PDF(Pubmed)
Abstract：
In countries where soil-transmitted helminth (STH) infections are endemic, deworming programs are recommended to reduce morbidity; however, increasing levels of resistance to benzimidazoles are of concern. In an observational study in Peru, we studied the clinical efficacy of 400 mg of albendazole 20 days after treatment among children aged 2-11 years. Of 426 participants who provided samples, 52.3% were infected with a STH, 144 (33.8%) were positive for Ascaris (41.8% light, 50.8% moderate, and 7.4% heavy infections), 147 (34.5%) were positive for Trichuris (75.2% light, 22.5% moderate, and 2.3% heavy infections), and 1.1% were positive for hookworm species (100% light infections). Additional stool samples were examined at 20, 90, and 130 days after the initial treatment. At 20 days post-administration of albendazole, the cure rate (CR) of Ascaris infection was 80.1% (95% CI: 73.5-86.7), and the egg reduction rate (ERR) was 70.8% (95% CI: 57.8-88.7); the CR for Trichuris infection was 27.1% (95% CI: 20.0-34.3), and the ERR was 29.8% (95% CI: -1.40 to 57.5). Among participants with persistent or recurrent infections with Trichuris, the combined therapy of albendazole (400 mg) and ivermectin at 600 µg/dose increased overall CR for Trichuris infection to 75.2% (95% CI: 67.3-83.2%) with an ERR of 84.2% (95% CI: 61.3-93.8%). Albendazole administration alone for the control of STH was associated with high rates of treatment failure, especially for Trichuris. Combined single doses of albendazole and ivermectin was observed to have improved efficacy.
摘要：
在土壤传播的蠕虫(STH)感染流行的国家，建议实施驱虫计划以降低发病率；然而，增加对苯并咪唑的抗性水平是令人担忧的。在秘鲁的一项观察研究中，我们研究了400mg阿苯达唑治疗20天后对2-11岁儿童的临床疗效。在426名提供样本的参与者中，52.3%感染了STH，144（33.8％）的蛔虫阳性（41.8％的光，50.8%中度,和7.4%的重度感染)，147人(34.5%)为鞭虫阳性(75.2%为轻，22.5%中等,和2.3%严重感染)，和1.1％的钩虫物种呈阳性（100％轻度感染）。在初始治疗后20、90和130天检查额外的粪便样品。阿苯达唑给药后20天，蛔虫感染的治愈率(CR)为80.1%(95%CI:73.5-86.7),减卵率（ERR）为70.8％（95％CI：57.8-88.7）；鞭虫感染的CR为27.1％（95％CI：20.0-34.3），ERR为29.8%（95%CI：-1.40~57.5）。在持续性或复发性鞭毛虫感染的参与者中，阿苯达唑(400mg)和伊维菌素(600µg/剂)的联合治疗可将毛虫感染的总CR提高至75.2%(95%CI:67.3-83.2%),ERR为84.2%(95%CI:61.3-93.8%).单独使用阿苯达唑控制STH与高治疗失败率相关。尤其是对毛虫。观察到联合单剂量的阿苯达唑和伊维菌素具有改善的功效。
