Helminthiasis remains a public health issue in endemic areas. Various drugshave been proposed to improve efficacy against helminths. The study aimed to assessthe safety and efficacy of three... Show moreHelminthiasis remains a public health issue in endemic areas. Various drugshave been proposed to improve efficacy against helminths. The study aimed to assessthe safety and efficacy of three different anthelmintic combinations to treat Trichuristrichiura infections. We conducted a randomized assessors-blind clinical trial involvingchildren aged 2–17 years with T. trichiura. Participants were randomly assigned to oneof three treatment arms. On the first and third days, all participants got albendazole400 mg, and on the second day, albendazole (arm A), mebendazole 500 mg (arm B), orpyrantel 125 mg/kg (arm C). We assessed treatment efficacy using the cure rate (CR) andegg reduction rate (ERR) at 3 and 6 weeks post-treatment. At 3 weeks post-treatment,ERR and CR were highest in study arm A [ERR = 94%, 95% confidence interval (CI):92–95; CR = 71%; 95% CI: 58–81] compared to the B and C arms. Decrease in ERR wassignificant only for arm B versus arm A (P-value <0.001); decrease in ERR was significantfor arms B and C (P-value <0.001). No statistical difference was observed in CR whencomparing arms A and B (P-value =1.00) and C (P-value =0.27). At 6 weeks, a decreasein ERR was observed in three arms, significant only for arm C, 81% (95% CI: 78–83). Asignificant increase in egg counts was observed between 3 and 6 weeks post-treatment.All treatments were safe with mild adverse events. Albendazole 400 mg/day (arm A)showed the highest efficacy against trichuriasis. Nonetheless, this treatment regimenwas able to cure half of the treated individuals highlighting concerns about controllingthe transmission of T. trichiura. Show less
Objective To report the prevalence of polyparasitism during pregnancy in the Lambarene region of Gabon and its association with newborn birth weight.Method Pregnant women in their third trimester... Show moreObjective To report the prevalence of polyparasitism during pregnancy in the Lambarene region of Gabon and its association with newborn birth weight.Method Pregnant women in their third trimester were recruited in a prospective study between November 2011 and March 2015. Parasite infection status was assessed microscopically in stool, urine and blood samples. Maternal demographic and obstetrical characteristics and newborns anthropometric data were collected. Multivariable logistic regression was used to assess the association between low birth weight and polyparasitism.Results 678 of 927 pregnant women were included for analysis with mean age (SD) of 25 (6.8) years. The analysis showed that 69% (468/678) were infected with at least one parasite (Plasmodium spp., Schistosoma spp., soil-transmitted helminths, filarial infections). This comprised of 38% with monoparasitism and 31% polyparasitism. The proportion of newborn babies with a weight below 2500 g (LBW) in our study was 21% (142/678). Compared to pregnant women without infection, women with monoparasitic infection had adjusted Odds Ratio confidence interval 95% CI (aOR [95%CI]) of 1.6 [0.95-2.73], those with two parasites had aOR 95%CI of 2.63 [1.51-4.62], and those with more than two parasites had aOR of 5.08 [2.5-10.38] for delivering a newborn with low birth weight.Conclusion In Lambarene, an endemic area for multiple parasite infections, there is a high prevalence of polyparasitism in pregnant women. Polyparasitism is associated with low birth weight. Therefore, there is an urgent need for active screening and treatment of parasite infections in pregnant women to assess the potential public health benefit of such interventions. Show less
Mombo-Ngoma, G.; Yazdanbakhsh, M.; Adegnika, A.A.; Kremsner, P.G.; Ramharter, M. 2017
Background: In malarious areas of the world, a higher proportion of the population has blood group O than in non-malarious areas. This is probably due to a survival advantage conferred either by an... Show moreBackground: In malarious areas of the world, a higher proportion of the population has blood group O than in non-malarious areas. This is probably due to a survival advantage conferred either by an attenuating effect on the course of or reduction in the risk of infection by plasmodial parasites. Here, the association between ABO blood group and incidence of placental malaria was assessed in order to determine the possible influence of the former on the latter. Methods: Data from a study in Lambarene, Gabon, and data from three previously published reports of studies in The Gambia, Malawi and Sudan, were compiled and compared. ABO blood groups were cross-tabulated with placental malaria stratified by parity. Odds ratios (OR), stratified by parity, were calculated for the outcome, placental parasitaemia, and compared between blood group O vs. non-O mothers in all four studies. Random effects meta-analysis of data from individual studies from areas with perennial hyper/holoendemic transmission was performed. Results: In Gabon, the odds ratio (OR) for active placental parasitaemia in mothers with group O was 0.3 (95% CI 0.05-1.8) for primiparae and 0.7 (95% CI 0.3-1.8) for multiparae. The OR for primiparae in the published study from The Gambia was 3.0 (95% CI 1.2-7.3) and, in Malawi, 2.2 (95% CI 1.1-4.3). In the Sudanese study, no OR for primiparae could be calculated. The OR for placental parasitaemia in group O multiparae was 0.8 (95% CI 0.3-1.7) in the Gambia, 0.6 (95% CI 0.4-1.0) in Malawi and 0.4 (95% CI 0.1-1.8) in Sudan. Combining data from the three studies conducted in hyper-/holo-endemic settings (Gambia, Malawi, Gabon) the OR for placental malaria in blood group O multiparae was 0.65 (95% CI 0.44-0.96) and for primiparae 1.70 (95% CI 0.67-4.33). Conclusion: Studies conducted in The Gambia and Malawi suggest that blood group O confers a higher risk of active placental infection in primiparae, but a significantly lower risk in multiparae. These findings were not confirmed by the study from Gabon, in which statistically non-significant trends for reduced risk of placental parasitaemia in those with blood group O, regardless of parity, were observed. Show less
