Science and Technology Production
The American Journal of Tropical Medicine and Hygiene - Mass drug administration for helminths with albendazole and ivermectin in an area endemic for StrongyloidesMass drug administration for helminths with albendazole and ivermectin in an area endemic for Strongyloides
Congress
Authorship:
Krolewiecki,A ; Socías,E ; Cajal, P ; Juarez,M ; Villalpando,C ; Carlos,M ; Davila,M ; Palacio,K ; Di Paolo,A ; Samuels,A ; Nutman,T. ; Gil,J.F ; Tarragona,S ; Abril,M ; Gold,S ; Jaime,C ; CIMINO, RUBÉN OSCAR ; Lammie,PDate:
2011Publishing House and Editing Place:
The American Society of Tropical Medicine andSummary *
Management of soil transmitted helminths (STH) in highly endemic communities is based on school-based mass drug administration (MDA) programs. Due to its unique characteristics, decisions on the optimal tools needed for evaluating prevalence, monitoring efficacy, selecting appropriate communities for intervention and determining the appropriate medications are further complicated when Strongyloides stercoralis (St st) is included in the spectrum of targeted STHs. In 2010, a community-based MDA program was started in Orán, northwestern Argentina, an area highly endemic for STH (including St st) The goal of the program is to assess the performance of single dose combination therapy with albendazole and ivermectin, and to report the utility of a new recombinant antigen based ELISA for St st as a tool for assessing seroprevalence. The intervention population consisted of approximately 2400 individuals; 1200 from 3 rural communities, and an additional 1200 from 3 urban/peri-uban communities. Plantations in the rural area and street blocks in the urban/peri-urban area were used as the unit of randomization; 20% of the population was selected for sampling. The following parameters were assessed in each individual: single stool specimen analyzed through a comprehensive panel including sedimentation concentration, Harada- Mori, agar plate and Baermann techniques; St st NIE-ELISA serology and hemoglobin . We present the preliminary results of the initial pilot intervention in one rural and one urban community . The overall prevalence of STH by stool examination was found to be 32%, with 12% positive for St st. Sensitivity increased to 31% for St st when NIE-ELISA was included. A total of 864 individuals from 2 communities with a population of 1127 persons were treated with ivermectin and albendazole. Active and passive surveillance revealed no significant (Grade 3 or 4) adverse events. Only 3 individuals refused treatment. This initial MDA comprehensively targeting STH with the added use of St st serology for prevalence calculations is a promising approach with an appropriate safety and efficacy proven regimen. Further inclusion of the remaining communities and rounds of treatment will provide valuable information for defining a strategy for the management of STH in highly endemic communities. Information provided by the agent in SIGEVAKey Words
drugshelminthsOrán , ArgentinaStrongyloides stercolaris