The Effectiveness of Albendazole in Reducing Soil-Transmitted Helminth Infection Among 9 to 12 year-old Students from 5thGrade of a Public Elementary School in the Philippines
Abstract
Context
Soil-Transmitted Helminth (STH) infections are among the neglected tropical diseases with the highest prevalence and incidence in children aged 6 to 15 years. Appropriate health and nutrition interventions are necessary to prevent long-term adverse effects of parasitic infection. One example is the biannual school-based mass drug administration by the Department of Health in partnership with the Department of Education, as recommended by the World Health Organization.
Objectives
The general objective of the study is to determine the effectiveness of albendazole in reducing STH infection among school-aged children in 5th grade. Specifically, the study aims to identify the most common type of STH infection among the respondents, and to calculate the cure rate (CR) and egg reduction rate (ERR) overall and for each helminth species.
Study Design
Descriptive and comparative
Study Setting
Stool samples from the students were collected at a local public elementary school and processed in the Microbiology Laboratory of the Cebu Institute of Medicine.
Participants
All grade five students were invited to participate, with a final sample size of 188 respondents.
Maneuver
A total of four stool samples were collected from each participant: two before deworming (July 16-26, 2019) and two more 14 to 21 days after the first deworming cycle. All samples were analyzed using the Kato-Katz method. McNemars test was used as the statistical tool.
Main Outcome Measures
Percentage and intensity of STH infection, cure rate (CR), egg reduction rate (ERR), and effectiveness of intervention
Results
Of the 49 respondents, 10 (20.41%) were positive for STH at baseline. Single infection with Ascaris lumbricoides (12.24%) was most frequent, followed by co-infection with A. lumbricoides and Trichuris trichiura (4.08%), and single infection with T. trichiura (2.04%). Albendazole yielded a 100% CR and ERR for A. lumbricoides. CR and ERR for T. trichiura were 33.33% and 51.25%, respectively.
Implications
The drug is effective in reducing viable egg count in infected patients but is not sufficient to cure patients with T. trichiura infection.
Conclusion
A single 400 mg dose of Albendazole was effective against ascariasis. It was also effective against trichuriasis in terms of egg reduction, but not in terms of cure rate.
Recommendations
The DOH protocol should be re-evaluated regarding the use of a triple dose of albendazole instead of a single dose to address T. trichiura infection. Follow-up surveillance is recommended to monitor the effectiveness of the deworming program. Educating stakeholders to increase awareness and participation is also advised. Future researchers should investigate possible risk factors contributing to STH infection to inform further preventive action.
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