度流行。首选治疗药物是伊维菌素,在秘鲁的某些机构,噻苯达唑作为第二选择。本研究的目的是评估噻苯达唑(25mg/kg/天)每日两次(饭后)给药三天对粪类圆线虫慢性感染个体的疗效和耐受性。该研究在秘鲁昌查马约省拉梅尔塞德医院(流行地区)进行,为期90天。研究纳入了32名确诊为粪类圆线虫感染的个体(22名女性和10名男性,平均年龄±标准差=9.31±8.11岁)。随访检测包括嗜酸性粒细胞计数、血细胞比容、琼脂平板粪便培养以及经Lumbreras改良的贝曼氏技术。治愈率为90.6%。与治疗失败组相比,治愈患者的平均嗜酸性粒细胞计数显著下降(从1168个嗜酸性粒细胞/立方厘米降至665个,p=0.006),而治疗失败组略有上升(从618个嗜酸性粒细胞/立方厘米升至897个,p=0.125)。两组的血细胞比容均有所增加(分别为2%和3%)。6.2%的个体出现头痛、头晕和上腹部疼痛等不良反应。结论是,所研究的方案显示出高有效率且耐受性良好。因此,在高度流行地区控制这种寄生虫的项目中可考虑采用该方案。

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