Comparative Efficacy and Reinfection of Albendazole-mebendazole, Albendazole-pyrantel Pamoate, and Mebendazole on Soil-transmitted Helminths

Nirmalia Husin; Ayodhia Pitaloka Pasaribu; Muhammad Ali; Erwin Suteno; Wilhans Wijaya; Syahril Pasaribu

doi:10.3889/oamjms.2020.5110

Authors

Nirmalia Husin Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Ayodhia Pitaloka Pasaribu Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Muhammad Ali Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Erwin Suteno Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Wilhans Wijaya Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Syahril Pasaribu Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.5110

Keywords:

Efficacy, Soil-transmitted helminths, Albendazole, Mebendazole, Pyrantel pamoate, Medicine combination, Reinfection

Abstract

BACKGROUND: Soil-transmitted helminths (STHs) infection (i.e., Ascaris lumbricoides, Trichuris trichiura, and hookworm) are commonly found as a single infection as well as a mixture of the three kinds of helminths that requires a broad anthelmintic spectrum. Some study revealed that combination of anthelmintic provides better efficacy.

AIM: The objective of the study was to compare the efficacy of combination treatment of albendazole-mebendazole, albendazole-pyrantel pamoate, and mebendazole alone in treating STHs infection as well as the rate of reinfection post-treatment.

METHODS: In 2018, a randomized controlled trial was conducted in Batubara district, North Sumatera. School-aged children diagnosed for STH were randomly allocated to (1) albendazole-mebendazole; (2) albendazole-pyrantel pamoate; or (3) mebendazole treatment groups. Here, we report the efficacy (cure rates [CRs] and egg-reduction rates [ERR]) and reinfection rates determined 12 weeks post-treatment. Chi-square test was used to compare the drug efficacy and reinfection rate between three groups.

RESULTS: A total of 309 children complete baseline and follow-up data. The efficacy was determined after 4 weeks post-treatment albendazole-pyrantel pamoate showed a significant higher efficacy against A. lumbricoides (CR: 93.5%; ERR: 100%) and T. trichiura (CR: 81.4%; ERR: 99%). For hookworm infection, results showed higher efficacy between the three groups after treatment. The reinfection rates 12 weeks after treatment for A. lumbricoides infection (Group 1: 3.1%; 2: 3%; 3: 1.3%) with p > 0.05 and for T. trichiura infection (Group 1: 19.2%; 2: 25%; 3: 1.5%) with p < 0.05.

CONCLUSION: This study showed the excellent efficacy of an albendazole-pyrantel pamoate combination against STHs infections. The highest reinfection rate was found in albendazole-pyrantel pamoate group for T. trichiura infection.

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