The efficacy of a single oral dose of albendazole against soil-transmitted helminthiasis in Ogun State, Nigeria

Soil Transmitted Helminths (STHs) are Neglected Tropical Diseases of global public health importance. This study evaluated the efficacy of albendazole (ALB) amongst primary school children aged 6 – 16 years in STH-endemic communities in Ogun State, Nigeria. Demographic characteristics were obtained and stool samples were collected and analysed by Kato-Katz at baseline and 15 and 21 days post-treatment. All study participants were treated with a single ALB 400 mg tablet. A total of 282 participants were screened at baseline, of which 151 were found to be excreting STH (51.4%) of which A. lumbricoides was the most prevalent STH (n = 137, 48.6%), followed by hookworm (n = 60 children, 21.3%) and T. trichiura (n = 3; 1.1%). The prevalence across the four schools varied from 31.3% to 73.9% for A. lumbricoides, from 6.8% to 56.3% for hookworm, and from 0.0% and 2.2% for T. trichiura  infections. Of the 151 children excreting any STH infection at baseline, 131 (86.8%) provided a stool sample 15 and 21 days after treatment. The mean fecal egg counts across these complete cases at baseline was 5,096 (± 13,735) eggs per gram (EPG) for A. lumbricoides, 2,202 (±7,849) for hookworms and 288 (±375) for T. trichiura. Fifteen days after drug administration the therapeutic efficacy, measured as the reduction in mean fecal egg count (FEC) following drug administration (ERR), was 99.7% (95CI: 99.4-99.9) for A. lumbricoides and 69.2% (95CI: 28.7-92.8) for hookworms. The hookworm ERR at day 14 was reduced due to the continued high egg output of one highly infected individual. One week later, 21 days following drug administration, ERR for hookworm also reached satisfactory levels (99.4% (95CI: 98.7-99.8)). This study highlights that ALB still shows satisfactory efficacy to Ascaris and hookworm infections in Ogun State, Nigeria.