The effect of different anthelmintic treatment regimens combined with iron supplementation on the nutritional status of schoolchildren in KwaZulu-Natal, South Africa: a randomized controlled trial


Taylor, M; Jinabhai, CC; Couper, I; Kleinschmidt, I; Jogessar, VB; (2001) The effect of different anthelmintic treatment regimens combined with iron supplementation on the nutritional status of schoolchildren in KwaZulu-Natal, South Africa: a randomized controlled trial. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95 (2). pp. 211-6. ISSN 0035-9203 DOI: 10.1016/S0035-9203(01)90171-3

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Abstract

A randomized controlled trial in KwaZulu-Natal (South Africa) of 428 primary-school pupils (stratified into 6 groups by age, sex and intervention) measured the effect of different anthelmintic treatments and iron supplementation regimens provided twice at 6-monthly intervals for 1 year (1996/97). Half the pupils received iron supplementation (ferrous fumarate 200 mg weekly for 10 weeks). Pupils received 2 anthelmintic regimens, either (i) albendazole 400 mg plus praziquantel 40 mg/kg or (ii) albendazole 400 mg on 3 consecutive days plus praziquantel 40 mg/kg or (iii) placebo. Baseline prevalences of Ascaris 55.9%, Trichuris 83.6%, hookworm spp. 59.4%, were reduced after 12 months for single-dose albendazole treatment to Ascaris 17.4% (P < 0.005), Trichuris 61.5% (NS), hookworm spp. 0% (P < 0.005), and for triple-dose albendazole treatment to Ascaris 14.8% (P < 0.005), Trichuris 25.0% (P < 0.01), hookworm 0% (P < 0.005). Schistosoma haematobium 43.4% was reduced among treated groups to 8.3% (P < 0.005). There were no significant changes in the anthropometry of the different treatment groups at either 6 or 12 months post treatment. Twelve months after treatment there was a significant increase in haemoglobin levels (P = 0.02) among pupils receiving triple-dose albendazole, praziquantel and ferrous fumarate; pupils receiving no anthelmintic treatment showed a significant decrease as did pupils who received triple-dose albendazole and praziquantel but no iron. Regular 6-monthly anthelmintic treatment significantly reduced the prevalence of Ascaris, hookworm spp. and S. haematobium infections (P < 0.05). Triple-dose treatment for Trichuris was significantly more effective than a single dose of albendazole 400 mg (P = 0.002). In areas with schistosomiasis, hookworm infection and high prevalence of Trichuris infection, combination treatment with praziquantel, triple-dose albendazole, plus iron supplementation, is likely to improve pupils' health and haemoglobin levels.

Item Type: Article
Keywords: Adolescent, Albendazole/administration & dosage, Anemia/blood/prevention & control, Anthelmintics/*administration & dosage, Ascariasis/blood/drug therapy, Body Height, Child, Double-Blind Method, Drug Combinations, Female, Helminthiasis/blood/*drug therapy, Hemoglobins/analysis, Humans, Iron/*administration & dosage, Male, Praziquantel/administration & dosage, Regression Analysis, Risk Factors, Schistosomiasis haematobia/blood/drug therapy, Trichuriasis/blood/drug therapy, Adolescent, Albendazole, administration & dosage, Anemia, blood, prevention & control, Anthelmintics, administration & dosage, Ascariasis, blood, drug therapy, Body Height, Child, Double-Blind Method, Drug Combinations, Female, Helminthiasis, blood, drug therapy, Hemoglobins, analysis, Humans, Iron, administration & dosage, Male, Praziquantel, administration & dosage, Regression Analysis, Risk Factors, Schistosomiasis haematobia, blood, drug therapy, Trichuriasis, blood, drug therapy
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 11355564
Web of Science ID: 168722700027
URI: http://researchonline.lshtm.ac.uk/id/eprint/9959

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