Analysis of the population-level impact of co-administering ivermectin with albendazole or mebendazole for the control and elimination of Trichuris trichiura
Author(s)
Type
Journal Article
Abstract
INTRODUCTION: Soil-transmitted helminth (STH) infections are predominately controlled by providing children with preventive chemotherapy with either albendazole or mebendazole. However, neither has a high efficacy against Trichuris trichiura. This low efficacy limits the overall effectiveness of the current STH control programmes against T. trichiura. It has been demonstrated that co-administering ivermectin with albendazole or mebendazole significantly increases the efficacy of current treatments, which may increase the overall effectiveness of control programmes. METHODS: Using a STH transmission mathematical model, we evaluated the potential impact of co-administering ivermectin with albendazole or mebendazole to treat T. trichiura within a preventive chemotherapy programme targeting children (2-15 year olds). We evaluated the impact in terms of reduction in prevalent infections, mean worm burden, and prevalence of heavy infections. RESULTS: Although the current treatment strategy reduced T. trichiura worm burden and prevalence of heavy infections, due to their poor efficacy the long term impact of preventive chemotherapy for children was smaller compared to the other STH. Co-administering ivermectin increased the projected impact of the preventive chemotherapy programme in terms of all three of the explored metrics, practically in high transmission settings. Furthermore, ivermectin co-administration greatly increased the feasibility of and timeframe for breaking transmission. CONCLUSIONS: Co-administering ivermectin notably increased the projected impact of preventive chemotherapy in high transmission settings and increased the feasibility for breaking transmission. This has important implications for control programmes, some of which may be shifting focus from morbidity control to interruption of transmission, and some of which may be logistically unable to provide preventive chemotherapy twice a year as recommended. However, the benefit of co-administering ivermectin is limited by the fact that 2-5 year olds are often ineligible to receive treatment.
Date Issued
2016-03-02
Date Acceptance
2016-02-23
Citation
Parasite Epidemiology and Control, 2016, 1 (2), pp.177-187
ISSN
2405-6731
Publisher
Elsevier
Start Page
177
End Page
187
Journal / Book Title
Parasite Epidemiology and Control
Volume
1
Issue
2
Copyright Statement
© 2016 The Authors. Published by Elsevier Ltd on behalf of World Federation of
Parasitologists. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
Parasitologists. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
License URL
Subjects
ALB, albendazole
Control
ERRs, egg reduction rates
Elimination
IVM, ivermectin
Ivermectin co-administration
MBZ, mebendazole
Mass drug administration
Pre-SAC, preschool-aged
R0, basic reproductive number
SAC, school-aged children
STH, soil-transmitted helminth
Soil-transmitted helminth
Trichuris trichiura
WASH, water, sanitation and hygiene
WHO, World Health Organisation
Publication Status
Published