Title : Therapeutic efficacy of albendazole against Ascaris lumbricoides and its reinfection rate among school children in northwest Ethiopia: An open-label trial design
Abstract:
Background:
Despite extensive implementation of mass drug administration using ALB for school children, ascariasis remains a major health problem that requires continuous monitoring of ALB efficacy. This study aimed to evaluate the therapeutic efficacy of ALB against ascariasis and re-infection among patients with SAC in Northwest Ethiopia.
Methods: A single-arm open-label trial was conducted at Chuahit Primary School from June to September 2023. A total of 415 school children were recruited using convenient sampling techniques. Nearly 2 g of stool were collected and screened using direct wet-mount and KK techniques. Of these, 50 school children who tested positive for A. lumbricoides were treated with a single dose ( 400mg) of ALB. Cure and egg reduction rates were evaluated within 2-3 weeks post-treatment. The reinfection rate of the baseline-cured individuals was assessed 3 months after ALB treatment using concentration methods. Pre-tested, semi-structured questionnaires were used to collect demographic and factors of reinfection data. Data were entered into Epi-data (version 7.2) and exported to STATA (version 17) for analysis. Descriptive statistics, paired t-tests, bivariate analysis, and multivariate logistic regression were performed. A P-value < 0.05 with a 95% confidence interval was considered statistically significant.
Result: In this study, the cure and egg reduction rates of a single dose of ALB against A.lumbercoid were found to be 92.3%[95% CI: 87.5%–97.2%] and 96.7% [95% CI: 87.8%-100%], respectively. Of the 46 school children considered for assessing the re-infection rate, about 34.7% [21.8% - 47.6%] were found to have been re-infected. Poor latrine utilization [AOR = 5.52; 95% CI: 1.07-28.5] and finger nail trimming practice [AOR= 0.064; 95% CI: 0.009-0.42] were significantly associated with A. lumbricoides re-infection [P<0.05].
Conclusion Therapeutic efficacy of single-dose ALB (400mg) was efficient against A. lumbricoides, yet a high re-infection rate was observed in the study area. This underscores the importance of promoting proper hygiene practices, including regular fingernail trimming and toilet utilization strategies, alongside sustained MDA campaigns with ALB (400mg) to achieve disease elimination goals.
