Treating Soil-Transmitted Helminth with Novel Albendazole Plus Ivermectin Coformulation
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on February 26th, 2025
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Soil-transmitted helminth infections are commonly treated and prevented with a single dose of albendazole or mebendazole. While these medications are highly effective against hookworm species such as Ancylostoma duodenale and Necator americanus, they are less effective at clearing Strongyloides stercoralis and Trichuris trichiura. To address this gap, a study funded by the European Union was conducted to evaluate the efficacy of combining albendazole with ivermectin for treating all major soil-transmitted helminth infections.
The study included 1,001 children, with an average age of 11, attending schools in Ethiopia, Kenya, and Mozambique. Stool samples were analyzed using the Kato–Katz thick smear and modified Baermann methods, revealing a baseline Trichuris trichiura prevalence of 64%. Baseline hookworm and Strongyloides stercoralis infection rates were reported at 36% and 10%, respectively.
The participants were randomly assigned to receive one of three treatment regimens: either a single 400 mg dose of albendazole, a single combined dose of albendazole (400 mg) plus ivermectin (9 mg for children under 45 kg and 18 mg for those heavier), or albendazole combined with ivermectin daily for three consecutive days. Albendazole disrupts the worm’s digestive system by inhibiting tubulin polymerization, leading to starvation and death. Ivermectin acts by binding to voltage-gated chloride channels, increasing their permeability and resulting in parasite paralysis and death.
Stool analysis on the seventh day after treatment initiation showed that the three-dose co-formulation of albendazole and ivermectin was the most effective at clearing helminths, achieving cure rates of 97.2% for Trichuris trichiura, and 100% for both hookworms and Stronglyoides stercoralis. These rates were significantly higher compared to those observed with albendazole monotherapy, which had cure rates of 35.9%, 65.1%, and 81.3%, respectively. The researchers noted that the finding regarding Stronglyoides stercoralis was less statistically robust due to the limited sample size, but previous studies have already demonstrated ivermectin’s efficacy against this parasite.
The study included 1,001 children, with an average age of 11, attending schools in Ethiopia, Kenya, and Mozambique. Stool samples were analyzed using the Kato–Katz thick smear and modified Baermann methods, revealing a baseline Trichuris trichiura prevalence of 64%. Baseline hookworm and Strongyloides stercoralis infection rates were reported at 36% and 10%, respectively.
The participants were randomly assigned to receive one of three treatment regimens: either a single 400 mg dose of albendazole, a single combined dose of albendazole (400 mg) plus ivermectin (9 mg for children under 45 kg and 18 mg for those heavier), or albendazole combined with ivermectin daily for three consecutive days. Albendazole disrupts the worm’s digestive system by inhibiting tubulin polymerization, leading to starvation and death. Ivermectin acts by binding to voltage-gated chloride channels, increasing their permeability and resulting in parasite paralysis and death.
Stool analysis on the seventh day after treatment initiation showed that the three-dose co-formulation of albendazole and ivermectin was the most effective at clearing helminths, achieving cure rates of 97.2% for Trichuris trichiura, and 100% for both hookworms and Stronglyoides stercoralis. These rates were significantly higher compared to those observed with albendazole monotherapy, which had cure rates of 35.9%, 65.1%, and 81.3%, respectively. The researchers noted that the finding regarding Stronglyoides stercoralis was less statistically robust due to the limited sample size, but previous studies have already demonstrated ivermectin’s efficacy against this parasite.