Albendazole chemotherapy for treatment of diarrhoea in patients with AIDS in Zambia: a randomised double blind controlled trial

Abstract Objective : To determine the value of short course, high dose albendazole chemotherapy in the treatment of persistent diarrhoea related to HIV in unselected patients in urban Zambia. Design : A randomised double blind placebo controlled trial of albendazole 800 mg twice daily for two weeks. Patients were monitored intensively for one month and followed for up to six months. Setting : Home care AIDS services in Lusaka and Ndola. Patients : 174 HIV seropositive patients with persistent diarrhoea (defined as loose but not bloody stools three or more times a day for three weeks or longer). No investigations were undertaken except HIV testing after counselling. Main outcome measures : Proportion of time periods during which diarrhoea was experienced after completion of treatment; proportion of patients with full remission after completion of treatment; mortality. Results : The patients taking albendazole had diarrhoea on 29% fewer days than those taking placebo (P Conclusions : For HIV infected Zambians with diarrhoea of more than three weeks9 duration albendazole offers substantial relief from symptoms and may be used empirically, without prior investigation. Key messages Enteric intracellular protozoa can be identified in most of these patients in hospital in Lusaka Albendazole (800 mg twice daily for two weeks) reduced the time with diarrhoea over six months The Karnofsky score, a simple clinical assessment, identified patients most likely to benefit Albendazole had no measurable effect on mortality