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Efficacy and safety of ivermectin against Trichuris trichiura in preschool- and school-aged children : a randomized controlled dose-finding trial

Wimmersberger, David and Coulibaly, Jean T. and Schulz, Jessica D. and Puchkow, Maxim and Huwyler, Jörg and N'Gbesso, Yves and Hattendorf, Jan and Keiser, Jennifer. (2018) Efficacy and safety of ivermectin against Trichuris trichiura in preschool- and school-aged children : a randomized controlled dose-finding trial. Clinical Infectious Diseases, 67 (8). pp. 1247-1255.

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Official URL: https://edoc.unibas.ch/65680/

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Abstract

Although trichuriasis affects millions of children worldwide, recommended drugs lack efficacy and new treatment options are urgently needed. Ivermectin has promising potential to complement the anthelminthic armamentarium.; A randomized placebo-controlled trial was conducted in rural Côte d'Ivoire to provide evidence on the efficacy and safety of ascending oral ivermectin dosages in preschool-aged children (PSAC) and school-aged children (SAC) infected with Trichuris trichiura. The primary outcome was the cure rate (CR) for T. trichiura infection, and the secondary outcomes were safety, egg-reduction rates (ERRs) against T. trichiura infection, and CRs and ERRs against other soil-transmitted helminth species.; A total of 126 PSAC and 166 SAC were included in an available case analysis. In PSAC, efficacy against T. trichiura did not differ between 200 µg/kg ivermectin and placebo treatment arm, as expressed in CRs (20.9% [95% confidence interval {CI}, 11.9%-52.8%] vs 19.5% [10.4%-49.9%]) and geometric mean ERRs (78.6% [60.1%-89.5%] vs 68.2% [40.5%-84.8%]). In SAC, the highest administered ivermectin dose of 600 µg/kg had a low CRs (12.2% [95% CI, 4.8%-32.3%]) and moderate ERRs (66.3% [43.8%-80.2%]). Only mild adverse events and no organ toxicity, based on serum biomarkers, was observed.; Ivermectin can be administered safely to PSAC with trichuriasis. Given the low efficacy of ivermectin monotherapy against T. trichiura infection, further research should investigate the optimal drug combinations and dosages with ivermectin against soil-transmitted helminthiasis.; ISRCTN15871729 (www.isrctn.com).
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Human and Animal Health > One Health (Zinsstag)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Helminth Drug Development (Keiser)
UniBasel Contributors:Keiser, Jennifer and Hattendorf, Jan and Coulibaly, Jean
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Oxford University Press
ISSN:1058-4838
e-ISSN:1537-6591
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:15 Nov 2018 13:59
Deposited On:15 Nov 2018 13:59

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