Fachbereich Veterinärmedizin



    Reduced efficacy of albendazole against Ascaris lumbricoides in Rwandan schoolchildren (2017)

    Zeitschriftenartikel / wissenschaftlicher Beitrag
    Krücken, Jürgen (WE 13)
    Fraundorfer, Kira (WE 13)
    Mugisha, Jean Claude
    Ramünke, Sabrina (WE 13)
    Sifft, Kevin C.
    Geus, Dominik
    Habarugira, Felix
    Ndoli, Jules
    Sendegeya, Augustin
    Mukampunga, Caritas
    Bayingana, Claude
    Aebischer, Toni
    Demeler, Janina (WE 13)
    Gahutu, Jean Bosco
    Mockenhaupt, Frank P.
    von Samson-Himmelstjerna, Georg (WE 13)
    International journal for parasitology. Drugs and drug resistance; 7(3) — S. 262–271
    ISSN: 2211-3207
    URL (Volltext): http://www.sciencedirect.com/science/article/pii/S2211320717300337
    DOI: 10.1016/j.ijpddr.2017.06.001
    Institut für Parasitologie und Tropenveterinärmedizin

    Robert-von-Ostertag-Str. 7-13
    Gebäude 35, 22, 23
    14163 Berlin
    Tel.+49 30 838 62310 Fax.+49 30 838 62323

    Abstract / Zusammenfassung

    Control of human soil-transmitted helminths (STHs) relies on preventive chemotherapy of schoolchildren applying the benzimidazoles (BZ) albendazole or mebendazole. Anthelmintic resistance (AR) is a common problem in nematodes of veterinary importance but for human STHs, information on drug efficacy is limited and routine monitoring is rarely implemented. Herein, the efficacy of single dose albendazole (400 mg) was evaluated in 12 schools in the Huye district of Rwanda where Ascaris is the predominant STH. Ascaris eggs were detected by wet mount microscopy and the Mini-FLOTAC method to assess cure rate (CR) and faecal egg count reduction (FECR). Blood and faecal samples were analysed for co-infections with Plasmodium sp. and Giardia duodenalis, respectively. Ascaris positive samples collected before and after treatment were analysed for putatively BZ-resistance associated β-tubulin gene single nucleotide polymorphisms. The overall CR was 69.9% by Mini-FLOTAC and 88.6% by wet mount microscopy. The FECR was 75.4% and the 95% calculated confidence intervals were 50.4–87.8% using sample variance, 55.4–88.8% by bootstrapping, and 75.0–75.7% applying a Markov Chain Monte Carlo Bayesian approach. FECR varied widely between 0 and 96.8% for individual schools. No putative BZ-resistance associated polymorphisms were found in the four Ascaris β-tubulin isotype genes examined. Since FECRs <95% indicate reduced efficacy, these findings raise the suspicion of BZ resistance. In the absence of respective molecular evidence, heritable AR in the local Ascaris populations cannot be formally proven. However, since FECRs <95% indicate reduced efficacy, BZ resistance may be suspected which would be alarming and calls for further analyses and routine monitoring in preventive chemotherapy programs.