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Keywords:

  • schistosomiasis;
  • onchocerciasis;
  • lymphatic filariasis;
  • praziquantel;
  • albendazole;
  • ivermectin
  • Esquistosomiasis;
  • oncocercosis;
  • filariasis linfática;
  • praziquantel;
  • albendazol;
  • ivermectina

Summary

Objectives  To compare (i) side effects associated with the simultaneous adminstration of praziquantel, albendazole and ivermectin with side affects associated with albendazole and ivermectin only and (ii) coverage by volunteers distributing three or two drugs.

Methods  Two-arm comparative study in northern Ghana integrated praziquantel distribution into an existing lymphatic filariasis and onchocerciasis control programme using Community Directed Distributors. The control arm continued to distribute only ivermectin and albendazole. Dosages of ivermectin and praziquantel were based on height. Treatment was directly observed, and all two/three drugs were co-administered. Adverse effects were recorded based on passive surveillance. Parasitological, anthropometric and haematological data were collected at baseline.

Results  Prevalence of Schistosoma haematobium infection among 1001 (boys: 47.9% girls: 52.1%) school-age children (6–15 years) [intervention: 30.0% (CI: 23.1–34.2); control: 23.0% (CI: 18.9–27.0)], mean haemoglobin, weight and age were similar among the intervention and control groups. While 1676 (99.1%) compounds in the control area were visited and 15 020 (96.58%) people were treated, only 1375 (88.5%) compounds in the intervention area were visited and 8454 (80.97%) people treated (P < 0.001). The numbers of adverse effects were similar (intervention: 50/6896; control: 130/15 020). The most reported adverse effects was headache (intervention: 14/50; control: 13/130), followed by body weakness, which was reported more from the intervention group (intervention: 13/50, 95% CI: 14.6–40.3; control: 6/130, 95% CI: 1.7–9.8]. Sixty-six per cent (6896/10 441) of the eligible population received praziquantel.

Conclusions  Reported adverse events were mild and managed at the subdistrict level with no cases of hospitalization; intensive health education will, however, be required to improve coverage.

Objetivos:  Comparar (1) los efectos secundarios asociados con la administración simultánea de pazicuantel, albendazol e ivermectina con los efectos secundarios asociados al albendazol e ivermectina solas; y (2) cobertura por voluntarios distribuyendo tres o dos medicamentos.

Métodos:  Estudio comparativo de dos brazos en el norte de Ghana integrando la distribución de prazicuantel en un programa existente de control de la filariasis linfática y oncocercosis utilizando distribuidores dirigidos por la comunidad. En el brazo control se continuó distribuyendo solo la ivermectina y el albendazol. Las dosis de ivermectina y prazicuantel se basaban en la altura. El tratamiento era de observación directa y todos los medicamentos (dos o tres) fueron co-administrados. Los efectos adversos se registraron basándose en una vigilancia pasiva. Los datos parasitológicos, antropométricos y hematológicos se recolectaron al inicio del estudio.

Resultados:  La prevalencia de la infección por S. haematobium entre 1,001 (niños: 47.9% niñas: 52.1%) niños en edad escolar (6-15 años) [intervención: 30.0% (IC: 23.1-34.2); control: 23.0% (IC: 18.9-27.0)], la hemoglobina media, el peso y la edad eran similares entre los grupos de la intervención y de control. Mientras que se visitaron 1,676 (99.1%) viviendas en el área de control y se trató a 15,020 (96.58%) personas, solo se visitaron 1,375 (88.5%) viviendas en el área de la intervención y se trataron 8,454 (80.97%) personas [P < 0.001]. El número de efectos adversos era similar (intervención: 50/6896; control: 130/15,020). Los efectos adversos más reportados eran el dolor de cabeza (intervención: 14/50; control: 13/130), seguido por la debilidad corporal que se reportó más en el grupo de intervención (intervención: 13/50, 95% CI: 14.6–40.3; control: 6/130, 95% CI: 1.7–9.8]. Un sesenta y seis por ciento (6,896/10,441) de la población elegible recibió praziquantel.

Conclusiones:  Los eventos adversos reportados eran leves y manejables a nivel del sub-distrito, sin casos de hospitalización; sin embargo, es necesario el que haya un fuerte compromiso en pos de la educación sanitaria si se quiere mejorar la cobertura.