pyrantel-pamoate and Hookworm-Infections

Soil-transmitted helminths (Ascaris lumbricoides, hookworm and Trichuris trichiura) infect about one-fifth of the world's population. The currently available drugs are all highly efficacious against A. lumbricoides. However, they are only moderately efficacious against hookworm and poorly efficacious against T. trichiura. Oxantel, a tetrahydropyrimidine derivative discovered in the 1970s, has recently been brought back to our attention given its high efficacy against T. trichiura infections (estimated 76% cure rate and 85% egg reduction rate at a 20 mg/kg dose). This review summarizes the current knowledge on oxantel pamoate and its use against T. trichiura infections in humans. Oxantel pamoate acts locally in the human gastrointestinal tract and binds to the parasite's nicotinic acetylcholine receptor (nAChR), leading to a spastic paralysis of the worm and subsequent expulsion. The drug is metabolically stable, shows low permeability and low systemic bioavailability after oral use. Oxantel pamoate was found to be safe in humans, with only a few mild adverse events reported. Several clinical trials have investigated the efficacy of this drug against T. trichiura and suggest that oxantel pamoate is more efficacious against T. trichiura than the currently recommended drugs, which makes it a strong asset to the depleted drug armamentarium and could help delay or even prevent the development of resistance to existing drugs. We highlight existing data to support the use of oxantel pamoate against T. trichiura infections.

Topics: Animals; Antinematodal Agents; Dose-Response Relationship, Drug; Drug Interactions; Hookworm Infections; Humans; Pyrantel Pamoate; Trichuris

More than a quarter of the human population is likely infected with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) in highly endemic areas. Preventive chemotherapy is the mainstay of control, but only 4 drugs are available: albendazole, mebendazole, levamisole, and pyrantel pamoate.. To assess the efficacy of single-dose oral albendazole, mebendazole, levamisole, and pyrantel pamoate against A lumbricoides, hookworm, and T trichiura infections.. A systematic search of PubMed, ISI Web of Science, ScienceDirect, the World Health Organization library database, and the Cochrane Central Register of Controlled Trials (1960 to August 2007).. From 168 studies, 20 randomized controlled trials were included.. Information on study year and country, sample size, age of study population, mean infection intensity before treatment, diagnostic method used, time between evaluations before and after treatment, cure rate (the percentage of individuals who became helminth egg negative following treatment with an anthelminthic drug), egg reduction rate, adverse events, and trial quality was extracted. Relative risk, including a 95% confidence interval (CI), was used to measure the effect of the drugs on the risk of infection prevalence with a random-effects model.. Single-dose oral albendazole, mebendazole, and pyrantel pamoate for infection with A lumbricoides resulted in cure rates of 88% (95% CI, 79%-93%; 557 patients), 95% (95% CI, 91%-97%; 309 patients), and 88% (95% CI, 79%-93%; 131 patients), respectively. Cure rates for infection with T trichiura following treatment with single-dose oral albendazole and mebendazole were 28% (95% CI, 13%-39%; 735 patients) and 36% (95% CI, 16%-51%; 685 patients), respectively. The efficacy of single-dose oral albendazole, mebendazole, and pyrantel pamoate against hookworm infections was 72% (95% CI, 59%-81%; 742 patients), 15% (95% CI, 1%-27%; 853 patients), and 31% (95% CI, 19%-42%; 152 patients), respectively. No pooled relative risks could be calculated for pyrantel pamoate against T trichiura and levamisole for any of the parasites investigated.. Single-dose oral albendazole, mebendazole, and pyrantel pamoate show high cure rates against A lumbricoides. For hookworm infection, albendazole was more efficacious than mebendazole and pyrantel pamoate. Treatment of T trichiura with single oral doses of current anthelminthics is unsatisfactory. New anthelminthics are urgently needed.

Topics: Albendazole; Ancylostomatoidea; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Hookworm Infections; Humans; Levamisole; Mebendazole; Pyrantel Pamoate; Soil; Trichuriasis; Trichuris

This article discusses strongyloidiasis, hookworm infection, trichostrongyliasis, ascariasis, trichuriasis (whipworm infection), and enterobiasis (pinworm infection). For each infection, the author describes the organism, the epidemiology and geographic distribution, symptomatology and pathogenesis, and diagnosis and treatment.

Topics: Adolescent; Adult; Age Factors; Animals; Ascariasis; Child; Child, Preschool; Female; Hookworm Infections; Humans; Infant; Intestinal Diseases, Parasitic; Male; Mebendazole; Nematode Infections; Oxyuriasis; Piperazines; Pyrantel Pamoate; Strongyloides; Strongyloidiasis; Thiabendazole; Trichostrongylosis; Trichuriasis

Diagnosis of soil-transmitted helminths (STHs) in developing countries is commonly based on microscopic detection of eggs in stool samples, using the Kato-Katz (KK) method, which has a poor sensitivity for detecting light intensity infections. We compared the performance of the KK method and real-time PCR in the framework of a randomized trial, which evaluated four novel treatments against Trichuris trichiura and concomitant STH infections.. Two stool samples obtained from 320 participants were examined at baseline and follow-up with quadruplicate KK and PCR analyses of one of the two samples using "bead-beating" for DNA extraction. At follow-up, 80 samples were negative according to both PCR and KK and 173 were positive with both methods for any of the STHs. Relative to PCR, the calculated sensitivity of KK at follow-up was 83.6%, 43.0% and 53.8% for T. trichiura, for hookworm and for Ascaris lumbricoides, respectively. The sensitivity of PCR compared with KK at this time point was 89.1% for T. trichiura, 72.7% for hookworm and 87.5% for A. lumbricoides. Cure rates (CRs) for T. trichiura and A. lumbricoides were slightly lower with the PCR method. For hookworm CRs with KK were mostly significantly lower, namely 36.7%, 91.1%, 72.2% and 77.8% for moxidectin, moxidectin in combination with tribendimidine, moxidectin in combination with albendazole and albendazole in combination with oxantel pamoate, respectively, whereas with PCR the CRs were 8.3%, 82.6%, 37.1% and 57.1%, respectively.. In conclusion, a single real-time PCR is as sensitive as quadruplicate KK for T. trichiura and A. lumbricoides detection but more sensitive for hookworm, which has an influence on the estimated treatment efficacy. PCR method with DNA extraction using the "bead-beating protocol" should be further promoted in endemic areas and laboratories that can afford the needed equipment. The study is registered at ISRCTN (no. 20398469).

Topics: Adolescent; Albendazole; Ancylostomatoidea; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Child; Diagnostic Tests, Routine; DNA, Helminth; Feces; Female; Hookworm Infections; Humans; Macrolides; Male; Phenylenediamines; Pyrantel Pamoate; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Soil; Trichuriasis; Trichuris; Young Adult

Albendazole and mebendazole are commonly used to control hookworm, but have shortcomings in their efficacy profiles. We assessed whether triple drug therapy (TDT) with albendazole, pyrantel pamoate, and oxantel pamoate was more effective than the co-administration of two drugs for the treatment of hookworm infections.. A randomised, single-blind trial was done from Sept 27 until Nov 17, 2017, in Laos. Children (6-15 years) from six schools were invited to participate. Hookworm-positive children were randomly assigned (2:2:1:1) by a computer stratified list (block sizes of six and 12) to TDT with albendazole (400 mg), pyrantel pamoate (20 mg/kg), and oxantel pamoate (20 mg/kg); albendazole plus oxantel pamoate; pyrantel pamoate plus oxantel pamoate; or mebendazole (500 mg) combined with both pyrantel pamoate and oxantel pamoate (used as proof of concept to compare the two TDTs). Two stool samples were collected at baseline and follow-up (17-30 days after treatment) and analysed with the Kato-Katz method. The primary outcome was the proportion of hookworm egg-negative children at follow-up in all Kato-Katz slides (cure rate [CR]) in the TDT with albendazole, pyrantel pamoate, and oxantel pamoate group compared with the albendazole plus oxantel pamoate and pyrantel pamoate plus oxantel pamoate groups. Secondary outcomes were tolerability 3 h and 24 h after treatment, egg reduction rates (ERRs) against hookworm, and efficacy against concomitant soil-transmitted helminth infections. Participating children and field and laboratory technicians were masked to treatment allocation. All children with follow-up data were included in the primary analysis. This trial is registered with ClinicalTrials.gov, number NCT03278431.. 1529 children were assessed for eligibility, of whom 533 provided complete baseline data and 414 provided complete outcome data. The CR was higher for the TDT albendazole, pyrantel pamoate, and oxantel pamoate (116 [84%] of 138) than with albendazole plus oxantel pamoate (73 [53%] of 138; odds ratio 4·7, 95% CI 2·7-8·3; p<0·0001) and pyrantel pamoate plus oxantel pamoate (36 [52%] of 69; 4·8, 2·5-9·3; p<0·0001). The geometric ERR of the TDT albendazole, pyrantel pamoate, and oxantel pamoate (99·9%) was higher than that for albendazole plus oxantel pamoate (99·0%; difference in ERR 0·9 percentage points, 95% CI 0·5-1·4), and pyrantel pamoate plus oxantel pamoate (99·2%; 0·7 percentage points, 0·3-1·3). Adverse events were reported by six (1%) children 3 h and none 24 h after treatment, without any difference across treatment groups.. TDT with albendazole, pyrantel pamoate, and oxantel pamoate could make a difference, in particular in the context of soil-transmitted helminth elimination. Pyrantel pamoate might be a useful alternative to prevent benzimidazole resistance; however, larger trials are needed to confirm this finding.. Swiss National Science Foundation.

Topics: Adolescent; Albendazole; Ancylostomatoidea; Animals; Anthelmintics; Child; Drug Combinations; Female; Hookworm Infections; Humans; Laos; Male; Mebendazole; Pyrantel Pamoate; Single-Blind Method; Treatment Outcome

Infections with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) are widespread and often occur concomitantly. These parasitic-worm infections are typically treated with albendazole or mebendazole, but both drugs show low efficacy against T. trichiura. Albendazole is the drug of choice against hookworm.. In this double-blind trial conducted on Pemba Island, Tanzania, we randomly assigned children, 6 to 14 years of age, to receive one of four treatments: oxantel pamoate at a dose of 20 mg per kilogram of body weight, plus 400 mg of albendazole, administered on consecutive days; oxantel pamoate at a single dose of 20 mg per kilogram; albendazole at a single dose of 400 mg; or mebendazole at a single dose of 500 mg. We assessed the efficacy and safety profile of oxantel pamoate-albendazole when used in the treatment of T. trichiura infection (primary outcome) and concomitant soil-transmitted helminth infection (secondary outcome). Efficacy was determined by means of assessment of the cure rate and egg-reduction rate. Adverse events were assessed four times after treatment.. Complete data were available for 458 children, of whom 450 were infected with T. trichiura, 443 with hookworm, and 293 with A. lumbricoides. The cure rate of T. trichiura infection was significantly higher with oxantel pamoate-albendazole than with mebendazole (31.2% vs. 11.8%, P=0.001), as was the egg-reduction rate (96.0% [95% confidence interval {CI}, 93.5 to 97.6] vs. 75.0% [95% CI, 64.2 to 82.0]). The cure rate with albendazole (2.6%) and the egg-reduction rate with albendazole (45.0%; 95% CI, 32.0 to 56.4) were significantly lower than the rates with mebendazole (P=0.02 for the comparison of cure rates). Oxantel pamoate had low efficacy against hookworm and A. lumbricoides. Adverse events (mainly mild) were reported by 30.9% of all children.. Treatment with oxantel pamoate-albendazole resulted in higher cure and egg-reduction rates for T. trichiura infection than the rates with standard therapy. (Funded by the Medicor Foundation and the Swiss National Science Foundation; Current Controlled Trials number, ISRCTN54577342.).

Topics: Adolescent; Albendazole; Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Child; Double-Blind Method; Drug Therapy, Combination; Female; Hookworm Infections; Humans; Male; Mebendazole; Pyrantel Pamoate; Trichuriasis; Trichuris

To study the anthelmintic effect of albendazole composite (containing 67 mg of albendazole and 83.3 mg base of pyrantel pamoate per tablet).. A randomized controlled study was carried out to compare the efficacy of a single dose of 3 or 2 tablets of albendazole composite versus a single dose of 400 mg of albendazole or 10 mg base/kg of pyrantel pamoate for treatment of intestinal nematodiasis including 1,864 cases infected with hookworm, 1,568 cases infected with Ascaris, 1,785 cases infected with Tricuris trichiura and 373 children infected with Enterobius vermicularis.. In adults, the egg negative conversion rate of a single dose of 3 or 2 tablets of albendazole composite reached 65.0% and 52.7% for hookworm infection (P < 0.01), 100% and 100% for Ascaris infection, and 26.5% and 19.2% for Trichuris infection (P < 0.01), respectively. There were significantly better effect against hookworm with 3 tablets of albendazole composite than that with single albendazole or pyrantel pamoate (65.0% vs. 47.6% and 38.5%, P < 0.01). The effect of 2 tablets of albendazole composite against hookworm was also higher than that of single pyrantel pamoate (P < 0.01) and equal to single albendazole but the anthelmintic effect against Trichuris infection was lower than that of single albendazole (19.2% vs. 26.5%). In 2-6-year-old children, the effect of 1.5 tablets of albendazole composite against Enterobius vermicularis infection showed an egg negative conversion rate of 100% which was higher than that of single pyrantel pamoate (100% vs. 83.0%, P < 0.01). The worm collection data showed that the worm-expelling action of albendazole composite was much more rapid than that of albendazole. There were no adverse effects of albendazole composite on blood picture, liver or renal function and ECG. The side effect of both 3 and 2 tablets of albendazole composite was mild and transcient.. Albendazole composite exhibits a synergistic effect of both albendazole and pyrantel pamoate.

Topics: Adolescent; Adult; Aged; Albendazole; Animals; Antinematodal Agents; Ascaris; Child; Child, Preschool; Drug Combinations; Drug Synergism; Enterobius; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Middle Aged; Parasite Egg Count; Pyrantel Pamoate

Chewable pyrantel pamoate tablets were administered to children randomly assigned to three treatment groups. Individuals in each group were instructed either to swallow whole, to chew and swallow, or to swallow previously pulverized tablets. With respect to Ascaris, results of posttreatment stool examinations indicated no differences in cure rates and egg reduction rates between the different modes of treatment. However, for both hookworm and Trichuris, mean egg counts increased for both swallow and chew groups, but decreased in the pulverized group. In addition to the highest egg reduction rates, the most parasitological cures were also seen in the pulverized group for these two worms. The status of standards for chewable tablets is discussed. Until the standards are changed it is recommended that all chewable tablets be crushed before swallowing.

Topics: Adolescent; Ascariasis; Child; Hookworm Infections; Humans; Mastication; Nematode Infections; Pyrantel Pamoate; Tablets; Trichuriasis

A total of 166 cases were divided into 3 groups: group A comprised 55, group B 54 and group C 57 cases. Group A received ivermectin 0.1 mg/kg orally at a single dose, the cure rates were 100%, 3.8% and 50% for ascaris, hookworm and trichuris, infections respectively: group B received ivermectin 0.2 mg/kg orally at a single dose, the corresponding cure rates were 95.5%, 11.8% and 76.5% respectively; group C received pyrantel pamoate 10 mg/kg orally at a single dose, the corresponding cure rates were 95.5%, 29.6% and 31.6% respectively. Although the cure rates were very low for hookworm infection in both group A and B, however, a number of adult worms of Ancylostoma duodenale and Necator americanus were expelled aster medication; It indicates that ivermectin has some effects on these two species of human hookworm. Side effects were mild and transient in all groups.

Topics: Adolescent; Adult; Ancylostoma; Animals; Ascariasis; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Ivermectin; Necator americanus; Nematode Infections; Pyrantel Pamoate; Trichuriasis

The efficacy of broad-spectrum anthelmintics in current use was studied in Hengshan County, Hunan Province. The vermicides under study include albendazole (400mg, single dose), mebendazole composite (mebendazole 100 mg and levamisole 25mg bid x 3d), oxantel pyrantel pamoate composite (pyrantel pamoate 150 mg and oxantel pamoate 150 mg bid x 2d), and pyrantel pamoate composite (base 10 mg/kg, single dose). Therapeutic effect assessed 2 weeks after medication revealed Ascaris egg negative rates or cure rates (CR) of 97.5-100% for the former 3 regimens, and 80.9% for the latter one; while CR for hookworm infection were 95.4%, 78.6-100%, 96.7% and 83.3%, respectively. A follow-up survey pursued 4 weeks post treatment showed no significant difference in CR for the above regimens. Judging from CR in Trichuris trichiura infection, pyrantel pamoate composite was recommended as the drug of choice (89.3%), which was followed by mebendazole composite (64.6-83.8%) and albendazole (28.2-42.6%), whereas pyrantel pamoate was inefficacious. Obvious egg reduction rates were evidenced post application of the above drugs in trichuriasis treatment except pyrantel pamoate at single dose.

Topics: Albendazole; Anthelmintics; Ascariasis; Drug Combinations; Hookworm Infections; Humans; Mebendazole; Nematode Infections; Pyrantel Pamoate; Trichuriasis

Eight trials were conducted in dogs to document the efficacy of ivermectin (6 micrograms/kg of body weight) and pyrantel pamoate (5 mg of active pyrantel/kg) in a beef-based chewable formulation against Dirofilaria immitis, Ancylostoma caninum, Uncinaria stenocephala, Toxocara canis, and Toxascaris leonina. Three studies involved induced infection with D immitis, and 5 studies involved induced or natural infection with hookworms and ascarids. In 3 intestinal parasite trials, the efficacy of the combination chewable tablet was compared with each of its components. Results indicated that 1 component did not interfere with the activity of the other. In 1 heartworm and 2 intestinal parasite trials, the efficacy of pyrantel, ivermectin/pyrantel combination, or ivermectin with pyrantel dosage of 10 mg/kg was evaluated. The ivermectin/pyrantel combination was 100% effective in preventing development of D immitis larvae. Efficacy of the combined product against T canis, Toxascaris leonina, A caninum, and U stenocephala was 90.1, 99.2, 98.5, and 98.7%, respectively. In the intestinal parasite trials, each individual component was found not to interfere with the anthelmintic action of the other. Increasing the dosage of pyrantel to 10 mg/kg (2 x that in the combination) did not interfere with the efficacy of ivermectin against heartworm or increase the activity of pyrantel against intestinal parasites.

Topics: Administration, Oral; Ancylostomatoidea; Ancylostomiasis; Animals; Dirofilariasis; Dog Diseases; Dogs; Drug Combinations; Female; Hookworm Infections; Intestinal Diseases, Parasitic; Ivermectin; Male; Nematode Infections; Pyrantel Pamoate; Tablets; Toxocariasis

In a trial involving 185 school children, pyrantel pamoate (Combantrin) at a dose of 20 mg/kg body weight for 1-3 days was found to be very effective against the Ascaris and moderately effective against the hookworm, with mean cure rates ranging from 93.3-96.7% and 53.3-73.3% respectively. No apparent action against the Trichuris was detected, a mean cure rate of between 34.2 and 46.1% being only slightly, but not significantly, better than the 33.8% cure for a placebo-treated control group. Single and multiple doses of the suspension and tablet formulations of the drug were well tolerated. From the series of randomized and controlled trials conducted, we recommend that, in this area, the appropriate dose of the drug to use for treating ascariasis is 10 mg/kg per day for 1 day, and for infections which include hookworm, 20 mg/kg per day for 3 days.

Topics: Adolescent; Ascariasis; Child; Clinical Trials as Topic; Female; Hookworm Infections; Humans; Male; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Trichuriasis

Levamisole (Decaris, Belgium) was tested in Iran, Brazil, and in Mississippi and Louisiana for its efficacy as a single-dose oral treatment for Ascaris infections. Subjects were children ages 2 to 15 years, and numbers treated with levamisole and comparative anthelmintics are as follows: 453 with levamisole; 461 with piperazine citrate; 17 with pyrantel pamoate; and 19 with a placebo. Cure rates and total reduction in mean egg counts observed were 92% and 98% respectively for levamisole and 66% and 90% for piperazine. Sixteen of 17 treated with pyrantel pamoate were cured. In none of the drugs were there notable side reactions, but in all four studies side effects were more frequent with piperazine than with levamisole. Levamisole was found to be a well-tolerated, highly effective single-dose ascaricide. It should prove to be particularly useful for mass chemotherapy in Ascaris control programs.

Topics: Adolescent; Antinematodal Agents; Ascariasis; Brazil; Child; Child, Preschool; Clinical Trials as Topic; Drug Evaluation; Female; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Iran; Levamisole; Louisiana; Male; Mississippi; Parasite Egg Count; Piperazines; Placebos; Pyrantel Pamoate; Trichuriasis

Topics: Adult; Benzimidazoles; Clinical Trials as Topic; Female; Hookworm Infections; Humans; Male; Mebendazole; Necatoriasis; Pyrantel; Pyrantel Pamoate; Tetrachloroethylene; Thailand

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Clinical Trials as Topic; Drug Evaluation; Female; Hookworm Infections; Humans; Male; Middle Aged; Necatoriasis; Pyrantel; Pyrantel Pamoate; Tablets

The clearance of hookworm (Necator americanus) ova by a single dose of tetrachlorethylene (T.C.E.) was compared with that produced by single and multiple dose regimes of bephenium hydroxynaphthoate and pyrantel pamoate. Single doses of bephenium and pyrantel were inferior to T.C.E. Three daily doses of bephenium or pyrantel produced effects comparable with a single dose of T.C.E. Because of the low cost and lack of side effects, T.C.E. remains the drug of choice in the treatment of N. americanus in infections; the only disadvantage of T.C.E. is its unnoticed deterioration under tropical conditions.

Topics: Administration, Oral; Adult; Bephenium Compounds; Body Weight; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Evaluation; Feces; Hemoglobins; Hookworm Infections; Humans; Necator; Necatoriasis; Pyrantel; Pyrantel Pamoate; Sri Lanka; Tetrachloroethylene

Topics: Albendazole; Ancylostomatoidea; Animals; Child; Helminths; Hookworm Infections; Humans; Laos; Mebendazole; Pyrantel; Pyrantel Pamoate; Single-Blind Method; Soil

Soil-transmitted helminths infect 1.5 billion people worldwide. Treatment with anthelminthics is the key intervention but interactions between anthelminthic agents and the gut microbiota have not yet been studied. In this study, the effects of four anthelminthic drugs and combinations (tribendimidine, tribendimidine plus ivermectin, tribendimidine plus oxantel-pamoate, and albendazole plus oxantel-pamoate) on the gut microbiota were assessed. From each hookworm infected adolescent, one stool sample was collected prior to treatment, 24 h post-treatment and 3 weeks post-treatment, and a total of 144 stool samples were analyzed. The gut bacterial composition was analyzed using 16S rRNA gene sequencing. Tribendimidine given alone or together with oxantel-pamoate, and the combination of albendazole and oxantel pamoate were not associated with any major changes in the taxonomic composition of the gut microbiota in this population, at both the short-term post-treatment (24 h) and long-term post-treatment (3 weeks) periods. A high abundance of the bacterial phylum Bacteroidetes was observed following administration of tribendimidine plus ivermectin 24 h after treatment, due predominantly to difference in abundance of the families Prevotellaceae and Candidatus homeothermaceae. This effect is transient and disappears three weeks after treatment. Higher abundance of Bacteroidetes predicts an increase in metabolic pathways involved in the synthesis of B vitamins. This study highlights a strong relationship between tribendimidine and ivermectin administration and the gut microbiota and additional studies assessing the functional aspects as well as potential health-associated outcomes of these interactions are required.

Topics: Adolescent; Albendazole; Anthelmintics; Ascariasis; Bacteria; Bacteroidetes; Biotin; DNA, Bacterial; Drug Therapy, Combination; Feces; Gastrointestinal Microbiome; Hookworm Infections; Humans; Ivermectin; Metabolic Networks and Pathways; Parasite Egg Count; Phenylenediamines; Pyrantel Pamoate; RNA, Ribosomal, 16S; Trichuriasis

The purpose of this report is to describe a case involving severe anemia in a patient from New Caledonia. Endoscopic discovery of adult hematophagic hookworms in mainland France is novel because it is exceptional. However, this case also reminds us that hookworm disease is extremely widespread in the world. It often goes unrecognized causing progressive, insidious anemia that can be severe though long-term tolerance is good.

Topics: Aged; Ancylostomatoidea; Anemia, Iron-Deficiency; Animals; Antinematodal Agents; Dietary Supplements; Female; Hookworm Infections; Humans; Iron; Pyrantel Pamoate; Treatment Outcome

Intestinal nematode infections are considered highly endemic in the Chinese province of Jiangsu. In May 1997, the prevalence of intestinal nematodes infections was determined among all of the inhabitants aged 5 to 65 of the southern Jiangsu village of Yaojiakon (Wujiang County) and the northern Jiangsu village of Jianmiao (Pizhou County). It was determined that the prevalence of ascariasis, trichuriasis and hook worm infection was greatly reduced compared to when it was last measured in 1990. The reduction was noted to be particularly impressive in Yaojiakon village where the prevalence of ascariasis and trichiuriasis fell to 2% and 1.5% respectively. Much of this reduction was attributed to improvements in economic development which have occurred in southern Jiangsu Province at a rapid pace. In contrast, the reduction in nematode infections among villagers living in northern Jiangsu was more modest. The most striking reduction in both villages was in school-aged children who since 1988 have received yearly treatments with anthelminthic drugs. The intensity of nematode infections was investigated for hookworm where 70% of hookworm-infected Yaojiakon villagers were found to harbor light infections (< 400 eggs per gram) compared to 83% of hookworm-infected Jianmiao villagers. Necator americanus was the predominant hookworm in Yaojiakon village (South), whereas Ancylostoma duodenale predominated in Jianmiao village (North). The majority (76%) of hookworm-infected patients developed IgG antibodies against N. americanus antigen, although 20% of uninfected patients living in the village also had circulating antibodies. Intestinal nematode infections continue to be a significant public health problem in Jiangsu Province although their prevalence has decreased since 1990.

Topics: Adolescent; Adult; Animals; Antibodies, Helminth; Antinematodal Agents; Ascariasis; Ascaris; Child; Child, Preschool; China; Enzyme-Linked Immunosorbent Assay; Hookworm Infections; Humans; Middle Aged; Necator americanus; Parasite Egg Count; Prevalence; Pyrantel Pamoate; Trichuriasis; Trichuris

1. The third therapeutic scheme should be used in the hospital. 2. The second and third therapeutic scheme may be used in mass treatment. 3. The 4th-6th therapeutic scheme is to be considered, reviewed, and evaluated. 4. Model and technology of permanent worms control is to be studied. 5. The treatment and control of Ascaris were simple. Cure with low reinfection rate and long reinfection period was remarkable. 6. The prevalence rate and reinfection rate of Trichiuris was high, and not so sensitive to any antelmintics. 7. The reinfection rate in the second group was not superior to the first group and the third group. This revealed no effectiveness of ovicidal and larvicidal on the helminthiasis. 8. Reinfection rate in the third therapeutic scheme was the least group. 9. Toxicity and side effect were not found in any anthelmintics. 10. Broad Spectrum Anthelmintics are necessary in mass treatment or blind treatment.

Topics: Albendazole; Anthelmintics; Ascariasis; Child; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Mebendazole; Pyrantel Pamoate; Treatment Outcome; Trichuriasis

The effectiveness of the combination of pyrantel pamoate (5 mg kg-1) and ivermectin (6 micrograms kg-1) against the canine hookworms Uncinaria stenocephala and Ancylostoma caninum was determined. This combination is intended for monthly use as a heartworm preventative and for treatment and control of canine hookworms. The formulation was found to be effective (99.6% reduction in worm burdens) against both species of hookworms in experimentally infected dogs. No adverse effects due to the drug combination were observed in any dog during the course of this study.

Topics: Administration, Oral; Ancylostoma; Ancylostomatoidea; Ancylostomiasis; Animals; Dog Diseases; Dogs; Drug Combinations; Feces; Female; Hookworm Infections; Ivermectin; Male; Parasite Egg Count; Pyrantel Pamoate; Specific Pathogen-Free Organisms

Different periodic selective chemotherapeutic schemes were used to control hookworm and other soil-transmitted helminthiases in eight villages in five counties in Zhejiang Province, China, 1985-1988. The results showed that the prevalence rates of hookworm, ascariasis, and trichuriasis decreased from 35.0-74.4%, 47.0-.76% and 22.9-47.5% to 3.2-15.8%, 9.9-47.8%, and 3.5-31.2%, respectively, using pyrantel pamoate (10 mg/kg for 1-2 days) or albendazole (400 mg for 1-2 days, once or twice a year for 2-3 years). The eggs per gram of feces of hookworm and Trichuris trichiura also dropped markedly after control. Moreover, the mean hemoglobin levels of sampled populations increased after several treatments. The authors recommend periodic selective chemotherapy as the main method to control soil-transmitted helminthiases, especially hookworm infections.

Topics: Agriculture; Albendazole; Animals; Ascariasis; Ascaris; Child; China; Female; Hemoglobins; Hookworm Infections; Humans; Larva; Male; Pyrantel Pamoate; Trichuriasis

Studies of patterns of reinfection with four species of intestinal nematodes (Ascaris, hookworm, Trichuris and Enterobius) in 174 individual patients following chemotherapeutic treatment revealed statistical evidence for predisposition to heavy or light infection (relative to the average level in the overall population). Analyses of associations between the abundances of the four species of nematodes within a combined sample of 525 worm burdens showed significant correlations between 5 out of the 6 possible pair-wise comparisons between species. The relevance of these results to the design of control programmes based on chemotherapeutic application is discussed.

Topics: Adolescent; Adult; Age Factors; Animals; Ascariasis; Child; Child, Preschool; Disease Susceptibility; Feces; Female; Hookworm Infections; Humans; India; Infant; Male; Mathematics; Oxyuriasis; Parasite Egg Count; Pyrantel Pamoate; Trichuriasis

Topics: Animals; Anthelmintics; Ascariasis; Dog Diseases; Dogs; Drug Combinations; Hookworm Infections; Pyrantel; Pyrantel Pamoate; Toxocariasis; Trichuriasis

A study was carried out to find out the incidence of helminthic infections in hospitalized patients at Sher-e-Bangla Medical College, Barisal and to determine the comparative efficacy of pyrantel pamoate, levamisole, and mebendazole. It was observed that 76.2 per cent of total hospitalized patients were infected with intestinal helminths. Polyparasitism (52.6 per cent) was more frequent than single infection (21.8 per cent). Amongst these, 47.5 per cent was suffering from Asearis lumbricoides (AL), 42.5 per cent from Hookworm (H.W) and 65.8 per cent from trichuris trichura (TT). Out of 255 cases examined separately, 40 per cent was suffering from Enterobious vermicularis (EV) infection. The comparative study showed that mebendazole produced egg negative stool in 90.9 per cent of AL, 95.6 per cent of HW and 86.8 per cent of TT after eight days of treatment. On the other hand, pyrantel pamoate cured AL in 93.3 per cent, HW in 78.5 per cent and TT in 34.2 per cent eases. Levamisole cured 75 per cent AL, 4.1 per cent H.W. and 22.2 per cent TT within the same period.

Topics: Adolescent; Adult; Ascariasis; Bangladesh; Benzimidazoles; Drug Therapy, Combination; Hookworm Infections; Humans; Levamisole; Mebendazole; Pyrantel; Pyrantel Pamoate; Trichuriasis

The results are presented of a horizontal epidemiological survey of intestinal infections of children aged between six months and 15 years in three adjacent villages in northern Bangladesh. On the basis of 203 stool sample examinations, the prevalence of Ascaris lumbricoides, Trichuris trichiura, hookworm and amoebic infections was estimated as 68, 56, 53 and 19%, respectively. Age-specific prevalence data indicated that approximately 90% of the children were harbouring patent Ascaris infections by the time they were four years old and there was some evidence to suggest differences in the pattern of age-prevalence between male and female children. The intensity of Ascaris infection was found to rise to its maximum value within the first four years of life. No significant differences were detected in the mean worm burdens of children aged between four and 15 years. Each child in this age-group harboured on average 10 worms. The frequency distribution of numbers of A. lumbricoides per host was found to be overdispersed, with a value of the negative binomial parameter, k, of 0.44. The degree of aggregation was found to be approximately the same for each age-class of the population between one and 15 years (0.26 less than or equal to k less than or equal to 0.82). No evidence was found to suggest a density-dependent reduction in the weight of either male or female Ascaris within the range one to 43 worms per host.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Ascariasis; Bangladesh; Child; Child, Preschool; Dysentery, Amebic; Escherichia coli Infections; Feces; Hookworm Infections; Humans; Infant; Intestinal Diseases, Parasitic; Parasite Egg Count; Pyrantel Pamoate; Trichuriasis

Topics: Adolescent; Adult; Antinematodal Agents; Ascariasis; Benzimidazoles; Child; Child, Preschool; Costs and Cost Analysis; Cyclopropanes; Female; Hookworm Infections; Humans; Infant; Liberia; Male; Mebendazole; Pyrantel Pamoate; Trichuriasis

Topics: Helminthiasis; Hookworm Infections; Humans; Male; Military Medicine; Nepal; Pyrantel; Pyrantel Pamoate

The anthelminthic efficacy of pyrantel pamoate (Combantrin) in a single dose of 10 mg/kg body weight was compared with that of thiabendazole (Mintezol) in two doses each of 25 mg/kg body weight in a controlled trial. Follow-up examination, 6 weeks after treatment with Combantrin gave cure rates of 93.8%, and 29.1% for infection with Ascaris and the Hookworm respectively, and 44.3% and 27.3% in those treated with Mintezol. The reduction in hookworm egg counts was higher in patients treated with Combantrin than with Mintezol, and Combantrin was better tolerated. Neither drug was effective against the Trichuris. The results are compared with those from other parts of the world.

Topics: Adolescent; Ascariasis; Child; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Pyrantel; Pyrantel Pamoate; Strongyloidiasis; Thiabendazole; Trichuriasis

Topics: Ascariasis; Child; Child, Preschool; Female; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Nematode Infections; Oxyuriasis; Pyrantel Pamoate; Socioeconomic Factors; Strongyloidiasis; Trichuriasis; United States

The efficacy of mebendazole and pyrantel pamoate was studied in two groups of 59 and 58 cases, respectively, of patients with polyparasitosis. Mebendazole had a cure rate of 96%, 82.2%, 71.4% and 66.6% in A. lumbricoides, hookworm, T. trichiura and S. stercoralis, respectively, while the corresponding figures for pyrantel pamoate were 92.6%, 85.7%, 19.4% and 0%. Pyrantel pamoate is considered to have no significant effect on T. trichiura and S. stercoralis. None of the drugs had any effect on T. saginata. Both drugs have been found to be equally effective against enterobiasis by various authors. It is recommended that pyrantel pamoate be the drug of choice in cases of multiple parasitic infections excluding T. trichiura and S. stercoralis whereas those with one or both of these in addition to others should be treated with mebendazole. Mebendazole can be prescribed for patients with clinical evidence of helminthic infections even where stool examination is not possible as it covers almost the whole range of common helminthic infections. The only limitation for poorer patients however is its cost. Pyrantel pamoate has a wider applicability for the poorer patients in spite of the fact that it is ineffective against trichurids and S. stercoralis.

Topics: Adolescent; Adult; Ascariasis; Benzimidazoles; Child; Female; Hookworm Infections; Humans; Male; Mebendazole; Middle Aged; Pyrantel; Pyrantel Pamoate; Strongyloidiasis

Topics: Amebicides; Anti-Inflammatory Agents; Antimalarials; Ascariasis; Benzenesulfonates; Cestode Infections; Echinococcosis; Entamoebiasis; Hookworm Infections; Humans; Malaria; Niclosamide; Niridazole; Oxyuriasis; Parasitic Diseases; Paromomycin; Pyrantel Pamoate; Schistosomiasis; Strongyloidiasis; Tartrates; Tetrachloroethylene; Tetracycline; Thiabendazole; Toxocariasis; Trichinellosis

Topics: Ascariasis; Child; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Mebendazole; Nematode Infections; Oxyuriasis; Piperazines; Pyrantel Pamoate; Strongyloidiasis; Tetrachloroethylene; Thiabendazole; Trichinellosis; Trichuriasis

Topics: Adolescent; Adult; Aged; Drug Evaluation; Female; Hookworm Infections; Humans; Male; Mauritius; Middle Aged; Parasite Egg Count; Pyrantel; Pyrantel Pamoate

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Hookworm Infections; Humans; Middle Aged; Parasite Egg Count; Pyrantel; Pyrantel Pamoate

The most common worm infection in children in the United States is pinworm infection. In second place is roundworm infection. Agents that are effective against these nematodes in a high proportion of cases are available. In hookworm disease, generally seen in older children, tetrachloroethylene treatment is being supplanted by use of drugs less likely to have adverse side effect. Visceral larva migrans is difficult to diagnose and to treat, and our best hope for control lies in prevention.

Topics: Animals; Ascariasis; Bephenium Compounds; Cats; Child; Dogs; Female; Hookworm Infections; Humans; Larva Migrans, Visceral; Nematode Infections; Oxyuriasis; Piperazines; Pyrantel Pamoate; Tetrachloroethylene; Thiabendazole; Trichuriasis

Topics: Adult; Africa, Western; Animals; Ascaridiasis; Cats; Dogs; Feces; Female; Helminthiasis; Hookworm Infections; Humans; Male; Necator; Pyrantel; Pyrantel Pamoate; Rats; Schistosomiasis; Strongyloidiasis

Two adults of Cyclodontostomum purvisi were recovered from faecal specimen of a 47 year-old male who had suffered from capillariasis, in Kaeng Khoi District, Saraburi Province, Thailand; Adults of C. purvisi were also recovered from the large intestine of B. savilei and B. indica trapped in the same area and in Pak Philli District, Nakhon Nayok Province. This is the first record of human infection with C. purvisi and of the occurrence in B. savilei and B. indica in Thailand.

Topics: Animals; Feces; Hookworm Infections; Humans; Male; Middle Aged; Parasite Egg Count; Pyrantel Pamoate; Rats; Thailand