埃塞俄比亚西北部学童服用甲苯达唑治疗土壤传播蠕虫后的治疗效果及再感染率
Treatment efficacy and re-infection rates of soil-transmitted helminths following mebendazole treatment in schoolchildren, Northwest Ethiopia.
作者信息
Zeleke Ayalew Jejaw, Bayih Abebe Genetu, Afework Solomon, Gilleard John S
机构信息
Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
出版信息
Trop Med Health. 2020 Nov 12;48(1):90. doi: 10.1186/s41182-020-00282-z.
BACKGROUND
Transmission of soil-transmitted helminth (STH) infection remains high in Ethiopia. This study aimed at assessing the therapeutic efficacy of mebendazole against soil-transmitted helminths and determining the re-infection rates of the parasites among schoolchildren in Northwest Ethiopia.
METHODS
A school-based cross-sectional study was conducted. Data was collected using a structured questionnaire. Stool specimens were examined using direct wet mount microscopy and Kato-Katz methods. Schoolchildren who tested positive for soil-transmitted helminths were treated with 500 mg single-dose of mebendazole. Cure and egg reduction rates were evaluated 2 to 3 weeks post treatment. Moreover, the re-infection rate of these parasites among those who were cured was determined 1 year after treatment. Data were analyzed using SPSS version 20. P value < 0.05 was considered as statistically significant.
RESULT
A drug efficacy study was conducted on 62, 52, and 14 children infected by Ascaris lumbricoides (A. lumbricoides), hookworm, and Trichuris trichiura (T. trichiura), respectively. The cure rates (CR) of mebendazole against A. lumbricoides, hookworm, and T. trichiura were found to be 96.9%, 23.1%, and, 28.6%, respectively. The egg reduction rate (ERR) of A. lumbricoides was found to be 99.6% whereas 49.6% and 56.3% were reported for hookworm and T. trichiura, respectively. Eighty schoolchildren who were treated and cured from any STH infections were included for the determination of re-infection rate. Out of 80 children, 36.3% (29/80) were found to be re-infected after 1 year: 22 (75.9%), 6 (20.7%), and 1 (1.3%) of study participants were re-infected with A. lumbricoides, hookworm, and both infections, respectively. All re-infections were grouped under the "light infection" category.
CONCLUSION
Mebendazole was found to be highly effective against A. lumbricoides, but had relatively low efficacy against hookworms and T. trichiura. These results bring into question the use of mebendazole in STH mass drug administration (MDA) programs in this region if albendazole, a drug with higher efficacy against hookworms, is available. Moreover, a significant number of treated children were re-infected with either or both of A. lumbricoides or hookworms 1 year after treatment emphasizing the need for better integrated intestinal helminthiasis control measures.
背景
在埃塞俄比亚，土壤传播的蠕虫感染率仍然很高。本研究旨在评估甲苯达唑对土壤传播蠕虫的治疗效果，并确定埃塞俄比亚西北部学童中寄生虫的再感染率。
方法
进行了一项基于学校的横断面研究。使用结构化问卷收集数据。粪便标本采用直接湿片显微镜检查和改良加藤厚涂片法进行检测。对土壤传播蠕虫检测呈阳性的学童给予500毫克单剂量甲苯达唑治疗。在治疗后2至3周评估治愈率和虫卵减少率。此外，在治疗1年后确定治愈者中这些寄生虫的再感染率。使用SPSS 20版软件进行数据分析。P值<0.05被认为具有统计学意义。
结果
分别对62名、52名和14名感染蛔虫、钩虫和鞭虫的儿童进行了药物疗效研究。甲苯达唑对蛔虫、钩虫和鞭虫的治愈率分别为96.9%、23.1%和28.6%。蛔虫的虫卵减少率为99.6%，而钩虫和鞭虫的虫卵减少率分别为49.6%和56.3%。80名接受治疗并治愈任何土壤传播蠕虫感染的学童被纳入再感染率的测定。在80名儿童中，1年后有36.3%（29/80）被再次感染：研究参与者中分别有22名（75.9%）、6名（20.7%）和1名（1.3%）再次感染蛔虫、钩虫以及同时感染这两种寄生虫。所有再感染均归为“轻度感染”类别。
结论
发现甲苯达唑对蛔虫高度有效，但对钩虫和鞭虫的疗效相对较低。如果有对钩虫疗效更高的阿苯达唑，那么这些结果使该地区在土壤传播蠕虫群体药物驱虫（MDA）项目中使用甲苯达唑受到质疑。此外，大量接受治疗的儿童在治疗1年后再次感染蛔虫或钩虫或同时感染这两种寄生虫，这突出表明需要更好地综合控制肠道蠕虫病的措施。
Zotero 插件