Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new zentel research articles will be listed here shortly after becoming available to us.
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Vet Parasitol. 2008 May 10;
Entrocasso C, Alvarez L, Manazza J, Lifschitz A, Borda B, Virkel G, Mottier L, Lanusse C
Combination of anthelmintic drugs from different chemical groups has been proposed as alternative parasite control strategies where failure of individual drugs is documented. The main goal of the current trial was to compare the clinical anthelmintic efficacy of albendazole (ABZ) and ivermectin (IVM) given either separately or co-administered to lambs naturally infected with gastrointestinal nematodes resistant to both molecules. Seventy (70) Corriedale lambs naturally infected with multiple resistant gastrointestinal nematodes were involved in the efficacy trial: the animals were allocated into 7 experimental groups (n=10) and treated with either ABZ intravenously (iv) (ABZ(IV)), IVM(IV), ABZ(IV)+IVM(IV), ABZ intraruminally (ir) (ABZ(IR)), IVM subcutaneously (sc) (IVM(SC)) and ABZ(IR)+IVM(SC) or kept as untreated controls. The indirect estimation of the efficacy of the different treatments was performed by the faecal egg count reduction test (FECRT). Additionally, four animals randomly chosen from the untreated control and ABZ(IV,) IVM(IV) and ABZ(IV)+IVM(IV) experimental groups were sacrificed 15 days post-treatment to evaluate the efficacy against different adult resistant nematode parasites. The results were statistically compared by a non-parametric ANOVA (Kruskal-Wallis test). The following egg output reduction values were obtained: 73.4% (ABZ(IV)), 79.0% (IVM(IV)), 91.9% (ABZ(IV)+IVM(IV)), 43.5% (ABZ(IR)), 79.8% (IVM(SC)) and 70.8% (ABZ(IR)+IVM(SC)). The efficacy against Haemonchus spp. was 95.1 (ABZ(IV)), 99.3 (IVM(IV)) and 99.9% (ABZ(IV)+IVM(IV)), while the efficacy against Trichostrongylus colubriformis for the same treatment groups was 79.6, 100 and 99.9%. The data obtained on the assessment of the ABZ-IVM combination indicates that no potentiation synergism is observed. This work is complementary to a parallel study that demonstrated the lack of negative pharmacokinetic interactions between the two anthelmintics acting by different mode of action. Thus, an additive effect may be achieved against nematodes resistant to both compounds. Further work is required to understand the implications of potential pharmacokinetic/pharmacodynamic interactions between anthelmintics before drug combined formulations are developed to be introduced into the pharmaceutical market.
Phase I biotransformation of albendazole in lancet fluke (Dicrocoeliumdendriticum).
Res Vet Sci. 2008 Jun 17;
Cvilink V, Szotáková B, Křížová V, Lamka J, Skálová L
Dicroceliosis, a lancet fluke infection, is a frequent parasitosis of small ruminants and the anthelmintic drug albendazole (ABZ) is effective in control of this parasitosis. The aim of our project was to study the metabolism of ABZ and ABZ sulphoxide (ABZ.SO) in lancet fluke. Both invitro (subcellular fractions of fluke homogenates) and exvivo experiments (adult flukes cultivated in medium) were performed for this purpose. ABZ was metabolised invitro by lancet fluke NADPH-dependent enzymes by two oxidative steps (sulphoxidation and sulphonation). The apparent kinetic parameters of these reactions have been determined. In the exvivo experiments, only ABZ sulphoxidation was observed. The stereospecificity in ABZ sulphoxidation invitro was slight, with preferential formation of (+)-ABZ.SO enantiomer. In contrast (-)-ABZ.SO formation predominated in exvivo experiments. Sulphoreduction of ABZ.SO occurred neither invivo nor exvivo. The detection of ABZ oxidative metabolites indicates the presence of drug metabolising oxidases in lancet fluke.
Treatment of eosinophilia with albendazole.
Southeast Asian J Trop Med Public Health. 2008 May; 39(3): 517-20
Insiripong S, Siriyakorn N
Twenty-five patients with eosinophil counts > 1,000/mm3 of unknown etiology were treated with albendazole 400 mg twice daily for 7 days were compared with 25 eosinophilic control patients who were not treated. The average eosinophil count in the treated group was 2,079/mm3 (range 1,002-7,629/mm3) and in the control group was 2,047/mm3 (range 1,002-6,468/mm3). One month later the eosinophil counts of both groups were re-evaluated. Effective treatment was defined as an eosinophil count < 1,000/mm3. In the treatment group, 80% had a reduction in the eosinophil count to < 1,000/mm3 while only 12% of the control had a reduction to this level. No side effects were observed in either group. In conclusion, albendazole was found to be highly-effective in the management of patients with eosinophilia without obvious causes.
Human toxocariasis: a report of nine cases.
Acta Paediatr. 2008 Jun 12;
Saporito L, Scarlata F, Colomba C, Infurnari L, Giordano S, Titone L
Aim: Human toxocariasis is caused by infection with the larval stage of nematode parasites of dogs and cats, Toxocara canis or Toxocara cati. These helminths are not able to complete their life cycle in undefinitive hosts and so undergo aberrant migrations in the tissues causing a wide spectrum of signs and symptoms. Eosinophilia is often severe and sometimes represents the only sign of infection, except in ocular and neurological forms. Methods: We describe the clinical features of nine children affected by toxocariasis admitted to our Infectious Diseases department from 2004 to 2006. Results: Fever and hepatomegaly were the most common clinical findings. In two cases eosinophilia was not present. Diagnosis was performed by enzyme-linked immunosorbent assay employing excretory-secretory antigens of Toxocara. canis larvae. All patients were successfully treated with oral albendazole with no side effects. Conclusion: Toxocariasis should be considered in differential diagnosis of eosinophilia and in patients with seizures of uncertain origin, isolated hepatomegaly and splenomegaly, bronchospasms or skin rash.
Trans R Soc Trop Med Hyg. 2008 Jun 10;
Njenga SM, Wamae CN, Njomo DW, Mwandawiro CS, Molyneux DH
Annual single-dose mass treatment of endemic populations with a combination of either diethylcarbamazine (DEC) or ivermectin plus albendazole is recommended as the mainstay of lymphatic filariasis elimination programmes. We evaluated the impact of two rounds of annual mass drug administration (MDA) of DEC and albendazole on bancroftian filariasis in a pilot elimination programme in an endemic area of Kenya. Overall prevalence of microfilaraemia decreased by 65.4%, whereas community microfilarial load decreased by 84% after the two MDAs. The prevalence of parasite antigenaemia determined by immunochromatographic test (ICT) declined significantly by 43.5% after the two MDAs. We also studied the effect of mass treatment on the sensitivity of the ICT. Although the sensitivity of the test before treatment was high (89.9%; kappa=0.909) sensitivity was lower after two MDAs (59.3%; kappa=0.644). The finding raises concern about the reliability of the ICT in long-term monitoring of infection and for establishing programmatic endpoints. The results of the present study indicate a relatively high effectiveness of MDA using a DEC/albendazole combination against Wuchereria bancrofti infection and, therefore, it may be a useful strategy to eliminate lymphatic filariasis in onchocerciasis-free areas.
Long-term evaluation of patients with hydatidosis treated with albendazole and praziquantel.
Int J Immunopathol Pharmacol. 2008 Apr-Jun; 21(2): 429-35
Haralabidis S, Diakou A, Frydas S, Papadopoulos E, Mylonas A, Patsias A, Roilides E, Giannoulis E
Hydatidosis is a usually asymptomatic chronic disease. In most patients who undergo surgery, hydatidosis is not resolved due to high recurrence rate. However, long-term treatment with albendazole has been found to have a significant efficacy that has been further improved when albendazole is combined with praziquantel and fat-rich diet. In this study a retrospective evaluation of the outcome of hydatidosis in 70 patients, was performed. In group A, a combined chemotherapy of albendazole plus praziquantel was given after surgical removal of cysts. In group B chemotherapy alone was administered without surgery. Sera of all patients were assayed for IgG, IgM, IgA and IgE antibodies by ELISA. In addition, ultrasonography (US) and/or computerized tomography (CT) scans were performed every 3 months for 18 months, and then, each year until the end of follow-up. The difference between the two kinds of treatment used in the present study was found to be not significant, nor was the difference of the shrinkage and extended calcification of the HCs between the two groups. However, the difference of the shrinkage of the HCs of more than 80%, as well as the extended calcifications of the cysts between the two groups were found to be statistically significant. In all patients high levels of IgG and IgA were detected, while IgE in group A and/or IgM in group B were marginally detected above the background level throughout the study. Level of IgG was strongly fluctuated and significantly decreased at 11.7 years after the end of chemotherapy, or at 8.5 years after relapses in group A, while was dramatically decreased at 3.6 years after the termination of chemotherapy in group B. Relapses occurred in 11.4% of patients within the first six months after end of chemotherapy. After additional chemotherapy with albendazole for 3-6 months, all of them were considered cured at 8.5 years of follow up.
Am J Trop Med Hyg. 2008 Jun; 78(6): 924-8
Liang JL, King JD, Ichimori K, Handzel T, Pa'au M, Lammie PJ
American Samoa began a territory-wide mass drug administration (MDA) program with diethylcarbamazine and albendazole in 2000 after baseline surveys indicated that 16.5% of 2,989 residents were infected with Wuchereria bancrofti based on tests for circulating filarial antigen. Follow-up surveys were conducted in 2001, 2003, and 2006, using convenience samples of residents of sentinel villages. Antigenemia prevalence in 2001 (11.5%) and 2003 (13.5%) showed no change. After the 2003 sentinel assessment, improvements were made in the social mobilization and drug distribution strategies. In 2006, after a total of 5 years of MDA and 3 years of improved MDA participation, the antigenemia prevalence dropped from 11.5% (2001) to 0.95% (2006) (P < 0.0001). In 2006, antigenemia prevalence was greater in males (1.5%) than females (0.4%) (P = 0.04). The decline in antigenemia prevalence shows the effectiveness of MDA and changes made in social mobilization and drug distribution.
Rev Neurol. 2008 Jun 1-15; 46(11): 671-4
Diazgranados-Sánchez JA, Barrios-Arrázola G, Costa JL, Burbano-Pabon J, Pinzón-Bedoya J
INTRODUCTION: Neurocysticercosis is a public health problem that can be found in many parts of the world, especially in developing countries, and today's high rates of immigration are making it increasingly more common in developed countries. Cysticidal treatment of neurocysticercosis is a controversial issue because it is only partially effective against vesicular and colloidal-shaped cysts when the parasite persists after a course of albendazole or praziquantel, the only two therapeutic options that are currently available. Ivermectin is a very effective, safe veterinary and human antiparasitic drug, with occasional very mild side effects. It has been used for over 25 years in cases of endoparasitosis that do not respond well to treatment, such as filariasis, oncocerciasis, strongyloidiasis, etc. and also in ectoparasitoses, such as pediculolsis capitis and myasis. It acts in the myoneural junction on the receptors in the chloride channel by increasing their permeability and causing paralysis in adult worms or by a mediated immune mechanism when it acts on immature forms. CASE REPORTS: We report the cases of four patients who were previously treated with albendazole reiteratively with radiological evidence, which shows the persistence of viable vesicular or colloidal-shaped cysts. These patients were given 10 mg/day of ivermectin for 15 consecutive days or 10 mg/day as an average for 30 days, with excellent clinical and radiological progress. CONCLUSIONS: Ivermectin was effective and did not give rise to any side effects when used to treat these four patients, who were resistant to conventional treatment with albendazole and/or praziquantel.
PLoS Negl Trop Dis. 2008; 2(5): e241
Tohon ZB, Mainassara HB, Garba A, Mahamane AE, Bosqué-Oliva E, Ibrahim ML, Duchemin JB, Chanteau S, Boisier P
BACKGROUND: In the framework of the monitoring and evaluation of the Nigerian schistosomiasis and soil-transmitted helminth control programme, a follow-up of children took place in eight sentinel sites. The objective of the study was to assess the evolution of Schistosoma haematobium infection and anaemia in schoolchildren after a single administration of praziquantel (PZQ) and albendazole. METHODS/PRINCIPAL FINDINGS: Pre-treatment examination and follow-up at one year post-treatment of schoolchildren aged 7, 8, and 11 years, including interview, urine examination, ultrasound examination of the urinary tract, and measurement of haemoglobin. Before treatment, the overall prevalence of S. heamatobium infection was 75.4% of the 1,642 enrolled children, and 21.8% of children excreted more than 50 eggs/10 ml urine. Prevalence increased with age. The overall prevalence of anaemia (haemoglobin
Parasit Vectors. 2008 May 27; 1(1): 14
Amarillo ML, Belizario VY, Sadiang-Abay JT, Sison SA, Dayag AM
ABSTRACT: BACKGROUND: Mass drug administration (MDA) has been one of the strategies endorsed by the World Health Assembly for lymphatic filariasis (LF) elimination. Many factors, however, affect the acceptability of the MDA in the Philippines with acceptability defined as the ingestion of drugs -diethylcarbamazine and albendazole during MDA. These drugs were mainly distributed in fixed sites and mopping up activities were conducted through house-to-house visits to increase treatment coverage. The aim of conducting the study was to determine the MDA acceptance rate among a population endemic for LF, and the factors associated with MDA acceptance. METHODS: In April 2005, a stratified cluster survey involving 437 respondents aged 18 years old and above in Agusan del Sur, Philippines was conducted. Key informant interviews and focused group discussions were performed among community leaders and health service providers. Descriptive statistics and coverage estimates were calculated with appropriate sampling weights applied to all analyses. Factors assessed for association with receipt of antifilarial drugs and MDA acceptance were respondents' socio-demographic characteristics, knowledge, attitudes, beliefs and perceptions on LF. Pearson chi-squared test was used to determine factors associated with MDA acceptance. RESULTS: Results showed that 63.3% of the sampled population received the antifilarial drugs; of these, 94.5% ingested the drugs, yielding an acceptance rate of 60%. Half of the sampled population received the drugs from a fixed site, while only 13% was mopped up. A majority of the sampled population were aware of LF and MDA. Knowledge on LF prevention, cause, treatment and diagnosis and adverse events was low to moderate. Knowledge on LF and perceived benefits of antifilarial drugs were found to be associated with MDA acceptance (p=0.08). Health workers remain the front liners in the MDA implementation. Local government units were aware of LF and MDA, but support was insufficient. CONCLUSIONS: The proportion of the sampled population that received and ingested the antifilarial drugs was much lower than the reported coverage. The target coverage rate of 85% may be achieved with sufficient groundwork for MDA, buy-in from the local government, greater efforts exerted to increase the people's knowledge on LF and MDA and their understanding of perceived benefits of the drugs. These would contribute to the successful elimination of LF in the province.