Preventive Chemotherapy in the Fight against Soil-Transmitted Helminthiasis: Achievements and Limitations. Issue 7 (July 2018)

• Record Type: Journal Article
• Authors: Schulz, Jessica D.; Moser, Wendelin; Hürlimann, Eveline; Keiser, Jennifer
• Is Part Of: Trends in parasitology. Volume 34:Issue 7(2018)
• Page Start: 590
• Page End: 602
• Publication Date: 2018-07
• Subjects: anthelmintic drugs -- drug efficacy -- drug resistance -- soil-transmitted helminths -- preventive chemotherapy -- worm burden; Parasitology -- Periodicals; Parasitology -- Periodicals; Biology -- Periodicals; Parasitology; Biology; Parasitologie -- Périodiques; Online resources; 571.999
• DOI: 10.1016/j.pt.2018.04.008
• Languages: English
• ISSNs: 1471-4922

Abstract

Abstract : Soil-transmitted helminths (STHs) are endemic in more than half of the world's countries. The World Health Organization has advocated targeted preventive chemotherapy (PC) to control STH infections by distributing albendazole or mebendazole to at-risk populations. While the overall impact and sustainability of this strategy is disputed, a decrease in moderate and heavy STH infections can be largely attributed to a scale-up of drug distribution. Two factors might jeopardise the success of PC programs. First, the benzimidazoles possess unsatisfactory efficacy against Trichuris trichiura infections. Second, increased drug distributions might trigger anthelmintic resistance. This review presents an overview of the burden of STH infections, the evolution of PC along with its success and challenges, recent estimates of the efficacy of recommended drugs, and alternative treatment options. Highlights: For controlling STH infections, millions of single doses of albendazole and mebendazole are distributed yearly in the framework of PC. Although PC caused a drop in the number of moderate and heavy STH infections, its overall impact is highly disputed. The STH burden has steadily declined with time but still more than one billion people are infected globally. Albendazole and mebendazole do not have high efficacy against all STH infections when used in single oral doses – for example, mebendazole lacks efficacy against hookworm; neither drug has high efficacy against T. trichiura . Resistance against both drugs has been observed in the veterinary field but has not yet been confirmed in human medicine. A few drugs with anthelmintic activity – as well as potential drug combinations with enhanced efficacy profiles – have been identified but they need further evaluation to better treat infections with all STHs.