Thereaputic efficacy of single dose Albendazole against Ascaris lumbricoides, prevalence of re-infection, and its associated factors among school children at Northwest Ethiopia: an open-label trial study

Abstract

BACKGROUND: Despite extensive implementation of albendazole (ALB) mass drug administration to reduce Ascaris lumbricoides among school childrens, it remains a major chilhood health concern which needs close monitoring of ALB efficacy. Additionally, ALB donot prevent re-infection, and determinat for re-infection needs investigation. Thus, the study aimed to evaluate an efficacy of ALB against A.lumbricoides, re-infection rate, and their risk factors among school age childern (SAC) at Northwest Ethiopia. METHODS: An open-label trial study was conducted at Chuahit Primary School from June to September 2023. A total of 415 SAC were recruited using convenient sampling techniques. Nearly 2 g of stool were collected and screened using direct wet-mount and Keto-katz (KK) techniques at baseline. Of these, 50 school children who tested positive for A. lumbricoides were treated with a single dose (400 mg) of ALB. A cure and egg reduction rates were evaluated within 2–3 weeks post-treatment using KK techinque. Addtionally, reinfection rate of A.lumbricoides was assessed 3 months after ALB treatment by formal-ether concentration techinque. Pre-tested, semi-structured questionnaire was used to collect sciodemographic, and risk factors of re-infection. Data were entered into Epi-data (version 4.6) and exported to STATA (version 14) for analysis. Descriptive statistics, paired t-tests, bivariate and multivariate logistic regression model were performed. A P-value < 0.05 with a 95% CI was considered as significant value. RESULT: In this study, the cure and egg reduction rates of a single dose of ALB against A.lumbricoides were found to be 92.3% [95% CI: 87.5%–97.2%] and 96.7% [95% CI: 87.8%-100%], respectively. Of the 46 school children considered for assessing the re-infection rate, about 34.7% [21.8% − 47.6%] were found to have been re-infected. Poor latrine utilization [AOR = 5.52; 95% CI: 1.07–28.5, P = 0.004] and finger nail trimming practice [AOR = 0.064; 95% CI: 0.009–0.42, P = 0.041] were significantly associated with A. lumbricoides re-infection. CONCLUSION: Efficacy of single-dose ALB (400 mg) was within WHO satisfactory level against A. lumbricoides although a high re-infection rate was observed in the study area. This underscores the importance of promoting proper hygiene practice like regular fingernail trimming and toilet utilization strategies, alongside sustained MDA campaigns with ALB (400 mg) to achieve disease elimination goals. TRIAL REGISTRATION: This trial is retrospectively registered at www.pactr.org (number PACTR202407793260730) on July 16, 2024.