Efficacy of a Single Dose of Albendazole (400mg) against Soil Transmitted Helminth Infections amongst Pre-School and School Aged Children in Bamenda, North West Region Cameroon

Abstract

To monitor anthelmintic drug efficacy, the World Health Organization recommends measuring the reduction in the number of eggs excreted in stool after drug administration. This study aimed to determine the efficacy of a single dose of albendazole (400 mg) against STHs amongst pre-school- and school-aged children. A community-based study targeting pre-school-aged (≤5 years) and school-aged (6-15 years) children in the rural communities of Ngo-Ketunjia, Batibo and Santa health districts was carried out. Stool analysis for parasitological cure rate was performed using stool ELISA coproantigen detection, while the egg reduction rate was assessed using the McMaster method: Out of 1,146 stool samples examined for STHs during the baseline survey, ELISA coproantigen detection showed a prevalence of 56.5% (648/1,146), whereas the McMaster technique showed a prevalence of 17.6% (202/1,146). The parasitological cure rate following a single dose of albendazole was 81.5%. Species-specific cure rates were: Ascaris lumbricoides 88.8% (245/276), hookworm (Necator americanus/Ancylostoma duodenale) 86.7% (150/173), Trichuris trichiura 60.3% (73/121) and Strongyloides stercoralis 76.9% (60/78). A single dose of albendazole (400 mg) was not highly effective against A. lumbricoides, Hookworm and T. trichiura, although the egg reduction rates (ERRs) for all three STH species were moderate: A. lumbricoides (91.7%; 1378/1503), Hookworm (89%; 808/908) and T. trichiura (30.9%; 79/256): Alternative strategies using species-specific combined therapy, together with an appropriate duration of treatment, are needed to reduce the transmission and burden of STHs in pre-school- and school-aged children.