Impact of repeated mass treatment on human Oesophagostomum and hookworm infections in northern Ghana
Tropical Medicine and International Health
Department of Parasitology, Leiden University Medical Centre, Leiden, Netherlands; School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana; DBL-Institute for Health Research and Development, Charlottenlund, Denmark; Department of Pharmacology and Therapeutics, Liverpool University, Liverpool, United Kingdom; Parasitic Diseases Research Centre, Ghana Health Service, Tamale, Ghana; Department of Parasitology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands
Oesophagostomum bifurcum is a common parasite of humans causing disease in parts of northern Ghana and northern Togo. The impact of repeated mass treatment with albendazole on infection with O. bifurcum and hookworm is analysed and the results compared with those in a control area where no treatment was given. At baseline, O. bifurcum and hookworm prevalences were 53.0% and 86.9%, respectively (n = 1011). After 12 months, following two rounds of albendazole treatment, prevalences decreased significantly to 5.4% for O. bifurcum and 36.8% for hookworm (n = 535). Twenty-four months after the baseline survey and following a total of four rounds of treatment, prevalences were further reduced to 0.8% and 23.4% for O. bifurcum and hookworm, respectively (n = 478). Overall, there was a significant decrease in the larval counts, measured as geometric mean larval count per 4 g of stool of O. bifurcum from 3.0 to 0.1 and of hookworm from 47.2 to 1.8. The fourth mass treatment was carried out in April 2003 by the Lymphatic Filariasis Elimination Programme. Overall, compliance to treatment varied from 70% to 80%. In the control area, Oesophagostomum prevalence increased from 18.5% to 37.0% and the intensity from 0.4 to 1.4. For hookworm, both prevalence (86.1-91.3%) and intensity (54.8-74.3) increased but not to a significant level. The prospects of eliminating human oesophagostomiasis from the intervention area, while simultaneously achieving an important reduction of hookworm prevalences by albendazole mass treatment, are discussed. © 2006 Blackwell Publishing Ltd.
albendazole; disease treatment; drug; filariasis; infectious disease; parasite prevalence; parasitic disease; adolescent; adult; aged; article; child; controlled study; feces analysis; female; geometry; Ghana; health program; health survey; hookworm infection; human; larval development; major clinical study; male; measurement; nematodiasis; patient compliance; prevalence; statistical significance; Strongyloidea; treatment outcome; Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Albendazole; Anthelmintics; Child; Child, Preschool; Endemic Diseases; Female; Ghana; Hookworm Infections; Humans; Infant; Male; Middle Aged; Oesophagostomiasis; Parasite Egg Count; Population Surveillance; Prevalence; Rural Health; Sex Distribution; Treatment Outcome; Africa; Ghana; Sub-Saharan Africa; Togo; West Africa; Ancylostomatoidea; Oesophagostomum; Oesophagostomum bifurcum