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Human Soil Transmitted Helminths (STH) Resistance to Benzimidazole in School Aged Children Living in Gabon (BenziR)

C

Centre de Recherche Médicale de Lambaréné

Status and phase

Completed
Phase 4

Conditions

Drug Resistance
Helminths Infection

Treatments

Drug: Benzimidazole Anthelmintic

Study type

Interventional

Funder types

Other

Identifiers

NCT04326868
0084/2019/PR/SG/CNER
CEI- 007/2019 (Other Identifier)

Details and patient eligibility

About

Soil-transmitted helminths (STHs) infections are common in subtropics and mostly affect the poorest communities, with an impact on human health in many parts of the world. In 2017, World Health organization (WHO) reports more than 1.5 billion people are infected with soil-transmitted helminths worldwide, including 568 million school-age children who need treatment and preventive interventions. Preventive chemotherapy and periodic mass administration with benzimidazoles (BZ) [albendazole (ABZ) and mebendazole (MBZ)] are used to control these parasites. However, rapid reinfection with Ascaris lumbricoides within six months after a completed treatment has been reported, while the reinfection with hookworms is slow. Similarly, the efficacy of these drugs on Trichuris trichiura cure rate is poor. After many years of use of this drug class, there is an increase possibility that BZ resistance could develop. This resistance may occur due to single nucleotide polymorphisms (SNPs) in the β-tubulin gene at positions 167, 198 or 200, as has been reported in animals. Little data exist to show whether any of these polymorphisms do influence the BZ efficacy against STH in humans. The present study will develop methods to look for molecular evidence of BZ drug resistance in human population in order to support the investigation of the control and elimination of neglected tropical diseases (NTDs) in our communities.

Full description

A Randomized Controlled Clinical Trial (RCT) cohort study, to evaluate the efficacy and safety of three benzimidazole derivates drug (Albendazole, Mebendazole, Albendazole Mebendazole, and Albendazole-Pyrantel) to treat major STH in school aged children from Lambaréné and surroundings. After obtaining informed consent from parents or guardians, stool samples will be collected, for infectious status. If positive the participant will be treated with either drug combination. The efficacy and SNP frequencies will be assessed at weeks 3 and 6 post treatment

Description of study population Children of school and preschool age (2 to 17 years old) living in Lambaréné and the surrounding areas are eligible. The choice of school and preschool-aged children is based on the fact that they constitute the main population at risk of infection. In addition, most of the resources available for public health interventions in many endemic areas of soil-transmitted helminths target this group as a cost-effective method for reaching a large part of the population.

The previous analysis of patient cohort reported a success rate of 61% multispecies prevalence amongst children in the study area and considering a significance level of 95% confidence interval (α =5%) and a minimum power of 80%, the investigators will have to include a total of 255 participants in the study

Enrollment

255 patients

Sex

All

Ages

2 to 17 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Living in Lambaréné and surrounding areas
  • Written informed consent or assent
  • Microscopy positive for any major Soil-Transmitted helminths

Exclusion criteria

  • Microscopy negative for any STH
  • Pregnant women
  • Do not be available for followed up.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

255 participants in 3 patient groups

Albendazole
Active Comparator group
Description:
ABZ (400mg)
Treatment:
Drug: Benzimidazole Anthelmintic
Albendazole and Mebendazole
Experimental group
Description:
ABZ 400mg + 1 tablet of MBZ (500mg)
Treatment:
Drug: Benzimidazole Anthelmintic
Albendazole and Pyrantel
Experimental group
Description:
ABZ (400mg) + Pyr (125 mg)
Treatment:
Drug: Benzimidazole Anthelmintic

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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