Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Type 2 Immunity Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America.
PLoS One. 2022 Aug 12;17(8):e0272821. doi: 10.1371/journal.pone.0272821. eCollection 2022.
In Malaysia, soil-transmitted helminth (STH) infections still persist among indigenous communities. In the past, local studies have focused mostly on epidemiologic aspects of STH infections with a scarcity of information on the efficacy of deworming treatment. The present study consisted of 2 phases: a cross-sectional phase on current epidemiological status and risk factors of STH infections and a longitudinal study over 6 weeks on triple dose albendazole efficacy against STH infections. A total of 253 participants were recruited at baseline and a pre-tested questionnaire was administered to obtain information on socio-demographics, environmental and behavioural risk factors. Stool samples were evaluated using a modified Kato-Katz technique. Cure rate (CR) and egg reduction rate (ERR) were assessed at 3 weeks following a 3-day course of 400mg albendazole treatment and infection status were observed again at 6 weeks. Baseline positivity of trichuriasis, ascariasis and hookworm infections were 56.1%, 11.9% and 20.2%, respectively. Multivariate analysis showed age below 18 years old (P = 0.004), without latrine in house (P = 0.042) and indiscriminate defecation (P = 0.032) were associated with STH infections. In the longitudinal study (N = 89), CR for trichuriasis was 64.6%, while CR of 100% was observed for both ascariasis and hookworm. ERR was above 90% for all three STH species. A rapid increased of Trichuris trichiura egg output was observed at 6 weeks. In conclusion, STH infections are highly prevalent among indigenous communities. Children and teenagers, poor sanitation and hygiene behaviour were determinants for STH infections. Triple dose albendazole is found to be efficacious against Ascaris lumbricoides and hookworm infections but has moderate curative effect with high ERR against T. trichiura. Although triple dose albendazole regimen has logistic challenges and may not be a routine option, consideration of this treatment regime may still be necessary in selective communities to reduce high intensity of T. trichiura infection.
在马来西亚，土壤传播性蠕虫（STH）感染仍然在土著社区中存在。过去，当地的研究主要集中在 STH 感染的流行病学方面，而关于驱虫治疗效果的信息却很少。本研究包括两个阶段：横断面阶段是关于 STH 感染的当前流行病学状况和危险因素，以及 6 周内三剂量阿苯达唑治疗 STH 感染的纵向研究。共招募了 253 名参与者，在基线时进行了预测试问卷，以获取社会人口统计学、环境和行为危险因素的信息。使用改良加藤厚涂片法评估粪便样本。在服用 400mg 阿苯达唑治疗 3 天后，进行为期 3 周的治疗，并在第 3 周评估治愈率（CR）和虫卵减少率（ERR），然后在第 6 周再次观察感染情况。基线时，鞭虫病、蛔虫病和钩虫病的阳性率分别为 56.1%、11.9%和 20.2%。多变量分析显示，年龄在 18 岁以下（P = 0.004）、家中无厕所（P = 0.042）和随地大小便（P = 0.032）与 STH 感染有关。在纵向研究（N = 89）中，鞭虫病的 CR 为 64.6%，而蛔虫病和钩虫病的 CR 均为 100%。所有三种 STH 物种的 ERR 均在 90%以上。在第 6 周时，观察到 Trichuris trichiura 卵的产量迅速增加。总之，土著社区中 STH 感染非常普遍。儿童和青少年、卫生条件差和卫生行为不当是 STH 感染的决定因素。三剂量阿苯达唑对蛔虫和钩虫感染有效，但对鞭虫的疗效中等，具有较高的 ERR。尽管三剂量阿苯达唑方案存在后勤挑战，并且可能不是常规选择，但在选择性社区中仍可能需要考虑这种治疗方案，以减少高强度的 T. trichiura 感染。
