RESUMEN
In countries where soil-transmitted helminth (STH) infections are endemic, deworming programs are recommended to reduce morbidity; however, increasing levels of resistance to benzimidazoles are of concern. In an observational study in Peru, we studied the clinical efficacy of 400 mg of albendazole 20 days after treatment among children aged 2-11 years. Of 426 participants who provided samples, 52.3% were infected with a STH, 144 (33.8%) were positive for Ascaris (41.8% light, 50.8% moderate, and 7.4% heavy infections), 147 (34.5%) were positive for Trichuris (75.2% light, 22.5% moderate, and 2.3% heavy infections), and 1.1% were positive for hookworm species (100% light infections). Additional stool samples were examined at 20, 90, and 130 days after the initial treatment. At 20 days post-administration of albendazole, the cure rate (CR) of Ascaris infection was 80.1% (95% CI: 73.5-86.7), and the egg reduction rate (ERR) was 70.8% (95% CI: 57.8-88.7); the CR for Trichuris infection was 27.1% (95% CI: 20.0-34.3), and the ERR was 29.8% (95% CI: -1.40 to 57.5). Among participants with persistent or recurrent infections with Trichuris, the combined therapy of albendazole (400 mg) and ivermectin at 600 µg/dose increased overall CR for Trichuris infection to 75.2% (95% CI: 67.3-83.2%) with an ERR of 84.2% (95% CI: 61.3-93.8%). Albendazole administration alone for the control of STH was associated with high rates of treatment failure, especially for Trichuris. Combined single doses of albendazole and ivermectin was observed to have improved efficacy.
Asunto(s)
Albendazol , Antihelmínticos , Helmintiasis , Ivermectina , Suelo , Humanos , Albendazol/uso terapéutico , Albendazol/administración & dosificación , Perú/epidemiología , Preescolar , Niño , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Masculino , Femenino , Suelo/parasitología , Helmintiasis/tratamiento farmacológico , Helmintiasis/epidemiología , Antihelmínticos/uso terapéutico , Antihelmínticos/administración & dosificación , Heces/parasitología , Quimioterapia Combinada , Animales , Resultado del Tratamiento , Tricuriasis/tratamiento farmacológico , Tricuriasis/epidemiología , Ascariasis/tratamiento farmacológico , Ascariasis/epidemiología , Trichuris/efectos de los fármacosRESUMEN
Intestinal parasites continue to be a public health problem in low- and middle-income countries. Broad use of anthelmintics during deworming programs is still necessary in many regions. However, description of the usage of these medications in general medical practice has been limited. The objective of this study was to determine the use of anthelmintic drugs and their indications in a group of Colombian patients. This was a descriptive study from a drug-dispensing database, identifying patients with prescriptions for anthelmintic drugs. A total of 381 cases were randomly selected, and their medical records were reviewed, analyzing sociodemographic, clinical, and pharmacological variables (indication of use). The lack of diagnosis registration or clinical manifestations of parasites was determined as a prescription without indication. In total, 50.9% (n = 194) of patients were female, and 67.4% of all patients were under 18 yr of age. The diagnosis of helminthiases was clearly stated in 114 (29.9%) patients, and only 4.2% (n = 16) of these had microbiological confirmation. The most commonly used anthelmintic drug was albendazole (70.4% of all prescriptions). The use of anthelmintics was not indicated in 266 cases (69.8%). Nutritional supplements or vitamin prescriptions were associated with using anthelmintics without indication (odds ratio: 2.25; 95% confidence interval: 1.26-4.03). A high proportion of patients lacked symptoms or diagnoses in their clinical records that supported the use of anthelmintic drugs.
Asunto(s)
Antihelmínticos , Helmintiasis , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Albendazol/uso terapéutico , Antihelmínticos/uso terapéutico , Colombia/epidemiología , Estudios Transversales , Helmintiasis/tratamiento farmacológico , Helmintiasis/epidemiologíaAsunto(s)
Helmintiasis , Enfermedades Parasitarias , Humanos , Enfermedades Parasitarias/tratamiento farmacológico , Helmintiasis/tratamiento farmacológico , Descubrimiento de Drogas , Enfermedades Desatendidas/tratamiento farmacológico , Antiparasitarios/farmacología , Antiparasitarios/uso terapéuticoRESUMEN
Intestinal helminthiasis is a neglected disease that affects a significant portion of the global population, specifically in developing countries, where medicinal plants are widely used for therapeutic purposes. With the purpose to identify the native species used in traditional Brazilian medicine for the management of helminthiasis, ethnopharmacological books edited in Brazil documenting the folk use of medicinal plants were analyzed. The native species cited in at least three studies were selected, and bibliographic research was performed using electronic databases to identify their scientifically validated anthelmintic properties. The search retrieved 133 native species belonging to 88 genera and 43 families from all six Brazilian biomes. Fabaceae (14 Genera and 25 Species) and Asteraceae (7 Genera and 8 Species) were the most frequently cited families. The most reported native species were Baccharis crispa Spreng., Hymenaea courbaril L., Senna occidentalis (L.) Link, Carapa guianensis Aubl., Stachytarpheta cayennensis (Rich.) Vahl, Annona glabra L., Hymenaea stigonocarpa Mart. ex Hayne, Spigelia anthelmia L., Simarouba versicolor A.St.-Hil. and Anacardium occidentale L. Bark (19%) and leaves (17%) were the most commonly used plant parts, and decoction (27%) was the most preferred method of preparation. Evidence of the anthelmintic properties of most species was confirmed using in vitro assays for key human and animal parasites, including Haemonchus contortus, Hymenolepis diminuta, Schistosoma mansoni and Trichostrongylus spp. The species S. alata, S. occidentalis, A. occidentale, and S. anthelmia have been the subject of many biological studies, supporting their use as vermicides. The overall results obtained in this review revealed that Brazil is rich in traditional herbal medicines used to manage helminthiasis; however pharmacological investigations are lacking to confirm their therapeutic properties. Thus, this study could serve as a baseline to validate their use and encourage further clinical investigation of their vermifuge potential.
Asunto(s)
Antihelmínticos , Baccharis , Helmintiasis , Plantas Medicinales , Animales , Humanos , Brasil , Fitoterapia/métodos , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud , Etnobotánica , Helmintiasis/tratamiento farmacológico , Antihelmínticos/farmacología , Antihelmínticos/uso terapéuticoRESUMEN
BACKGROUND: Deworming programs aimed at reducing morbidity and mortality from geohelminth infections are common in many countries where these infections are endemic, but data demonstrating increasing levels of resistance to albendazole and mebendazole are causes for concern. Studies to evaluate the clinical efficacy of deworming programs are critical to maintain high infection control goals. METHODS: We propose to assess the clinical efficacy of Peruvian national guidelines for deworming programs in a prospective observational study conducted in the Amazon River basin area near Iquitos, Peru. Major outcomes to be evaluated include (1) albendazole resistance of intestinal helminths (trichuriasis, ascariasis, hookworm), and (2) frequency of reinfection with intestinal helminths 4 months after treatment with albendazole. Children ages 2-11 years from the Belén District of Iquitos will be identified based on a community census. Following parental informed consent, demographic data, weight, and height will be recorded and a stool specimen for parasitological exam by direct observation and Kato-Katz concentration method, and helminthic egg counts will be collected prior to administration of albendazole, following Peruvian national guidelines. Follow-up stool specimens examined in the same manner will be collected at 20 days, 90 days, and 100 days following initial administration of albendazole, and based on parasites found repeat treatment will be administered in accordance with national guidelines. Real-time multiplex qPCR will be performed on helminth positive samples collected prior to initial deworming and on helminth-positive specimens detected on day 15-20. A total sample size of 380 participants was calculated based on total population in the target group and prevalence estimates of helminth infections and clinical resistance based on recent data. DISCUSSION: Data from observational clinical efficacy studies are important to guide geohelminth infection control programs. Trial registration https://www.researchregistry.com/ . Identification number: researchregistry7736; Registered retrospectively March 13, 2022; https://www.researchregistry.com/browse-the-registry#home/registrationdetails/622e024cf06132001e3327bf/.
Asunto(s)
Antihelmínticos , Helmintiasis , Helmintos , Infecciones por Trematodos , Albendazol/uso terapéutico , Animales , Antihelmínticos/uso terapéutico , Niño , Preescolar , Heces/parasitología , Helmintiasis/tratamiento farmacológico , Helmintiasis/epidemiología , Humanos , Parasitosis Intestinales , Estudios Observacionales como Asunto , Perú/epidemiología , Reinfección , Estudios Retrospectivos , Suelo/parasitología , Infecciones por Trematodos/tratamiento farmacológicoRESUMEN
INTRODUCTION: Infections caused by parasitic flatworms impose a considerable worldwide health burden. Recently, World Health Organization launched its roadmap for neglected diseases for the period 2021 to 2030 and oral treatment with praziquantel (PZQ) in tablet form is the main drug therapy for combating these diseases, but its use is limited by many drawbacks, including the high therapeutic dose due to the drug's low solubility and bioavailability. Among the strategies to improve PZQ performance, the use of drug nanocarriers has been cited as an interesting approach to overcome these pharmacological issues. AREAS COVERED: This review focuses on the various types of nanomaterials (polymeric, lipidic, inorganic nanoparticles, and nanocrystals) which have been recently used to improve PZQ therapy. In addition, recent advances in PZQ nanoformulations, developed to overcome the barriers of the conventional drug are described. EXPERT OPINION: Considering the poor rate of discovery in the anthelmintic segment observed in recent decades, the effective management of existing drugs has become essential. The application of new strategies based on nanotechnology can extend the useful life of PZQ in new and more effective formulations. Pharmaceutical nanotechnology can solve the pharmacokinetic challenges characteristic of PZQ and improve its solubility and bioavailability.
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Antihelmínticos , Helmintiasis , Antihelmínticos/química , Antihelmínticos/uso terapéutico , Disponibilidad Biológica , Helmintiasis/tratamiento farmacológico , Humanos , Praziquantel/farmacología , Praziquantel/uso terapéutico , SolubilidadRESUMEN
Soil-transmitted-helminth (STH) infections are a persistent global public health problem. Control strategies for STH have been based on the use of mass drug administration (MDA) mainly targeting preschool- and school-aged-children, although there is increasing interest in expanding treatment to include adults and others through community-wide MDA. Coverage assessment is critical to understanding the real effectiveness of albendazole (ALB) treatment in those MDA programs. The work described here aims to (i) evaluate the effect of type of diet (a heavy or light meal) and fasting before ALB treatment on the systemic disposition of ALB and its metabolites in treated human volunteers and (ii) evaluate the potential feasibility of detecting albendazole metabolites in urine. The data reported here demonstrate that the systemic availability of the active ALB-sulfoxide (ALBSO) metabolite was enhanced more than 2-fold after food ingestion (a heavy or light meal). ALB dissolution improvement related to the ingestion of food may modify the amount of drug/metabolites reaching the parasite, affecting drug efficacy and the overall success of MDA strategies. The measurement in urine samples of the amino-ALB-sulfone (NHALBSO2) derivative and ALBSO for up to 96 h suggests that it may be feasible to develop a noninvasive tool to evaluate compliance/adherence to ALB treatment.
Asunto(s)
Antihelmínticos , Helmintiasis , Absorción Fisiológica , Adulto , Albendazol/uso terapéutico , Antihelmínticos/uso terapéutico , Niño , Preescolar , Voluntarios Sanos , Helmintiasis/tratamiento farmacológico , Humanos , Administración Masiva de Medicamentos , SueloRESUMEN
BACKGROUND: Efforts to control soil-transmitted helminth (STH) infections have intensified over the past decade. Field-survey data on STH prevalence, infection intensity and drug efficacy is necessary to guide the implementation of control programs and should be of the best possible quality. METHODOLOGY: During four clinical trials designed to evaluate the efficacy of albendazole against STHs in Brazil, Ethiopia, Lao PDR and Tanzania, quality control (QC) was performed on the duplicate Kato-Katz thick smears and the data entry. We analyzed datasets following QC on both fecal egg counts (FECs) and data entry, and compared the prevalence of any STH infection and moderate-to-heavy intensity (MHI) infections and the drug efficacy against STH infections. RESULTS: Across the four study sites, a total of 450 out of 4,830 (9.3%) Kato-Katz thick smears were re-examined. Discrepancies in FECs varied from ~3% (hookworms) to ~6.5% (Ascaris lumbricoides and Trichuris trichiura). The difference in STH prevalence and prevalence of MHI infections using the datasets with and without QC of the FECs did not exceed 0.3%, except for hookworm infections in Tanzania, where we noted a 2.2 percentage point increase in MHI infections (pre-QC: 1.6% vs. post-QC: 3.8%). There was a 100% agreement in the classification of drug efficacy of albendazole against STH between the two datasets. In total, 201 of the 28,980 (0.65%) data entries that were made to digitize the FECs were different between both data-entry clerks. Nevertheless, the overall prevalence of STH, the prevalence of MHI infections and the classification of drug efficacy remained largely unaffected. CONCLUSION/SIGNIFICANCE: In these trials, where staff was informed that QC would take place, minimal changes in study outcomes were reported following QC on FECs or data entry. Nevertheless, imposing QC did reduce the number of errors. Therefore, application of QC together with proper training of the personnel and the availability of clear standard operating procedures is expected to support higher data quality.
Asunto(s)
Albendazol/uso terapéutico , Helmintiasis/tratamiento farmacológico , Control de Calidad , Ancylostomatoidea , Animales , Ascaris , Brasil/epidemiología , Ensayos Clínicos como Asunto , Etiopía/epidemiología , Heces/parasitología , Guías como Asunto , Helmintiasis/epidemiología , Helmintiasis/transmisión , Infecciones por Uncinaria/tratamiento farmacológico , Infecciones por Uncinaria/epidemiología , Humanos , Laos/epidemiología , Recuento de Huevos de Parásitos , Prevalencia , Suelo/parasitología , Tanzanía/epidemiología , TrichurisRESUMEN
BACKGROUND: Large-scale deworming programs have, to date, mostly targeted preschool- and school-age children. As community-based deworming programs become more common, deworming will be offered to women of reproductive age. The World Health Organization recommends preventive chemotherapy be administered to pregnant women only after the first trimester. It is therefore important for deworming programs to be able to identify women in early pregnancy. Our objective was to validate a short questionnaire which could be used by deworming program managers to identify and screen out women in early pregnancy. METHODOLOGY/PRINCIPAL FINDINGS: In May and June 2018, interviewers administered a questionnaire, followed by a pregnancy test, to 1,203 adult women living in the Peruvian Amazon. Regression analyses were performed to identify questions with high predictive properties (using the pregnancy test as the gold standard). Test parameters were computed at different decision tree nodes (where nodes represented questions). With 106 women confirmed to be pregnant, the positive predictive value of asking the single question 'Are you pregnant?' was 100%, at a 'cost' of a false negative rate of 1.9% (i.e. 21 women were incorrectly identified as not pregnant when they were truly pregnant). Additional questions reduced the false negative rate, but increased the false positive rate. Rates were dependent on both the combination and the order of questions. CONCLUSIONS/SIGNIFICANCE: To identify women in early pregnancy when deworming programs are community-based, both the number and order of questions are important. The local context and cultural acceptability of different questions should inform this decision. When numbers are manageable and resources are available, pregnancy tests can be considered at different decision tree nodes to confirm pregnancy status. Trade-offs in terms of efficiency and misclassification rates will need to be considered to optimize deworming coverage in women of reproductive age.
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Embarazo , Encuestas y Cuestionarios , Adulto , Femenino , Helmintiasis/tratamiento farmacológico , Helmintiasis/prevención & control , Humanos , Persona de Mediana Edad , Perú , Pruebas de EmbarazoRESUMEN
Intestinal parasites cause a significant public health problem worldwide due to the associated morbidities, mainly in infected school-aged children (SAC). The strategy of large-scale deworming in SAC to control the transmission of soil-transmitted helminths (STH) has been advocated by the World Health Organization and was recently adopted in Brazil; however, the long-term effects of mass deworming on the larger parasitological profile have been less studied. After a five-year period of school-based large-scale treatment for STH using an annual single dose of albendazole in a community of Sergipe state, Brazil, a marked reduction in prevalence was observed (15.4%% vs.7.4% for Ascaris sp., 6.0%% vs. 0.4% for hookworm, and 12.8%% vs. 4.5%% for Trichuris trichiura), with the exception of Strongyloides stercoralis, which had no statistically significant change in prevalence. There was, however, an increase in the prevalence of intestinal protozoans, specifically Entamoeba histolytica/E. dispar (0.0%% vs. 36.0%), Blastocystis hominis (0.0%% vs. 40.1%), and Giardia duodenalis (5.6%% vs. 14.5%). Although the findings showed a dramatic reduction in the prevalence of STH after four rounds of preventive chemotherapy, there was an increase in intestinal protozoan infections, indicating a change in the epidemiological profile.
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Helmintiasis/epidemiología , Parasitosis Intestinales/epidemiología , Infecciones por Protozoos/epidemiología , Suelo/parasitología , Albendazol/uso terapéutico , Animales , Brasil/epidemiología , Quimioprevención , Niño , Femenino , Helmintiasis/tratamiento farmacológico , Humanos , Masculino , PrevalenciaRESUMEN
BACKGROUND: Preventive chemotherapy (PC) with benzimidazole drugs is the backbone of soil-transmitted helminth (STH) control programs. Over the past decade, drug coverage has increased and with it, the possibility of developing anthelmintic resistance. It is therefore of utmost importance to monitor drug efficacy. Currently, a variety of novel diagnostic methods are available, but it remains unclear whether they can be used to monitor drug efficacy. In this study, we compared the efficacy of albendazole (ALB) measured by different diagnostic methods in a head-to-head comparison to the recommended single Kato-Katz. METHODS: An ALB efficacy trial was performed in 3 different STH-endemic countries (Ethiopia, Lao PDR and Tanzania), each with a different PC-history. During these trials, stool samples were evaluated with Kato-Katz (single and duplicate), Mini-FLOTAC, FECPAKG2, and qPCR. The reduction rate in mean eggs per gram of stool (ERR) and mean genome equivalents / ml of DNA extract (GERR) were calculated to estimate drug efficacy. PRINCIPAL FINDINGS AND CONCLUSIONS: The results of the efficacy trials showed that none of the evaluated diagnostic methods could provide reduction rates that were equivalent to a single Kato-Katz for all STH. However, despite differences in clinical sensitivity and egg counts, they agreed in classifying efficacy according to World Health Organization (WHO) guidelines. This demonstrates that diagnostic methods for assessing drug efficacy should be validated with their intended-use in mind and that other factors like user-friendliness and costs will likely be important factors in driving the choice of diagnostics. In addition, ALB efficacy against STH infections was lower in sites with a longer history of PC. Yet, further research is needed to identify factors that contribute to this finding and to verify whether reduced efficacy can be associated with mutations in the ß-tubulin gene that have previously been linked to anthelmintic resistance. TRIAL REGISTRATION: ClinicalTrials.gov NCT03465488.
Asunto(s)
Albendazol/uso terapéutico , Antihelmínticos/uso terapéutico , Helmintiasis/diagnóstico , Helmintiasis/tratamiento farmacológico , Suelo/parasitología , Administración Oral , Albendazol/administración & dosificación , Animales , Brasil , Niño , Pruebas Diagnósticas de Rutina/métodos , Etiopía , Heces/parasitología , Femenino , Helmintos/genética , Humanos , Laos , Masculino , Recuento de Huevos de Parásitos/métodos , Sensibilidad y Especificidad , Tanzanía , Tubulina (Proteína)/genética , Organización Mundial de la SaludRESUMEN
Helminth infections may inhibit the development of allergic diseases, including asthma. On the other hand, some helminth species may induce or worsen symptoms of asthma. This article discusses the impact of helminth infections on asthma as well as the potencial of helminth-derived molecules with regulatory characteristics in the prevention or treatment of this disease. The ability to induce regulation has been observed in animal models of asthma or cells of asthmatic individuals in vitro. Potential future clinical applications of helminth antigens or infection for prevention of asthma merit further translational research.
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Asma/etiología , Susceptibilidad a Enfermedades , Helmintiasis/complicaciones , Helmintiasis/inmunología , Helmintos/inmunología , Interacciones Huésped-Parásitos , Animales , Antihelmínticos/farmacología , Antihelmínticos/uso terapéutico , Susceptibilidad a Enfermedades/inmunología , Helmintiasis/tratamiento farmacológico , Helmintiasis/parasitología , Interacciones Huésped-Parásitos/inmunología , Humanos , Inmunomodulación/efectos de los fármacosRESUMEN
The gastrointestinal nematodes (GIN) stand out as an important cause of disease in small ruminant, especially on goat farm. Widespread resistance to synthetic anthelminthics has stimulated the research for alternative strategies of parasite control, including the use of medicinal plants. The present work summarizes the in vitro and in vivo studies of plants with activity against GIN of goats, focusing on the description of chemical constituents related to this effect. This review retrieved 56 scientific articles from 2008 to 2018 describing more than 100 different plant species. The most frequently investigated family was Fabaceae (30.7%). Most in vitro studies on the activity of plant extracts and fractions were carried out with of free-living stages nematodes. In vivo studies were conducted mainly with the use of plants in animal feed and generally showed lower effectiveness compared to in vitro assays. The main plant secondary metabolites associated with anthelmintic effect are condensed tannins, saponin and flavonoids. However, the studies with compounds isolated from plants and elucidation of their mechanisms of action are scarce. Herbal medicines are thought to be promising sources for the development of effective anthelmintic agents.
Asunto(s)
Antihelmínticos/farmacología , Enfermedades de las Cabras/parasitología , Helmintiasis Animal/parasitología , Parasitosis Intestinales/veterinaria , Nematodos/efectos de los fármacos , Infecciones por Nematodos/veterinaria , Extractos Vegetales/farmacología , Animales , Antihelmínticos/aislamiento & purificación , Antihelmínticos/uso terapéutico , Enfermedades de las Cabras/tratamiento farmacológico , Cabras , Helmintiasis/tratamiento farmacológico , Helmintiasis/parasitología , Helmintiasis Animal/tratamiento farmacológico , Parasitosis Intestinales/tratamiento farmacológico , Parasitosis Intestinales/parasitología , Nematodos/aislamiento & purificación , Infecciones por Nematodos/tratamiento farmacológico , Infecciones por Nematodos/parasitología , Pruebas de Sensibilidad Parasitaria , Extractos Vegetales/aislamiento & purificación , Extractos Vegetales/uso terapéutico , Plantas Medicinales/química , Resultado del TratamientoRESUMEN
BACKGROUND: The World Health Organization has recently reemphasized the importance of providing preventive chemotherapy to women of reproductive age in countries endemic for soil-transmitted helminthiasis as they are at heightened risk of associated morbidity. The Demographic and Health Surveys (DHS) Program is responsible for collecting and disseminating accurate, nationally representative data on health and population in developing countries. Our study aims to estimate the number of pregnant women at risk of soil-transmitted helminthiasis that self-reported deworming by antenatal services in endemic countries that conducted Demographic and Health Surveys. METHODOLOGY/PRINCIPAL FINDINGS: The number of pregnant women living in endemic countries was extrapolated from the United Nations World Population Prospects 2015. National deworming coverage among pregnant women were extracted from Demographic and Health Surveys and applied to total numbers of pregnant women in the country. Sub-national DHS with data on self-reported deworming were available from 49 of the 102 endemic countries. In some regions more than 73% of STH endemic countries had a DHS. The DHS report an average deworming coverage of 23% (CI 19-28), ranging from 2% (CI 1-3) to 35% (CI 29-40) in the different regions, meaning more than 16 million pregnant women were dewormed in countries surveyed by DHS. The deworming rates amongst the 43 million pregnant women in STH endemic countries not surveyed by DHS remains unknown. CONCLUSIONS/SIGNIFICANCE: These estimates will serve to establish baseline numbers of deworming coverage among pregnant women, monitor progress, and urge endemic countries to continue working toward reducing the burden of soil-transmitted helminthiasis. The DHS program should be extended to STH-endemic countries currently not covering the topic of deworming during pregnancy.
Asunto(s)
Antihelmínticos/uso terapéutico , Helmintiasis/tratamiento farmacológico , Helmintos/aislamiento & purificación , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Suelo/parasitología , Adulto , África/epidemiología , Animales , Asia/epidemiología , Enfermedades Endémicas/prevención & control , Femenino , Helmintiasis/epidemiología , Helmintos/clasificación , Helmintos/genética , Humanos , Embarazo , Complicaciones Parasitarias del Embarazo/epidemiología , Autoinforme , América del Sur/epidemiología , Organización Mundial de la Salud , Adulto JovenRESUMEN
INTRODUCTION: Oxfendazole (methyl [5-(phenylsulphinyl)-1H benzimidazole-2-yl] carbamate) has a particularly long metabolic half-life in ruminants, and its metabolite fenbendazole also has anthelminthic action. A very limited number of drugs are available for the treatment of some zoonotic helminth infections, such as neurocysticercosis and echinococcosis. More recent work has expanded oxfendazole's nonclinical safety profile and demonstrated its safety and bioavailability in healthy human volunteers, thus advancing the possibility of a new and greatly needed option for antiparasitic treatment of geohelminths and tissue parasites. Areas covered: The present article reviews evidence supporting the safety and efficacy of oxfendazole against both gut and tissue dwelling helminths in animals, as well as more recent safety and pharmacokinetic data supporting its potential for use in human parasitoses. Expert commentary: The pharmacokinetics, safety, and wide spectrum of efficacy of oxfendazole are consistently demonstrated in intestinal helminth infections of animals as well as in tissue dwelling larval cestode and trematode infections in diverse animal species. Now supported by first-in-human safety and pharmacokinetic data, oxfendazole becomes a promising alternative to the limited portfolio of antiparasitic drugs available to treat helminthic diseases of humans.
Asunto(s)
Antihelmínticos/uso terapéutico , Bencimidazoles/uso terapéutico , Helmintiasis/tratamiento farmacológico , Animales , Antihelmínticos/efectos adversos , Antihelmínticos/farmacocinética , Bencimidazoles/efectos adversos , Bencimidazoles/farmacocinética , Disponibilidad Biológica , Semivida , Helmintiasis/parasitología , Helmintiasis Animal/tratamiento farmacológico , Helmintiasis Animal/parasitología , Humanos , Zoonosis/tratamiento farmacológico , Zoonosis/parasitologíaRESUMEN
BACKGROUND: To work towards reaching the WHO goal of eliminating soil-transmitted helminth (STH) infections as a public health problem, the total number of children receiving anthelmintic drugs has strongly increased over the past few years. However, as drug pressure levels rise, the development of anthelmintic drug resistance (AR) is more and more likely to appear. Currently, any global surveillance system to monitor drug efficacy and the emergence of possible AR is lacking. Consequently, it remains unclear to what extent the efficacy of drugs may have dropped and whether AR is already present. The overall aim of this study is to recommend the best diagnostic methods to monitor drug efficacy and molecular markers to assess the emergence of AR in STH control programs. METHODS: A series of drug efficacy trials will be performed in four STH endemic countries with varying drug pressure (Ethiopia and Brazil: low drug pressure, Lao PDR: moderate drug pressure and Tanzania: high drug pressure). These trials are designed to assess the efficacy of a single oral dose of 400 mg albendazole (ALB) against STH infections in school-aged children (SAC) by microscopic (duplicate Kato-Katz thick smear, Mini-FLOTAC and FECPAKG2) and molecular stool-based diagnostic methods (quantitative PCR (qPCR)). Data will be collected on the cost of the materials used, as well as the time required to prepare and examine stool samples for the different diagnostic methods. Following qPCR, DNA samples will also be submitted for pyrosequencing to assess the presence and prevalence of single nucleotide polymorphisms (SNPs) in the ß-tubulin gene. These SNPs are known to be linked to AR in animal STHs. DISCUSSION: The results obtained by these trials will provide robust evidence regarding the cost-efficiency and diagnostic performance of the different stool-based diagnostic methods for the assessment of drug efficacy in control programs. The assessment of associations between the frequency of SNPs in the ß-tubulin gene and the history of drug pressure and drug efficacy will allow the validation of these SNPs as a marker for AR in human STHs. TRIAL REGISTRATION: The trial was retrospectively registered the 7th of March 2018 on Clinicaltrials.gov (ID: NCT03465488).
Asunto(s)
Antihelmínticos/administración & dosificación , Bencimidazoles/administración & dosificación , Resistencia a Medicamentos , Heces/parasitología , Helmintiasis/diagnóstico , Helmintiasis/tratamiento farmacológico , Helmintos/efectos de los fármacos , Adolescente , Animales , Biomarcadores/química , Brasil , Niño , Preescolar , Protocolos Clínicos , Etiopía , Femenino , Proteínas del Helminto/genética , Helmintiasis/parasitología , Helmintos/genética , Helmintos/fisiología , Humanos , Masculino , Recuento de Huevos de Parásitos , Polimorfismo de Nucleótido Simple , Instituciones Académicas/estadística & datos numéricos , Suelo/parasitología , Tubulina (Proteína)/genéticaRESUMEN
Increasing drug resistance in gastrointestinal (GI) parasites of livestock and concerns about chemical residues in animal products and the environment are driving the development of alternative control strategies that are less reliant on the use of synthetic drugs. An increasingly investigated approach is the use of bioactive forages with antiparasitic properties as part of the animal's diet (nutraceuticals) or as potential sources of novel, natural parasiticides. Chicory (Cichorium intybus) is a multi-purpose crop and one of the most promising bioactive forages in temperate regions, and numerous in vivo trials have explored its potential against parasitic nematodes in livestock. However, it is unclear whether chicory can induce a direct and broad activity against various GI parasites in different livestock species, and the levels of chicory in the diet that are required to exert an efficient antiparasitic effect. Moreover, the mechanisms leading to the reported parasiticidal activity of chicory are still largely unknown, and its bioactive phytochemicals have only recently been investigated. In this review, we summarise the progress in the study of the antiparasitic activity of chicory and its natural bioactive compounds against GI parasites in livestock, through examination of the published literature. The available evidence indicates that feeding chicory can reduce faecal egg counts and/or worm burdens of abomasal nematodes, but not infections with intestinal worms, in ruminants. Highly chicory-rich diets (≥ 70% of chicory dry matter in the diet) may be necessary to directly affect abomasal parasitism. Chicory is known to synthesise several bioactive compounds with potential antiparasitic activity, but most research has been devoted to the role of sesquiterpene lactones (SL). Recent in vitro studies have confirmed direct and potent activity of SL-rich extracts from chicory against different GI helminths of livestock. Chicory SL have also been reported to exhibit antimalarial properties and its potential antiprotozoal activity in livestock remains to be evaluated. Furthermore, the detailed identification of the main antiparasitic metabolites of chicory and their pharmacokinetics need further confirmation. Research gaps and perspectives on the potential use of chicory as a nutraceutical forage and a source of bioactive compounds for parasite control in livestock are discussed.
Asunto(s)
Alimentación Animal/análisis , Antiparasitarios/administración & dosificación , Cichorium intybus/química , Suplementos Dietéticos , Nematodos/efectos de los fármacos , Animales , Antihelmínticos/administración & dosificación , Antihelmínticos/química , Antiparasitarios/química , Bovinos , Heces/parasitología , Tracto Gastrointestinal/efectos de los fármacos , Tracto Gastrointestinal/parasitología , Helmintiasis/tratamiento farmacológico , Humanos , Parasitosis Intestinales/tratamiento farmacológico , Ganado/anatomía & histología , Ganado/parasitología , Recuento de Huevos de Parásitos , OvinosRESUMEN
The present study aimed to evaluate the frequency of deworming in horses treated at the HVU Large Animals Clinic. It was observed that the administered product, the frequency of administration and the date of the last vermifugation. We can see that many of the owners were not sure which product they used in the deworming of the animal, the frequency of administration was diverse according to the season, the date of the last deworming was very different in the results, factors that can contribute to a resistance to the anthelmintic used.
Asunto(s)
Animales , Antihelmínticos/uso terapéutico , Caballos/parasitología , Enfermedades Parasitarias en Animales/parasitología , Helmintiasis/prevención & control , Helmintiasis/tratamiento farmacológico , Parásitos/efectos de los fármacosRESUMEN
The present study aimed to evaluate the frequency of deworming in horses treated at the HVU Large Animals Clinic. It was observed that the administered product, the frequency of administration and the date of the last vermifugation. We can see that many of the owners were not sure which product they used in the deworming of the animal, the frequency of administration was diverse according to the season, the date of the last deworming was very different in the results, factors that can contribute to a resistance to the anthelmintic used.(AU)
Asunto(s)
Animales , Caballos/parasitología , Helmintiasis/prevención & control , Helmintiasis/tratamiento farmacológico , Parásitos/efectos de los fármacos , Antihelmínticos/uso terapéutico , Enfermedades Parasitarias en Animales/parasitologíaRESUMEN
BACKGROUND: Nutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic. METHODOLOGY/PRINCIPAL FINDINGS: From February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age. CONCLUSIONS/SIGNIFICANCE: In a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in particular, where whipworm and hookworm infections are of public health concern. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01748929).