Wardle Melissa T, Allen Samantha E, Gamboa Ricardo, Vilchez Percy, O'Neal Seth E, Muro Claudio, Lescano Andrés G, Moyano Luz M, Gonzalvez Guillermo E, González Armando E, Gilman Robert H, García Héctor H
School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA.
Department of Neurology, School of Medicine, University of California, Davis, Sacramento, CA, USA.
Lancet Reg Health Am. 2024 Aug 30;38:100876. doi: 10.1016/j.lana.2024.100876. eCollection 2024 Oct.
Mass drug administration (MDA) with niclosamide (NSM) can be used to control taeniasis, the cause of neurocysticercosis. NSM is 84.3% effective against taeniasis and is considered safe as it is not absorbed from the intestinal tract. However, information on its safety and effectiveness during MDA is limited. We evaluated the effectiveness of NSM and reported adverse events (AEs) during a cysticercosis elimination program in Tumbes, Peru.
Three rounds of NSM at 4-month intervals were offered to 77,397 eligible residents. We revisited all participants in their homes 72 h after each round to collect information regarding AEs. We also collected post-treatment stool samples to diagnose taeniasis after the first round, followed by a second sample at 30 days from those infected to evaluate NSM's effectiveness.
During implementation, 68,751 individuals were administered at least one dose of NSM (mean age 29 years, SD 20; 52% male), and 65,551 (95.3%) were visited post-treatment. 988 (1.5%) reported experiencing at least one AE. Almost all AEs (99.2%) were of mild intensity, with no severe AEs recorded. Of 211 participants diagnosed with taeniasis, 188 provided a follow-up stool sample 30-days after treatment and 141 were cured (treatment effectiveness 75.0%). Older age and higher coproantigen levels were significantly associated with treatment failure.
MDA with NSM is safe in endemic settings. However, the effectiveness following one dose is lower than expected, which suggests additional treatment may be necessary to enhance the infection control efforts.
The Bill and Melinda Gates Foundation.
使用氯硝柳胺进行群体药物驱虫（MDA）可用于控制绦虫病，而绦虫病是神经囊尾蚴病的病因。氯硝柳胺对绦虫病的有效率为84.3%，由于其不会从肠道吸收，因此被认为是安全的。然而，关于其在群体药物驱虫期间的安全性和有效性的信息有限。我们在秘鲁通贝斯的一项囊尾蚴病消除计划中评估了氯硝柳胺的有效性，并报告了不良事件（AE）。
每隔4个月对77397名符合条件的居民进行三轮氯硝柳胺驱虫。每轮驱虫72小时后，我们再次到所有参与者家中收集有关不良事件的信息。我们还收集了治疗后的粪便样本，在第一轮后诊断绦虫病，然后在感染后的30天从感染者中收集第二个样本，以评估氯硝柳胺的有效性。
在实施过程中，68751人至少服用了一剂氯硝柳胺（平均年龄29岁，标准差20；52%为男性）, 治疗后对65551人（95.3%）进行了回访。988人（1.5%）报告至少经历了一次不良事件。几乎所有不良事件（99.2%）的强度为轻度，没有记录到严重不良事件。在211名被诊断为绦虫病的参与者中，188人在治疗30天后提供了随访粪便样本，141人治愈（治疗有效率75.0%）。年龄较大和粪抗原水平较高与治疗失败显著相关。
在流行地区使用氯硝柳胺进行群体药物驱虫是安全的。然而，一剂后的有效性低于预期，这表明可能需要额外的治疗来加强感染控制工作。
比尔及梅琳达·盖茨基金会。
