Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study

ECHAZÚ, ADRIANA; JUAREZ, MARISA; VARGAS, PAOLA A.; CAJAL, SILVANA P.; CIMINO, RUBEN O.; HEREDIA, VIVIANA; CAROPRESI, SILVIA; PAREDES, GLADYS; ARIAS, LUIS M.; ABRIL, MARCELO; GOLD, SILVIA; LAMMIE, PATRICK; KROLEWIECKI, ALEJANDRO J.

PLOS NEGLECTED TROPICAL DISEASES

PUBLIC LIBRARY SCIENCE

Año: 2017 vol. 11

1935-2735

BackgroundRecommendations for soil-transmitted helminth (STH) control give a key role to dewormingof school and pre-school age children with albendazole or mebendazole; which might beinsufficient to achieve adequate control, particularly against Strongyloides stercoralis.The impact of preventive chemotherapy (PC) against STH morbidity is still incompletelyunderstood. The aim of this study was to assess the effectiveness of a community-basedprogram with albendazole and ivermectin in a high transmission setting for S. stercoralisand hookworm.MethodologyCommunity-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Sixcommunities (5070 people) were enrolled for community-based PC with albendazole andivermectin. Two communities (2721 people) were re-treated for second and third rounds.STH prevalence, anemia and malnutrition were explored through consecutive surveys.Anthropometric assessment of children, stool analysis, complete blood count and NIEELISAserology for S. stercoralis were performed.Principal findingsSTH infection was associated with anemia and stunting in the baseline survey that includedall communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreasedfrom 62% to 23% (p