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Vaz Nery S, Qi J, Llewellyn S, Clarke NE, Traub R, Gray DJ, Vallely AJ, Williams GM, Andrews RM, McCarthy JS, Clements ACA. Use of quantitative PCR to assess the efficacy of albendazole against Necator americanus and Ascaris spp. in Manufahi District, Timor-Leste. Parasit Vectors 2018; 11:373. [PMID: 29954461 PMCID: PMC6025744 DOI: 10.1186/s13071-018-2838-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/09/2018] [Indexed: 11/21/2022] Open
Abstract
Background Soil-transmitted helminths (STHs) including Ascaris lumbricoides, Necator americanus, Ancylostoma spp. and Trichuris trichiura are cause of significant global morbidity. To mitigate their disease burden, at-risk groups in endemic regions receive periodic mass drug administration using anthelmintics, most commonly albendazole and mebendazole. Assessing the efficacy of anthelmintic drugs is important for confirming that these regimens are working effectively and that drug resistance has not emerged. In this study we aimed to characterise the therapeutic efficacy of albendazole against Ascaris spp. and N. americanus in Timor-Leste, using a quantitative polymerase chain reaction (qPCR) method for parasite detection and quantification. Results A total of 314 participants from 8 communities in Timor-Leste provided stool samples before and 10–14 days after the administration of a single 400 mg dose of albendazole. Helminth infection status and infection intensity (measured in Ct-values and relative fluorescence units) were determined using qPCR. Efficacy was determined by examining the cure rates and infection intensity reduction rates. Albendazole was found to be highly efficacious against Ascaris spp., with a cure rate of 91.4% (95% CI: 85.9–95.2%) and infection intensity reduction rate of 95.6% (95% CI: 88.3–100%). The drug was less efficacious against N. americanus with a cure rate of 58.3% (95% CI: 51.4–64.9%) and infection intensity reduction rate of 88.9% (95% CI: 84.0–97.0%). Conclusions The observed cure rates and infection intensity reduction rates obtained for Ascaris spp. and to a lower extent N. americanus, demonstrate the continued efficacy of albendazole against these species and its utility as a mass chemotherapy agent in Timor-Leste. Furthermore, this study demonstrates the usefulness of qPCR as a method to measure the efficacy of anthelminthic drugs. Additional research is necessary to translate Ct-values into eggs per gram in a systematic way. Trial registration Australian and New Zealand Clinical Trials Registry 12614000680662 (registered 27 June 2014).
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Affiliation(s)
- Susana Vaz Nery
- Research School of Population Health, Australian National University, 62 Mills Rd, Canberra, 2601, ACT, Australia. .,Present Address: Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, 2052, NSW, Australia.
| | - Jessica Qi
- Medical School, Australian National University, Building 42, Canberra, ACT, 2601, Australia
| | - Stacey Llewellyn
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Brisbane, QLD 4006, Australia
| | - Naomi E Clarke
- Research School of Population Health, Australian National University, 62 Mills Rd, Canberra, 2601, ACT, Australia
| | - Rebecca Traub
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Darren J Gray
- Research School of Population Health, Australian National University, 62 Mills Rd, Canberra, 2601, ACT, Australia
| | - Andrew J Vallely
- Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, 2052, NSW, Australia
| | - Gail M Williams
- School of Public Health, The University of Queensland, Corner of Herston Road and Wyndham Street, Brisbane, QLD 4006, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia
| | - James S McCarthy
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Brisbane, QLD 4006, Australia
| | - Archie C A Clements
- Research School of Population Health, Australian National University, 62 Mills Rd, Canberra, 2601, ACT, Australia
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Bekana T, Mekonnen Z, Zeynudin A, Ayana M, Getachew M, Vercruysse J, Levecke B. Comparison of Kato-Katz thick-smear and McMaster egg counting method for the assessment of drug efficacy against soil-transmitted helminthiasis in school children in Jimma Town, Ethiopia. Trans R Soc Trop Med Hyg 2016; 109:669-71. [PMID: 26385937 DOI: 10.1093/trstmh/trv073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is a paucity of studies that compare efficacy of drugs obtained by different diagnostic methods. METHODS We compared the efficacy of a single oral dose albendazole (400 mg), measured as egg reduction rate, against soil-transmitted helminth infections in 210 school children (Jimma Town, Ethiopia) using both Kato-Katz thick smear and McMaster egg counting method. RESULTS Our results indicate that differences in sensitivity and faecal egg counts did not imply a significant difference in egg reduction rate estimates. CONCLUSION The choice of a diagnostic method to assess drug efficacy should not be based on sensitivity and faecal egg counts only.
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Affiliation(s)
- Teshome Bekana
- Department of Biomedical Science, Faculty of Public Health and Medical Science, Mettu University, Mettu, Ethiopia
| | - Zeleke Mekonnen
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Ahmed Zeynudin
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mio Ayana
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mestawet Getachew
- Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Jozef Vercruysse
- Department of Virology, Parasitology and Immunology, Ghent University, Belgium
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Ghent University, Belgium
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