Reduction in Hookworm Infection after Praziquantel Treatment among Children and Young Adults in Leyte, the Philippines

Julia G. Shaw Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Julia G. Shaw in
Current site
Google Scholar
PubMed
Close
,
Nitin Aggarwal Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Nitin Aggarwal in
Current site
Google Scholar
PubMed
Close
,
Luz P. Acosta Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Luz P. Acosta in
Current site
Google Scholar
PubMed
Close
,
Mario A. Jiz Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Mario A. Jiz in
Current site
Google Scholar
PubMed
Close
,
Hai-Wei Wu Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Hai-Wei Wu in
Current site
Google Scholar
PubMed
Close
,
Tjalling Leenstra Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Tjalling Leenstra in
Current site
Google Scholar
PubMed
Close
,
Hannah M. Coutinho Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Hannah M. Coutinho in
Current site
Google Scholar
PubMed
Close
,
Remigio M. Olveda Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Remigio M. Olveda in
Current site
Google Scholar
PubMed
Close
,
Jonathan D. Kurtis Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Jonathan D. Kurtis in
Current site
Google Scholar
PubMed
Close
,
Stephen T. McGarvey Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Stephen T. McGarvey in
Current site
Google Scholar
PubMed
Close
, and
Jennifer F. Friedman Master of Public Health Program, Department of Community Health, Brown University, Providence, Rhode Island; Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island; Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, Rhode Island; Research Institute for Tropical Medicine, Manila, The Philippines

Search for other papers by Jennifer F. Friedman in
Current site
Google Scholar
PubMed
Close
Restricted access

One small previous study found that praziquantel reduced hookworm infection. In this study, 607 subjects were enrolled in a longitudinal study. At enrollment and every 3 months for 18 months, three stool samples were collected, and the intensity of infection with Schistosoma japonicum and soil-transmitted helminths (STHs) was quantified. All subjects were treated with 60 mg/kg praziquantel at baseline. Three months post-treatment, the percent of subjects who were hookworm-infected decreased to 46.5% from 61% at baseline. The putative cure rate was 23.7%. The 95% confidence interval around the change in hookworm egg counts from baseline to 6 and 12 months post-treatment was negative and did not include zero. The percent reduction in hookworm egg counts from baseline to 3 months post-treatment was 40.8%. Praziquantel treatment did not decrease the infection intensity of STHs. Control programs using praziquantel may have the added benefit of reducing hookworm infection and anemia in areas of coendemnicity.

Author Notes

*Address correspondence to Jennifer F. Friedman, Center for International Health Research, Lifespan Hospital, Providence, RI 02903. E-mail: jennifer_friedman@brown.edu
†These authors contributed equally.

Authors' addresses: Julia G. Shaw, Master of Public Health Program, Department of Community Health and Center for International Health Research, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, E-mail: Julia_G_Shaw@brown.edu. Nitin Aggarwal, Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, E-mail: Nitin_Aggarwal@brown.edu. Luz P. Acosta, Research Institute for Tropical Medicine, Manila, the Philippines, E-mail: LPAcosta@yahoo.com. Mario A. Jiz, Center for International Health Research and Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, RI and Research Institute for Tropical Medicine, Manila, the Philippines, E-mail: Mario.a.jiz@gmail.com. Hai-Wei Wu, Tjalling Leenstra, and Jennifer F. Friedman, Center for International Health Research and Department of Pediatrics, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, E-mails: Haiwei_Wu@brown.edu, T.leenstra@hotnet.nl, and jennifer_friedman@brown.edu. Hannah M. Coutinho, Center for International Health Research, Departments of Pediatrics and Pathology, and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, E-mail: H.m.coutinho@hotmail.com. Remigio M. Olveda, Research Institute for Tropical Medicine, Manila, the Philippines, E-mail: Remi_olveda@yahoo.com.ph. Jonathan D. Kurtis, Center for International Health Research and Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, E-mail: Jonathan_Kurtis@brown.edu. Stephen T. McGarvey, Epidemiology Section, Department of Community Health and International Health Institute, Brown University, Providence, RI, E-mail: Stephen_McGarvey@brown.edu.

  • 1.

    Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ, 2006. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367: 15211532.

    • Search Google Scholar
    • Export Citation
  • 2.

    Hotez PJ, Kamath A, 2009. Neglected tropical diseases in sub-saharan Africa: review of their prevalence, distribution, and disease burden. PLoS Negl Trop Dis 3: e412.

    • Search Google Scholar
    • Export Citation
  • 3.

    Keiser J, Utzinger J, 2008. Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. J Am Med Assoc 299: 19371948.

    • Search Google Scholar
    • Export Citation
  • 4.

    Utzinger J, Vounatsou P, N'Goran EK, Tanner M, Booth M, 2002. Reduction in the prevalence and intensity of hookworm infections after praziquantel treatment for schistosomiasis infection. Int J Parasitol 32: 759765.

    • Search Google Scholar
    • Export Citation
  • 5.

    Montero R, Ostrosky P, 1997. Genotoxic activity of praziquantel. Mutat Res 387: 123139.

  • 6.

    Blair KL, Bennett JL, Pax RA, 1992. Praziquantel: physiological evidence for its site(s) of action in magnesium-paralysed Schistosoma mansoni. Parasitology 104: 5966.

    • Search Google Scholar
    • Export Citation
  • 7.

    Hall TM, Joseph GT, Strand M, 1995. Schistosoma mansoni: molecular cloning and sequencing of the 200-kDa chemotherapeutic target antigen. Exp Parasitol 80: 242249.

    • Search Google Scholar
    • Export Citation
  • 8.

    World Health Organization, 2006. Preventive Chemotherapy in Human Helminthiasis. Coordinated Use of Anthelminthic Drugs in Control Interventions: A Manual for Health Professionals and Programme Managers. Geneva: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 9.

    Buck AA, Anderson RI, MacRae AA, 1978. Epidemiology of poly-parasitism. IV. Combined effects on the state of health. Tropenmed Parasitol 29: 253268.

    • Search Google Scholar
    • Export Citation
  • 10.

    Chunge RN, Karumba N, Ouma JH, Thiongo FW, Sturrock RF, Butterworth AE, 1995. Polyparasitism in two rural communities with endemic Schistosoma mansoni infection in Machakos District, Kenya. J Trop Med Hyg 98: 440444.

    • Search Google Scholar
    • Export Citation
  • 11.

    Keiser J, N'Goran EK, Singer BH, Lengeler C, Tanner M, Utzinger J, 2002. Association between Schistosoma mansoni and hookworm infections among schoolchildren in Cote d'Ivoire. Acta Trop 84: 3141.

    • Search Google Scholar
    • Export Citation
  • 12.

    Tchuem Tchuente LA, Behnke JM, Gilbert FS, Southgate VR, Vercruysse J, 2003. Polyparasitism with Schistosoma haematobium and soil-transmitted helminth infections among school children in Loum, Cameroon. Trop Med Int Health 8: 975986.

    • Search Google Scholar
    • Export Citation
  • 13.

    Brooker S, Clements AC, 2009. Spatial heterogeneity of parasite co-infection: determinants and geostatistical prediction at regional scales. Int J Parasitol 39: 591597.

    • Search Google Scholar
    • Export Citation
  • 14.

    Ezeamama AE, McGarvey ST, Acosta LP, Zierler S, Manalo DL, Wu HW, Kurtis JD, Mor V, Olveda RM, Friedman JF, 2008. The synergistic effect of concomitant schistosomiasis, hookworm, and Trichuris infections on children's anemia burden. PLoS Negl Trop Dis 2: e245.

    • Search Google Scholar
    • Export Citation
  • 15.

    McGarvey ST, Aligui G, Graham KK, Peters P, Olds GR, Olveda R, 1996. Schistosomiasis japonica and childhood nutritional status in northeastern Leyte, the Philippines: a randomized trial of praziquantel versus placebo. Am J Trop Med Hyg 54: 498502.

    • Search Google Scholar
    • Export Citation
  • 16.

    Leenstra T, Acosta LP, Langdon GC, Manalo DL, Su L, Olveda RM, McGarvey ST, Kurtis JD, Friedman JF, 2006. Schistosomiasis japonica, anemia, and iron status in children, adolescents, and young adults in Leyte, Philippines. Am J Clin Nutr 83: 371379.

    • Search Google Scholar
    • Export Citation
  • 17.

    Friedman JF, Kanzaria HK, Acosta LP, Langdon GC, Manalo DL, Wu H, Olveda RM, McGarvey ST, Kurtis JD, 2005. Relationship between Schistosoma japonicum and nutritional status among children and young adults in Leyte, the Philippines. Am J Trop Med Hyg 72: 527533.

    • Search Google Scholar
    • Export Citation
  • 18.

    Koukounari A, Fenwick A, Whawell S, Kabatereine NB, Kazibwe F, Tukahebwa EM, Stothard JR, Donnelly CA, Webster JP, 2006. Morbidity indicators of Schistosoma mansoni: relationship between infection and anemia in Ugandan schoolchildren before and after praziquantel and albendazole chemotherapy. Am J Trop Med Hyg 75: 278286.

    • Search Google Scholar
    • Export Citation
  • 19.

    Albonico M, Savioli L, 1997. Hookworm infection and disease: advances for control. Ann Ist Super Sanita 33: 567579.

  • 20.

    World Health Organization, 2002. Prevention and Control of Schistosomiasis and Soil Transmitted Helminthiasis. Geneva: World Health Organization, 157.

    • Search Google Scholar
    • Export Citation
  • 21.

    Widjana DP, Sutisna P, 2000. Prevalence of soil-transmitted helminth infections in the rural population of Bali, Indonesia. Southeast Asian J Trop Med Public Health 31: 454459.

    • Search Google Scholar
    • Export Citation
  • 22.

    Tarafder MR, Carabin H, Joseph L, Balolong E Jr, Olveda R, McGarvey ST, 2009. Estimating the sensitivity and specificity of Kato-Katz stool examination technique for detection of hookworms, Ascaris lumbricoides and Trichuris trichiura infections in humans in the absence of a ‘gold standard.’ Int J Parasitol 40: 399404.

    • Search Google Scholar
    • Export Citation
  • 23.

    Steinmann P, Du ZW, Wang LB, Wang XZ, Jiang JY, Li LH, Marti H, Zhou XN, Utzinger J, 2008. Extensive multiparasitism in a village of Yunnan province, People's Republic of China, revealed by a suite of diagnostic methods. Am J Trop Med Hyg 78: 760769.

    • Search Google Scholar
    • Export Citation
  • 24.

    Knopp S, Mgeni AF, Khamis IS, Steinmann P, Stothard JR, Rollinson D, Marti H, Utzinger J, 2008. Diagnosis of soil-transmitted helminths in the era of preventive chemotherapy: effect of multiple stool sampling and use of different diagnostic techniques. PLoS Negl Trop Dis 2: e331.

    • Search Google Scholar
    • Export Citation
  • 25.

    Leenstra T, Coutinho HM, Acosta LP, Langdon GC, Su L, Olveda RM, McGarvey ST, Kurtis JD, Friedman JF, 2006. Schistosoma japonicum reinfection after praziquantel treatment causes anemia associated with inflammation. Infect Immun 74: 63986407.

    • Search Google Scholar
    • Export Citation
  • 26.

    Ezeamama AE, Friedman JF, Olveda RM, Acosta LP, Kurtis JD, Mor V, McGarvey ST, 2005. Functional significance of low-intensity polyparasite helminth infections in anemia. J Infect Dis 192: 21602170.

    • Search Google Scholar
    • Export Citation
  • 27.

    Stothard JR, 2009. Improving control of African schistosomiasis: towards effective use of rapid diagnostic tests within an appropriate disease surveillance model. Trans R Soc Trop Med Hyg 103: 325332.

    • Search Google Scholar
    • Export Citation
  • 28.

    Olds GR, King C, Hewlett J, Olveda R, Wu G, Ouma J, Peters P, McGarvey S, Odhiambo O, Koech D, Liu CY, Aligui G, Gachihi G, Kombe Y, Parraga I, Ramirez B, Whalen C, Horton RJ, Reeve P, 1999. Double-blind placebo-controlled study of concurrent administration of albendazole and praziquantel in schoolchildren with schistosomiasis and geohelminths. J Infect Dis 179: 9961003.

    • Search Google Scholar
    • Export Citation
  • 29.

    Utzinger J, Rinaldi L, Lohourignon LK, Rohner F, Zimmermann MB, Tschannen AB, N'Goran EK, Cringoli G, 2008. FLOTAC: a new sensitive technique for the diagnosis of hookworm infections in humans. Trans R Soc Trop Med Hyg 102: 8490.

    • Search Google Scholar
    • Export Citation
  • 30.

    Booth M, Vounatsou P, N'Goran EK, Tanner M, Utzinger J, 2003. The influence of sampling effort and the performance of the Kato-Katz technique in diagnosing Schistosoma mansoni and hookworm co-infections in rural Cote d'Ivoire. Parasitology 127: 525531.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 21 21 3
Full Text Views 350 91 0
PDF Downloads 142 35 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save