Mass treatment with albendazole reduces the prevalence and severity of Oesophagostomum-induced nodular pathology in northern Ghana

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene 2006-08, Vol.100 (8), p.760-766
• Main Authors: Ziem, J.B., Spannbrucker, N., Olsen, A., Magnussen, P., Diederen, B.M.W., Horton, J., Polderman, A.M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Albendazole; Albendazole - therapeutic use; Animals; Anthelmintics - therapeutic use; Child; Child, Preschool; Coproculture; Cross-Sectional Studies; Endemic Diseases - prevention & control; Feces - parasitology; Ghana; Ghana - epidemiology; Humans; Mass treatment; Nodular pathology; Oesophagostomiasis - drug therapy; Oesophagostomiasis - epidemiology; Oesophagostomiasis - prevention & control; Oesophagostomum - isolation & purification; Oesophagostomum bifurcum; Prevalence; Ultrasound
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2005.11.011

Previous surveys conducted in northern Ghana where Oesophagostomum bifurcum is endemic showed that O. bifurcum-induced nodular pathology could be detected in up to 50% of the inhabitants. The impact of albendazole-based mass treatment to control both infection and morbidity is assessed and compared with the situation in a control area where no mass treatment has taken place. A significant reduction in the prevalence of infection based on stool cultures was achieved following two rounds of mass treatment in one year: from 52.6% (361/686) pre treatment to 5.2% (22/421) 1 year later ( χ 1 2 = 210.1 ; P < 0.001). At the same time, the morbidity marker of ultrasound-detectable nodules declined from 38.2% to 6.2% ( χ 1 2 = 138.1 ; P < 0.001). There was a shift from multinodular pathology, often seen in heavy infections, to uninodular lesions. In the control villages where no treatment took place, O. bifurcum infection increased from 17.8% (43/242) to 32.2% (39/121) ( χ 1 2 = 9.6 ; P < 0.001). Nodular pathology decreased slightly from 21.5% to 19.0%, but a higher proportion of these subjects developed multinodular pathology compared with baseline ( χ 1 2 = 5.5 ; P = 0.019). It is concluded that repeated albendazole treatment significantly reduces O. bifurcum-induced morbidity.