TY - JOUR
T1 - The Effect of Three-Monthly Albendazole Treatment on Malarial Parasitemia and Allergy
T2 - A Household-Based Cluster-Randomized, Double-Blind, Placebo-Controlled Trial
AU - Wiria, Aprilianto E.
AU - Hamid, Firdaus
AU - Wammes, Linda J.
AU - Kaisar, Maria M.M.
AU - May, Linda
AU - Prasetyani, Margaretta A.
AU - Wahyuni, Sitti
AU - Djuardi, Yenny
AU - Ariawan, Iwan
AU - Wibowo, Heri
AU - Lell, Bertrand
AU - Sauerwein, Robert
AU - Brice, Gary T.
AU - Sutanto, Inge
AU - van Lieshout, Lisette
AU - de Craen, Anton J.M.
AU - van Ree, Ronald
AU - Verweij, Jaco J.
AU - Tsonaka, Roula
AU - Houwing-Duistermaat, Jeanine J.
AU - Luty, Adrian J.F.
AU - Sartono, Erliyani
AU - Supali, Taniawati
AU - Yazdanbakhsh, Maria
PY - 2013/3/19
Y1 - 2013/3/19
N2 - Background: Helminth infections are proposed to have immunomodulatory activities affecting health outcomes either detrimentally or beneficially. We evaluated the effects of albendazole treatment, every three months for 21 months, on STH, malarial parasitemia and allergy. Methods and Findings: A household-based cluster-randomized, double-blind, placebo-controlled trial was conducted in an area in Indonesia endemic for STH. Using computer-aided block randomization, 481 households (2022 subjects) and 473 households (1982 subjects) were assigned to receive placebo and albendazole, respectively, every three months. The treatment code was concealed from trial investigators and participants. Malarial parasitemia and malaria-like symptoms were assessed in participants older than four years of age while skin prick test (SPT) to allergens as well as reported symptoms of allergy in children aged 5-15 years. The general impact of treatment on STH prevalence and body mass index (BMI) was evaluated. Primary outcomes were prevalence of malarial parasitemia and SPT to any allergen. Analysis was by intention to treat. At 9 and 21 months post-treatment 80.8% and 80.1% of the study subjects were retained, respectively. The intensive treatment regiment resulted in a reduction in the prevalence of STH by 48% in albendazole and 9% in placebo group. Albendazole treatment led to a transient increase in malarial parasitemia at 6 months post treatment (OR 4.16(1.35-12.80)) and no statistically significant increase in SPT reactivity (OR 1.18(0.74-1.86) at 9 months or 1.37 (0.93-2.01) 21 months). No effect of anthelminthic treatment was found on BMI, reported malaria-like- and allergy symptoms. No adverse effects were reported. Conclusions: The study indicates that intensive community treatment of 3 monthly albendazole administration for 21 months over two years leads to a reduction in STH. This degree of reduction appears safe without any increased risk of malaria or allergies. Trial Registration: Controlled-Trials.com ISRCTN83830814.
AB - Background: Helminth infections are proposed to have immunomodulatory activities affecting health outcomes either detrimentally or beneficially. We evaluated the effects of albendazole treatment, every three months for 21 months, on STH, malarial parasitemia and allergy. Methods and Findings: A household-based cluster-randomized, double-blind, placebo-controlled trial was conducted in an area in Indonesia endemic for STH. Using computer-aided block randomization, 481 households (2022 subjects) and 473 households (1982 subjects) were assigned to receive placebo and albendazole, respectively, every three months. The treatment code was concealed from trial investigators and participants. Malarial parasitemia and malaria-like symptoms were assessed in participants older than four years of age while skin prick test (SPT) to allergens as well as reported symptoms of allergy in children aged 5-15 years. The general impact of treatment on STH prevalence and body mass index (BMI) was evaluated. Primary outcomes were prevalence of malarial parasitemia and SPT to any allergen. Analysis was by intention to treat. At 9 and 21 months post-treatment 80.8% and 80.1% of the study subjects were retained, respectively. The intensive treatment regiment resulted in a reduction in the prevalence of STH by 48% in albendazole and 9% in placebo group. Albendazole treatment led to a transient increase in malarial parasitemia at 6 months post treatment (OR 4.16(1.35-12.80)) and no statistically significant increase in SPT reactivity (OR 1.18(0.74-1.86) at 9 months or 1.37 (0.93-2.01) 21 months). No effect of anthelminthic treatment was found on BMI, reported malaria-like- and allergy symptoms. No adverse effects were reported. Conclusions: The study indicates that intensive community treatment of 3 monthly albendazole administration for 21 months over two years leads to a reduction in STH. This degree of reduction appears safe without any increased risk of malaria or allergies. Trial Registration: Controlled-Trials.com ISRCTN83830814.
UR - http://www.scopus.com/inward/record.url?scp=84875110209&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0057899
DO - 10.1371/journal.pone.0057899
M3 - Article
C2 - 23526959
AN - SCOPUS:84875110209
SN - 1932-6203
VL - 8
JO - PLoS ONE
JF - PLoS ONE
IS - 3
M1 - e57899
ER -