pyrantel-pamoate and Trichuriasis

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

The recommended anthelmintics show low efficacy in a single-dose regimen against Trichuris trichiura. Moxidectin, a new treatment for river blindness, might complement the drug armamentarium for the treatment and control of soil-transmitted helminthiasis. However, its efficacy against T trichiura has not yet been studied. The aim of the study was to assess the efficacy of moxidectin alone and in co-administrations against T trichiura infection.. A randomised, single-blind, non-inferiority trial was done in two primary schools and one secondary school in Pemba, Tanzania. Adolescents aged 12-18 years who tested positive for T trichiura were randomly assigned (5:5:3:3) with a computer-generated sequence to receive moxidectin (8 mg) plus albendazole (400 mg), albendazole (400 mg) plus oxantel pamoate (25 mg/kg; reference treatment), moxidectin (8 mg) plus tribendimidine (200 mg or 400 mg), or moxidectin (8 mg) alone. Study group assignments were masked from participants and laboratory technicians. The primary outcome was non-inferiority with a 2 percentage point margin for egg reduction rate (ERR) against T trichiura assessed as the relative change in the geometric mean egg counts from baseline to 14-21 days after treatment with the Kato-Katz method, based on the available case population. Cure rates (CR) and tolerability (assessed 3, 24, and 48 h post treatment) were secondary outcomes. The study is registered at ISRCTN (number 20398469) and is closed to accrual.. 701 students were enrolled between April 1, and Aug 7, 2017. Primary outcome data were available for 634 students. We observed ERRs of 98·5% for moxidectin plus albendazole and 99·8% for albendazole plus oxantel pamoate, resulting in an absolute difference of -1·2 percentage points (95% CI -1·8 to -0·8), meeting the non-inferiority margin. 100 (51%) of 197 students receiving moxidectin plus albendazole and 166 (83%) of 200 receiving albendazole plus oxantel pamoate were cured, indicating a difference of 32 percentage points (odds ratio 5·3, 95% CI 3·3 to 8·7). ERRs were 91·6% for moxidectin-tribendimidine and 83·2% for moxidectin. Only mild adverse events (mainly headache and stomach pain) were reported. The largest number of adverse events (126 [20%] of 632 students) was observed 24 h post treatment, with no difference among the individual treatment arms (ranging from 23 [19%] of 118 students treated with moxidectin to 38 [19%] of 199 with moxidectin plus albendazole).. Moxidectin plus albendazole showed non-inferiority to albendazole plus oxantel pamoate in terms of ERR; however, albendazole plus oxantel pamoate showed a considerably higher cure rate. Dose-optimisation studies with moxidectin and moxidectin plus albendazole should be considered since the efficacy of the dose used for the treatment of onchocerciasis (8 mg) in this study might not be optimal for the treatment of T trichiura infections.. Thrasher Foundation.

Topics: Administration, Oral; Adolescent; Albendazole; Animals; Anthelmintics; Child; Drug Therapy, Combination; Female; Humans; Macrolides; Male; Mebendazole; Phenylenediamines; Pyrantel Pamoate; Single-Blind Method; Trichuriasis; Trichuris

Commonly used drugs for preventive chemotherapy against soil-transmitted helminths (ie, albendazole and mebendazole) show low efficacy against Trichuris trichiura. Recent studies with oxantel pamoate revealed good cure rates and high egg-reduction rates against T trichiura. We aimed to assess the nature of the dose-response relation to determine the optimum dose.. We did a parallel, randomised, placebo-controlled, single-blind trial with oxantel pamoate in school-aged children (aged 6-14 years) infected with T trichiura on Pemba Island, Tanzania. Children were asked to provide two stool samples and children positive for T trichiura were eligible to participate in the trial. Children were excluded if they suffered from any systematic illness. Children were randomly assigned to six different oxantel pamoate doses (5-30 mg/kg) or a placebo. Randomisation was stratified by baseline infection intensity using random block sizes of seven and 14. The primary endpoints were cure rates and egg-reduction rates against T trichiura, both analysed by available case. Drug safety was assessed 2 h and 24 h after treatment. The trial is registered at www.isrctn.com, number ISRCTN86603231.. Between Oct 14, and Nov 28, 2014, we enrolled 480 participants and randomly assigned 350 children to the different oxantel pamoate doses or the placebo. 5 mg/kg oxantel pamoate was the minimum effective dose (10 of 46 children cured [cure rate 22%, 95% CI 11-36]; egg-reduction rate 85·0%, 64·5-92·9). An increased probability of being cured and reduced egg counts with escalating doses was recorded. At 25 mg/kg oxantel pamoate 27 of 45 children were cured (cure rate 60%, 95% CI 44-65) with an egg-reduction rate of 97·5% (94·4-98·9), and at 30 mg/kg 27 of 46 children were cured (59%, 43-73) with an egg-reduction rate of 98·8% (96·8-99·6). Oxantel pamoate was well tolerated across all treatment groups; only mild adverse events were reported by the participants 2 h (27 [10%]) and 24 h (12 [4%]) after treatment.. Our dose-finding study revealed an excellent tolerability profile of oxantel pamoate in children infected with T trichiura. An optimum therapeutic dose range of 15-30 mg/kg oxantel pamoate was defined. With a weight independent dose of 500 mg oxantel pamoate 95% of children aged 7-14 years in sub-Saharan Africa would receive doses of 11·7-32·0 mg/kg. Future research should include studies with oxantel pamoate in younger children and on different continents with the ultimate goal to be able to add oxantel pamoate to soil-transmitted helminth control programmes.. Swiss National Science Foundation.

Topics: Adolescent; Animals; Antinematodal Agents; Child; Dose-Response Relationship, Drug; Feces; Female; Humans; Male; Pyrantel Pamoate; Single-Blind Method; Tanzania; Trichuriasis; Trichuris

Existing anthelmintic drugs (eg, albendazole and mebendazole) have low efficacy against the intestinal nematode species Trichuris trichiura and the drug pipeline is exhausted. We aimed to investigate the strategy of combination chemotherapy with existing drugs to establish whether their efficacy could be enhanced and broadened.. In this randomised controlled trial, we compared three drug combinations and one standard drug alone in children aged 6-14 years in two schools on Pemba Island, Tanzania infected with T trichiura and concomitant intestinal nematodes. We assigned children, via a randomisation list with block sizes of either four or eight, to orally receive albendazole (400 mg) plus ivermectin (200 μg/kg); albendazole (400 mg) plus mebendazole (500 mg); albendazole (400 mg) plus oxantel pamoate (20 mg/kg); or mebendazole (500 mg) alone. The primary endpoints were the proportion of children cured of T trichiura infection and the reduction of T trichiura eggs in stool based on geometric means, both analysed by available case. This study is registered with ISRCTN, number ISRCTN80245406.. We randomly assigned 440 eligible children infected with T trichiura between Sept 2, and Oct 18, 2013, to one of the four treatment groups (110 children per group). Data for 431 children were included in the analysis for the primary endpoints. Albendazole plus oxantel pamoate (74 of 108 children cured [68·5%, 95% CI 59·6-77·4]; egg reduction 99·2%, 98·7-99·6) and albendazole plus ivermectin (30 of 109 cured [27·5%, 19·0-36·0]; egg reduction 94·5%, 91·7-96·3) were significantly more effective against T trichiura than mebendazole alone (nine of 107 cured [8·4%, 3·1-13·8]; egg reduction 58·5%, 45·2-70·9). Albendazole plus mebendazole had similar low efficacy (nine of 107 cured [8·4%, 3·1-13·8; egg reduction 51·6%, 35·0-65·3) to mebendazole alone. About a fifth of the children reported adverse events, which were mainly mild. Abdominal cramps and headache were the most common adverse events after treatment; abdominal cramps were reported by 13 (12·0%) children for albendazole plus ivermectin, 10 (9·3%) for albendazole plus mebendazole, 20 (18·2%) for albendazole plus oxantel pamoate, and 16 (14·5%) for mebendazole; headaches were reported by 5 (4·6%) children for albendazole plus ivermectin, 6 (5·6%) for albendazole plus mebendazole, 12 (10·9%) for albendazole plus oxantel pamoate, and 7 (6·4%) for mebendazole.. Our head-to-head comparison of three combination chemotherapies showed the highest efficacy for albendazole plus oxantel pamoate for the treatment of infection with T trichiura. Further studies should investigate the combination of albendazole plus oxantel pamoate so that it can be considered for soil-transmitted helminthiasis control programmes.. Medicor Foundation and Swiss National Science Foundation.

Topics: Administration, Oral; Adolescent; Albendazole; Animals; Anthelmintics; Child; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions; Feces; Female; Helminthiasis; Humans; Intestinal Diseases, Parasitic; Ivermectin; Male; Mebendazole; Parasite Egg Count; Pyrantel Pamoate; Tanzania; Treatment Outcome; Trichuriasis; Trichuris

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

Appetite and growth were studied in primary schoolboys (6-10 years) infected with Ascaris lumbricoides (86%) and Trichuris trichiura (100%) who received a single dose of pyrantel pamoate (which has little or no effect on Trichuris trichiura) or a placebo. Boys were examined, allocated at random by descending Ascaris egg count to pyrantel (PR, n = 36) or placebo (PL, n = 36) groups, treated, and re-examined 3 and 7 weeks later. The 2 groups did not differ significantly before treatment in helminth infections, appetite, or growth. Three and 7 weeks after treatment, the PR group exhibited significantly greater increases than did the PL group in weight (0.2 kg and 0.4 kg more, respectively) and percentage weight-for-age (0.6% and 1.7% points more, respectively). Appetite increased significantly in the PR group at 3 and 7 weeks (P < 0.0005 and P < 0.01, respectively) but not in the PL group. The prevalence and intensity of A. lumbricoides infection were greatly reduced in the PR group at 3 and 7 weeks (both P < 0.0001) but not in the PL group. We conclude that treatment with pyrantel pamoate may improve appetite and growth in school children in areas where A. lumbricoides infections and poor growth are highly prevalent.

Topics: Animals; Appetite; Ascariasis; Ascaris lumbricoides; Child; Follow-Up Studies; Growth; Humans; Indonesia; Male; Multivariate Analysis; Parasite Egg Count; Pyrantel Pamoate; Schools; Students; Time Factors; Trichuriasis; Urban Population

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

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

Topics: Anthelmintics; Ascariasis; Benzimidazoles; Child; Costs and Cost Analysis; Drug Administration Schedule; Female; Humans; Intestinal Diseases, Parasitic; Levamisole; Male; Mebendazole; Necatoriasis; 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: Albendazole; Humans; Macrolides; Phenylenediamines; Pyrantel Pamoate; Single-Blind Method; Trichuriasis

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

Topics: Animals; Antinematodal Agents; Female; Humans; Male; Pyrantel Pamoate; Trichuriasis; Trichuris

The current treatments against Trichuris trichiura, albendazole and mebendazole, are only poorly efficacious. Therefore, combination chemotherapy was recommended for treating soil-transmitted helminthiasis. Albendazole-mebendazole and albendazole-oxantel pamoate have shown promising results in clinical trials. However, in vitro and in vivo drug interaction studies should be performed before their simultaneous treatment can be recommended. Inhibition of human recombinant cytochromes P450 (CYPs) CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A4 was tested by exposure to albendazole, albendazole sulfoxide, mebendazole, and oxantel pamoate, as well as albendazole-mebendazole, albendazole sulfoxide-mebendazole, albendazole-oxantel pamoate, and albendazole sulfoxide-oxantel pamoate. A high-pressure liquid chromatography (HPLC)-UV/visible spectroscopy method was developed and validated for simultaneous quantification of albendazole sulfoxide, albendazole sulfone, mebendazole, and oxantel pamoate in plasma. Albendazole, mebendazole, oxantel pamoate, albendazole-mebendazole, and albendazole-oxantel pamoate were orally applied to rats (100 mg/kg) and pharmacokinetic parameters calculated. CYP1A2 showed a 2.6-fold increased inhibition by albendazole-oxantel pamoate (50% inhibitory concentration [IC50] = 3.1 μM) and a 3.9-fold increased inhibition by albendazole sulfoxide-mebendazole (IC50 = 3.8 μM) compared to the single drugs. In rats, mebendazole's area under the concentration-time curve (AUC) and maximal plasma concentration (Cmax) were augmented 3.5- and 2.8-fold, respectively (P = 0.02 for both) when coadministered with albendazole compared to mebendazole alone. Albendazole sulfone was slightly affected by albendazole-mebendazole, displaying a 1.3-fold-elevated AUC compared to albendazole alone. Oxantel pamoate could not be quantified, translating to a bioavailability below 0.025% in rats. Elevated plasma levels of albendazole sulfoxide, albendazole sulfone, and mebendazole in coadministrations are probably not mediated by CYP-based drug-drug interaction. Even though this study indicates that it is safe to coadminister albendazole-oxantel pamoate and albendazole-mebendazole, human pharmacokinetic studies are recommended.

Topics: Administration, Oral; Albendazole; Animals; Anthelmintics; Area Under Curve; Cytochrome P-450 Enzyme System; Drug Combinations; Drug Interactions; Gene Expression; Isoenzymes; Mebendazole; Mice; Microbial Sensitivity Tests; Pyrantel Pamoate; Rats; Rats, Sprague-Dawley; Soil; Trichuriasis; Trichuris

Topics: Albendazole; Animals; Anthelmintics; Female; Helminthiasis; Humans; Intestinal Diseases, Parasitic; Ivermectin; Male; Mebendazole; Pyrantel Pamoate; Trichuriasis

Since the nematodes Trichuris trichiura and T. suis are morphologically indistinguishable, genetic analysis is required to assess epidemiological cross-over between people and pigs. This study aimed to clarify the transmission biology of trichuriasis in Ecuador.. Adult Trichuris worms were collected during a parasitological survey of 132 people and 46 pigs in Esmeraldas Province, Ecuador. Morphometric analysis of 49 pig worms and 64 human worms revealed significant variation. In discriminant analysis morphometric characteristics correctly classified male worms according to host species. In PCR-RFLP analysis of the ribosomal Internal Transcribed Spacer (ITS-2) and 18S DNA (59 pig worms and 82 human worms), nearly all Trichuris exhibited expected restriction patterns. However, two pig-derived worms showed a "heterozygous-type" ITS-2 pattern, with one also having a "heterozygous-type" 18S pattern. Phylogenetic analysis of the mitochondrial large ribosomal subunit partitioned worms by host species. Notably, some Ecuadorian T. suis clustered with porcine Trichuris from USA and Denmark and some with Chinese T. suis.. This is the first study in Latin America to genetically analyse Trichuris parasites. Although T. trichiura does not appear to be zoonotic in Ecuador, there is evidence of genetic exchange between T. trichiura and T. suis warranting more detailed genetic sampling.

Topics: Albendazole; Animals; Anthelmintics; Ecuador; Humans; Phylogeny; Pyrantel Pamoate; Rural Population; Trichuriasis; Trichuris; Zoonoses

Topics: Albendazole; Animals; Antinematodal Agents; Female; Humans; Male; Pyrantel Pamoate; Trichuriasis; Trichuris

Topics: Albendazole; Animals; Antinematodal Agents; Female; Humans; Male; Pyrantel Pamoate; Trichuriasis; Trichuris

Topics: Albendazole; Animals; Antinematodal Agents; Female; Humans; Male; Pyrantel Pamoate; Trichuriasis; Trichuris

Topics: Albendazole; Animals; Antinematodal Agents; Female; Humans; Male; Pyrantel Pamoate; Trichuriasis; Trichuris

It is widely recognized that only a handful of drugs are available against soil-transmitted helminthiasis, all of which are characterized by a low efficacy against Trichuris trichiura, when administered as single doses. The re-evaluation of old, forgotten drugs is a promising strategy to identify alternative anthelminthic drug candidates or drug combinations.. We studied the activity of the veterinary drug oxantel pamoate against Trichuris muris, Ancylostoma ceylanicum and Necator americanus in vitro and in vivo. In addition, the dose-effect of oxantel pamoate combined with albendazole, mebendazole, levamisole, pyrantel pamoate and ivermectin was studied against T. muris in vitro and additive or synergistic combinations were followed up in vivo.. We calculated an ED50 of 4.7 mg/kg for oxantel pamoate against T. muris in mice. Combinations of oxantel pamoate with pyrantel pamoate behaved antagonistically in vitro (combination index (CI) = 2.53). Oxantel pamoate combined with levamisole, albendazole or ivermectin using ratios based on their ED50s revealed antagonistic effects in vivo (CI = 1.27, 1.90 and 1.27, respectively). A highly synergistic effect (CI = 0.15) was observed when oxantel pamoate-mebendazole was administered to T. muris-infected mice. Oxantel pamoate (10 mg/kg) lacked activity against Ancylostoma ceylanicum and Necator americanus in vivo.. Our study confirms the excellent trichuricidal properties of oxantel pamoate. Since the drug lacks activity against hookworms it is necessary to combine oxantel pamoate with a partner drug with anti-hookworm properties. Synergistic effects were observed for oxantel pamoate-mebendazole, hence this combination should be studied in more detail. Since, of the standard drugs, albendazole has the highest efficacy against hookworms, additional investigations on the combination effect of oxantel pamoate-albendazole should be launched.

Topics: Ancylostoma; Ancylostomiasis; Animals; Anthelmintics; Disease Models, Animal; Drug Synergism; Drug Therapy, Combination; Female; Mice; Mice, Inbred C57BL; Necator americanus; Necatoriasis; Parasitic Sensitivity Tests; Pyrantel Pamoate; Treatment Outcome; Trichuriasis; Trichuris

Irritable bowel syndrome (IBS) is common in countries where chronic parasitic infestations are endemic. However, the relationship between parasitic infection and IBS is not clear. The aim of this study was to examine whether chronic parasitic infection is accompanied by gut dysfunction and whether the continued presence of the parasite is required for the maintenance of the dysfunction. We used chronic Trichuris muris infection in Th1-biased susceptible AKR mice to evaluate this relationship. AKR mice were infected with T. muris and were euthanized on various days postinfection (pi) to examine worm burden, muscle function, and immune and inflammatory responses. Mice were treated with the anthelmintic oxantel pamoate to assess the effect of eradication of infection on muscle function. Infection resulted in persistence of the parasite, elevated IFN-γ, and increased MPO activity evident at 45 days pi. This was accompanied by a reduction in muscle contractility and excitatory innervation. Whereas parasite eradication at 7 days pi normalized IFN-γ and muscle contractility, eradication at 28 days pi failed to normalize muscle contractility. Administration of dexamethasone after parasite eradication normalized all parameters. Anthelmintic treatment improved histology except for eosinophils, which were normalized by subsequent dexamethasone therapy. Persistent gut dysfunction is independent of the continued presence of the parasite and is maintained by inflammatory process that includes eosinophils. Thus data in this preclinical model suggest that parasitic infection could be a cause of IBS, and the lack of symptomatic improvement following eradication is insufficient evidence to refute a causal relationship between the infection and IBS.

Topics: Adrenal Cortex Hormones; Animals; Anthelmintics; Anti-Inflammatory Agents; Chronic Disease; Colon; Dexamethasone; Gastrointestinal Diseases; Interferon-gamma; Male; Mice; Mice, Inbred AKR; Muscle Contraction; Muscle, Smooth; Peroxidase; Pyrantel Pamoate; Trichuriasis; Trichuris

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

Reinfection with hookworm (Necator americanus) following chemotherapy was studied over 2 years in a rural village in Madang Province, Papua New Guinea. The prevalence of hookworm infection had returned to pre-treatment levels after 2 years, and the geometric mean hookworm burden had returned to 58% of the pre-treatment value. The rate of acquisition of adult worms was independent of host age, and was estimated as a geometric mean of 2.9-3.3 worms/host/year (arithmetic mean 7.9-8.9 worms/host/year). There was significant predisposition to hookworm infection; the strength of this predisposition did not vary significantly between age or sex classes.

Topics: Age Factors; Animals; Ascariasis; Causality; Female; Humans; Incidence; Male; Necator americanus; Necatoriasis; Papua New Guinea; Pyrantel Pamoate; Recurrence; Sex Factors; Time Factors; Trichuriasis

The common anthelmintics, oxantel, mebendazole, albendazole and pyrantel were assessed for their comparative activity against Trichuris muris in mice. Mice were infected with T. muris and the infection was maintained by a brief cortisone administration during the second week of infection. Mice carrying the infection with different life cycle stages, viz. fourth stage larvae (L4), pre-adult and adult stages were dosed with anthelminitics. The worm burdens in control infection groups varied although infection dose and other conditions were uniformly followed. With various dose regimens tested, oxantel was highly potent; it eliminated completely pre-adult and adult stages, respectively at 25 and 12.5 mg kg-1 dose levels with significant activity also against adult worms at a 1.56 mg kg-1 dose level and against pre-adults at a 6.25 mg kg-1 level. Pre-adults required twice the dose given to that of adults for complete (100%) activity. Mebendazole was the next most active; a dosage of 37.5 mg kg-1 was completely active against pre-adults whereas a dosage of 2 x 50 mg kg-1 was required for complete elimination of adult worms. In addition, about 90% of the worms were eliminated with a single dose of 150 mg kg-1. However, a significant activity was seen against adults at a 25 mg kg-1 level and pre-adults at 37.5 mg kg-1, the lowest level tested. In comparison, albendazole did not induce complete clearance of pre-adult and adult stages even when tested at dose levels as high as 150 and 2 x 75 mg kg-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Albendazole; Animals; Anthelmintics; Dose-Response Relationship, Drug; Mebendazole; Mice; Pyrantel Pamoate; Trichuriasis

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 mixture of 150 mg mebendazole and 30mg pyrantel pamoate was given on 3 consecutive or near-consecutive days to 70 children infected with one or more of Necator americanus, Ascaris lumbricoides, Strongyloides stercoralis, S. fuelleborni-like and Trichuris trichiura. This treatment had an efficacy of 95 per cent for N. americanus infections, 100 per cent for A. lumbricoides, 57 per cent for Strongyloides spp., and 75 per cent for T. trichiura. The results indicate that the treatment given is effective against the infections of N. americanus and A. lumbricoides but is only partially effective for Strongyloides and T. trichiura infections.

Topics: Ascariasis; Benzimidazoles; Child, Preschool; Drug Therapy, Combination; Humans; Infant; Mebendazole; Necatoriasis; Nematode Infections; Papua New Guinea; Pyrantel; Pyrantel Pamoate; Strongyloidiasis; 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; Aged; Antinematodal Agents; Benzimidazoles; Child; Drug Therapy, Combination; Female; Humans; Male; Mebendazole; Middle Aged; Pyrantel; Pyrantel Pamoate; Trichuriasis

166 patients with trichuriasis have been treated at the Department of Tropical Diseases, Aurora Hospital, Helsinki, from January 1975 to October 1979. Final results could be confirmed in 141 patients. Thiabendazole was found discouraging, because of frequent side effects and low cure rate (29% of 24 in-patients). In contrast, a single dose of oxantel pamoate gave minimal side effects in 37 in-patients and in 80 outpatients with a high overall cure rate of 98%. Neither allergic nor adverse haematological reactions were encountered during 3 years and 10 months' experience of treatment with oxantel pamoate.

Topics: Adolescent; Adult; Anthelmintics; Antinematodal Agents; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Pyrantel; Pyrantel Pamoate; Thiabendazole; 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

A mixture of oxantel-pyrantel pamoate was given to 147 primary school children. A single daily dose of 15 mg per kg body weight was administered to cases with Ascaris lumbricoides and Trichuris trichiura infections. The same single daily dose was given for three consecutive days to 10 cases with hookworm infections. The cure rate was 93.7% for ascariasis and the egg reduction rate was 98.2%. A cure rate and an egg reduction rate for trichuriasis was 70.2% and 86.5% respectively. All cases with hookworm infection were cured. Side effects were light and did not cause any anxiety.

Topics: Adolescent; Ascariasis; Child; Drug Therapy, Combination; Humans; Indonesia; Necatoriasis; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Trichuriasis

Topics: Adolescent; Adult; Antinematodal Agents; Ascariasis; Benzimidazoles; Child; Child, Preschool; Drug Administration Schedule; Drug Combinations; Drug Therapy, Combination; Female; Humans; Intestinal Diseases, Parasitic; Male; Mebendazole; Necatoriasis; Nematode Infections; Pyrantel; Pyrantel Pamoate; Trichuriasis

Topics: Adult; Ascariasis; Ascaris; Female; Humans; Ovum; Pyrantel; Pyrantel Pamoate; Trichuriasis

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

Pyrantel pamoate at dosage of 10 mg per kilogramme body weight was given to each villager at 4-6 weeks intervals for three times. The infection rates of hookworms among those who received and did not received the drug decreased from 60.5% pre-treatment to 19.6% after the third treatment and then increased to 32.4% one year after the third treatment. Infection rates of A. lumbricoides and Strongyloides spp. among the villagers who received and did not received the drug decreased from 27.5% pre-treatment to 2.2% after the third treatment and then increased to 20.1% one year later for the former, while the latter decreased from 6.5% pre-treatment to 2.3% after the third treatment and 0.4% one year later. The infection rate of T. trichiura was found to increase as pyrantel pamoate had no effect on this nematode. The authors suggested that to obtain more satisfactory results the anthelmintic drug used must likewise be effective against T. trichiura particularly in areas where this nematode is a public health problem. It was also suggested that the duration of treatment should be prolonged.

Topics: Adolescent; Adult; Aged; Ascariasis; Child; Child, Preschool; Female; Helminthiasis; Humans; Infant; Male; Middle Aged; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Soil Microbiology; Strongyloidiasis; Trichuriasis

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

Topics: Adolescent; Adult; Ancylostomiasis; Anthelmintics; Ascariasis; Child; Female; Fumarates; Humans; Intestinal Diseases, Parasitic; Male; Mebendazole; Nematode Infections; Netherlands; Parasite Egg Count; Pyrantel Pamoate; Strongyloidiasis; Suriname; Thiabendazole; Trichuriasis

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

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