National Institute of Public Health, Ministry of Health, Vientiane, Lao People's Democratic Republic.
PLoS Negl Trop Dis. 2012 Jan;6(1):e1417. doi: 10.1371/journal.pntd.0001417. Epub 2012 Jan 3.
Albendazole and mebendazole are increasingly deployed for preventive chemotherapy targeting soil-transmitted helminth (STH) infections. We assessed the efficacy of single oral doses of albendazole (400 mg) and mebendazole (500 mg) for the treatment of hookworm infection in school-aged children in Lao PDR. Since Opisthorchis viverrini is co-endemic in our study setting, the effect of the two drugs could also be determined against this liver fluke.
We conducted a randomized, open-label, two-arm trial. In total, 200 children infected with hookworm (determined by quadruplicate Kato-Katz thick smears derived from two stool samples) were randomly assigned to albendazole (n=100) and mebendazole (n=100). Cure rate (CR; percentage of children who became egg-negative after treatment), and egg reduction rate (ERR; reduction in the geometric mean fecal egg count at treatment follow-up compared to baseline) at 21-23 days posttreatment were used as primary outcome measures. Adverse events were monitored 3 hours post treatment.
Single-dose albendazole and mebendazole resulted in CRs of 36.0% and 17.6% (odds ratio: 0.4; 95% confidence interval: 0.2-0.8; P=0.01), and ERRs of 86.7% and 76.3%, respectively. In children co-infected with O. viverrini, albendazole and mebendazole showed low CRs (33.3% and 24.2%, respectively) and moderate ERRs (82.1% and 78.2%, respectively).
CONCLUSIONS/SIGNIFICANCE: Both albendazole and mebendazole showed disappointing CRs against hookworm, but albendazole cured infection and reduced intensity of infection with a higher efficacy than mebendazole. Single-dose administrations showed an effect against O. viverrini, and hence it will be interesting to monitor potential ancillary benefits of a preventive chemotherapy strategy that targets STHs in areas where opisthorchiasis is co-endemic.
Current Controlled Trials ISRCTN29126001.
阿苯达唑和甲苯咪唑越来越多地被用于针对土壤传播性蠕虫（STH）感染的预防性化疗。我们评估了单剂口服阿苯达唑（400mg）和甲苯咪唑（500mg）治疗老挝小学生钩虫感染的疗效。由于肝吸虫在我们的研究环境中也同样流行，因此这两种药物对这种肝吸虫的疗效也可以确定。
我们进行了一项随机、开放标签、双臂试验。共有 200 名感染钩虫的儿童（通过从两份粪便样本中获取的四倍 Kato-Katz 厚涂片确定）被随机分配至阿苯达唑组（n=100）和甲苯咪唑组（n=100）。治疗后 21-23 天的治愈率（CR；治疗后粪便转阴的儿童百分比）和虫卵减少率（ERR；治疗随访时粪便虫卵计数的几何均数与基线相比的减少率）是主要的结局指标。治疗后 3 小时监测不良事件。
单剂阿苯达唑和甲苯咪唑的治愈率分别为 36.0%和 17.6%（比值比：0.4；95%置信区间：0.2-0.8；P=0.01），虫卵减少率分别为 86.7%和 76.3%。在同时感染肝吸虫的儿童中，阿苯达唑和甲苯咪唑的治愈率分别为 33.3%和 24.2%，虫卵减少率分别为 82.1%和 78.2%。
结论/意义：阿苯达唑和甲苯咪唑对钩虫的治愈率均不理想，但阿苯达唑的治愈率和降低感染强度的效果均高于甲苯咪唑。单次给药对肝吸虫有作用，因此在肝吸虫病流行地区，监测针对 STH 的预防性化疗策略的潜在辅助效益将是一件很有趣的事情。
当前对照试验 ISRCTN29126001。
