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Albendazole significantly reduced prevalence of intestinal nematodes
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Individuals treated with albendazole before immigrating to the United States had a significantly reduced incidence of intestinal nematodes compared with those who were untreated, according to study results.
A retrospective cohort study was conducted of 26,956 refugees from Africa and Southeast Asia who settled in Minnesota from 1993 to 2007. Of the cohort, 52.3% were male and 30.1% were children aged 2 to 14 years. (Children younger than 2 years and pregnant women were excluded.)
On May 1, 1999, the CDC issued a recommendation that before departing for the United States all African and Southeast Asian refugees receive a single dose of 600 mg albendazole for treatment of intestinal parasites.
Those who immigrated to the United States from January 1, 1993 to April 30, 1999 were classified as untreated (n=4,370); those who immigrated from May 1, 1999 to December 31, 2007 were classified as albendazole-treated (n=22,586).
The investigators found that nematodes, especially hookworms, were the most common parasite found in the stool of untreated individuals (20.8%). Of the treated individuals, only 4.7% had ≥1 nematodes in their stool specimens.
Schistosoma ova were present only in the African refugees with nematodes, but the prevalence rate was lower in the treated group (prevalence ratio, 0.60).
In the treated group, giardia was the most common parasite in both the Southeast Asian (17.2%) and African (5.7%) refugees.
Researchers said that single-dose albendazole is not uniformly effective against all intestinal parasites. They called it “highly effective” against hookworm and Ascaris lumbricoides, but only “minimally effective” against Strongyloides stercoralis and giardia.
Overall, the investigators found that treated refugees had a 77% reduction in prevalence in nematodes compared with the untreated group.
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