Low efficacy of single-dose albendazole and mebendazole against hookworm and effect on concomitant helminth infection in Lao PDR

Background: albendazole and mebendazole are increasingly deployed for preventive chemotherapy targeting soil-transmitted helminth (sth) infections. we assessed the efficacy of single oral doses of albendazole (400 mg) and mebendazole (500 mg) for the treatment of hookworm infection in school-aged children in lao pdr. since opisthorchis viverrini is co-endemic in our study setting,the effect of the two drugs could also be determined against this liver fluke. methodology: we conducted a randomized,open-label,two-arm trial. in total,200 children infected with hookworm (determined by quadruplicate kato-katz thick smears derived from two stool samples) were randomly assigned to albendazole (n = 100) and mebendazole (n = 100). cure rate (cr; percentage of children who became egg-negative after treatment),and egg reduction rate (err; reduction in the geometric mean fecal egg count at treatment follow-up compared to baseline) at 21-23 days posttreatment were used as primary outcome measures. adverse events were monitored 3 hours post treatment. principal findings: single-dose albendazole and mebendazole resulted in crs of 36.0% and 17.6% (odds ratio: 0.4; 95% confidence interval: 0.2-0.8; p = 0.01),and errs of 86.7% and 76.3%,respectively. in children co-infected with o. viverrini,albendazole and mebendazole showed low crs (33.3% and 24.2%,respectively) and moderate errs (82.1% and 78.2%,respectively). conclusions/significance: both albendazole and mebendazole showed disappointing crs against hookworm,but albendazole cured infection and reduced intensity of infection with a higher efficacy than mebendazole. single-dose administrations showed an effect against o. viverrini,and hence it will be interesting to monitor potential ancillary benefits of a preventive chemotherapy strategy that targets sths in areas where opisthorchiasis is co-endemic. clinical trial registration: current controlled trials isrctn29126001. © 2012 soukhathammavong et al.