Administration of Triclabendazole Is Safe and Effective in Controlling Fascioliasis in an Endemic Community of the Bolivian Altiplano

• Published in: PLoS neglected tropical diseases Vol. 6; no. 8; p. e1720
• Main Authors: Villegas, Fidel, Angles, René, Barrientos, René, Barrios, Gary, Valero, María Adela, Hamed, Kamal, Grueninger, Heiner, Ault, Steven K., Montresor, Antonio, Engels, Dirk, Mas-Coma, Santiago, Gabrielli, Albis Francesco
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.08.2012; Public Library of Science (PLoS)
• Subjects: Adolescent; Animals; Anthelmintics - administration & dosage; Anthelmintics - adverse effects; Benzimidazoles - administration & dosage; Benzimidazoles - adverse effects; Bile ducts; Bolivia - epidemiology; Chemoprevention - methods; Chemotherapy; Child; Child, Preschool; Community medicine; Data collection; Drug therapy; Drug-Related Side Effects and Adverse Reactions - epidemiology; Endemic Diseases; Fasciola hepatica - isolation & purification; Fascioliasis - drug therapy; Fascioliasis - epidemiology; Fascioliasis - prevention & control; Female; Fluke infections; Health aspects; Humans; Infections; Interviews as Topic; Male; Medicine; Morbidity; Pharmaceuticals; Public health; Treatment Outcome; Triclabendazole; Tropical diseases; Bolivia; Altiplano; Lake Titicaca; Benzimidazoles; Chemoprevention; Humans; Anthelmintics; Child, Preschool; Male; Treatment Outcome; Bolivia; Endemic Diseases; Fasciola hepatica; Animals; Drug-Related Side Effects & Adverse Reactions; Fascioliasis; Adolescent; Female; Interviews as Topic; Child
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0001720

The Bolivian northern Altiplano is characterized by a high prevalence of Fasciola hepatica infection. In order to assess the feasibility, safety and efficacy of large-scale administration of triclabendazole as an appropriate public health measure to control morbidity associated with fascioliasis, a pilot intervention was implemented in 2008. Schoolchildren from an endemic community were screened for fascioliasis and treated with a single administration of triclabendazole (10 mg/kg). Interviews to assess the occurrence of adverse events were conducted on treatment day, one week later, and one month after treatment. Further parasitological screenings were performed three months after treatment and again two months later (following a further treatment) in order to evaluate the efficacy of the intervention. Ninety infected children were administered triclabendazole. Adverse events were infrequent and mild. No serious adverse events were reported. Observed cure rates were 77.8% after one treatment and 97.8% after two treatments, while egg reduction rates ranged between 74% and 90.3% after one treatment, and between 84.2% and 99.9% after two treatments. The proportion of high-intensity infections (≥ 400 epg) decreased from 7.8% to 1.1% after one treatment and to 0% after two treatments. Administration of triclabendazole is a feasible, safe and efficacious public health intervention in an endemic community in the Bolivian Altiplano, suggesting that preventive chemotherapy can be applied to control of fascioliasis. Further investigations are needed to define the most appropriate frequency of treatment.