Efficacy of triclabendazole and albendazole against Fasciola spp. infection in cattle in Côte d'Ivoire: a randomised blinded trial

Triclabendazole is the anthelminthic of choice for the treatment of fascioliasis, however, it is not yet registered in many countries. Therefore, we investigated the efficacy of a single-dose of triclabendazole (12 mg/kg) or albendazole (15 mg/kg) against Fasciola spp. infection in cattle on farms in the northern part of Cote d'Ivoire in a randomized clinical trial. Faecal samples were obtained from 196 cattle, of which 155 (79.1%) were found positive for Fasciola spp. by the sedimentation technique. Cattle infected with Fasciola spp. were randomly allocated (3:3:1) to receive triclabendazole (n=66), albendazole (n=67) or left untreated to serve as control (n=22). Follow-up faecal samples were collected on days 21, 28, 90 and 188 post-treatment. No adverse events were observed as reported by the farmer in any of the treatment groups. The proportion of non-egg shedding cattle (PNES), assessed at day 21 (primary outcome), was significantly higher in cattle treated with triclabendazole (95.4%) compared to those receiving albendazole (70.3%; odds ratio [OR] 0.11, 95% confidence interval [CI] 0.03-0.39, p <0.001). The egg reduction rate (ERR) expressed as number of eggs per gram of faeces (epg), a secondary endpoint assessed at day 21 post-treatment, was significantly higher in the triclabendazole arm (arithmetic mean (AM) ERR=99.8%) than in the albendazole arm (AM ERR=92.2%), with a difference of 7.6%-points (95% CI: 0.9-14.5%-points, p=0.03). Reinfection rates at days 90 and 188 post-treatment (secondary endpoint) were lower in the triclabendazole arm (5.3% and 18.5%) compared to the albendazole arm (23.5% and 33.3%). This is the first report of efficacy of triclabendazole against Fasciola spp. in naturally infected cattle in Cote d'Ivoire. Our results confirm that triclabendazole is the most effective treatment of fascioliasis and therefore, should be considered for the control of livestock fascioliasis; if resources allow in combination with intermediate host snail control and raising farmers awareness of pasture and livestock management to avoid reinfection.