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84 cases of hydatid cysts in children are reported. Presenting sings were non-specific in more than 1/2 the children. Pulmonary localisation predominated and the chest X-ray alone gave the diagnosis in 47 cases with pulmonary cysts. Several organs were involved in 17 cases. Abdominal ultrasound was routinely performed for pulmonary presentations. CT scan was reserved for parenchymal lesions in order to quantify the exact number of cysts present. 107 procedures were performed. In the majority of cases conservative surgery was involved; endocystectomy for pulmonary cysts and partial cystectomy with capitonnage for abdominal cysts. Mebendazole treatment was not considered to be an alternative to surgical treatment and was only used in specific cases.
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Adherence assays were used to demonstrate the in vitro effect of serum-dependent cellular adherence of human buffy coat cells to infective larvae of Brugia malayi in filariasis patients treated with antifilarial drugs. In this study, microfilaraemic patients were treated with either diethylcarbamazine citrate (DEC), mebendazole or levamisole hydrochloride. It was found that DEC and mebendazole decreased the motility of infective larvae due to a direct action of the drugs. Sera of levamisole-treated patients caused increased adherence of human buffy coat cells to infective larvae, leading to a decrease in motility and cuticular damage as confirmed by scanning electron microscopic studies. However, serum of levamisole-treated patients alone could cause a similar lethal effect on infective larvae. Studies with the indirect fluorescent antibody test suggested that IgM was involved in this phenomenon. Complement did not appear to be important.
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We performed a randomized controlled trial in 2 schools in Zanzibar, Tanzania, to assess the efficacy and safety of albendazole (400 mg) plus placebo, albendazole plus ivermectin (200 μg/kg), mebendazole (500 mg) plus placebo, and mebendazole plus ivermectin in children with a parasitologically confirmed Trichuris trichiura infection. Cure rate (CR) and egg reduction rate were assessed by intent-to-treat analysis. Adverse events were monitored within 48 h after treatment.
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A total of 32 drugs were evaluated as regards their efficacy for oral treatment of Ichthyobodo necator infestation of rainbow trout. In preliminary trials, all drugs were supplied to infected fish at 40 g per kg of feed for 10 d. The majority of the drugs tested (1,3-di-6-quinolylurea, aminosidine, amprolium, benznidazole, bithionol, chloroquine, diethylcarbamazine, dimetridazole, diminazene aceturate, febantel, flubendazole, ketoconazole, levamisole, mebendazole, netobimin, niclosamide, niridazole, nitroscanate, nitroxynil, oxibendazole, parbendazole, piperazine, praziquantel, ronidazole, sulphaquinoxaline, tetramisole, thiophanate, toltrazuril and trichlorfon) were ineffectdive. Metronidazole and secnidazole were 100% effective (unlike the other nitroimidazoles tested, namely dimetridazole, benznidazole and ronidazole). The non-carbamate benzimidazole triclabendazole was likewise 100% effective.
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Mebendazole was found to be effective in the treatment of patients infected with adult guinea worms. The patients consistently reported a rapid relief of pain, tenderness and swelling. The worms emerge from the ulcers in a degenerated, fragmented form. No extraction of worms is needed as the fragments are expelled spontaneously. Some cases need repetition of treatment when fresh lesions appear but healing is as rapid as in original lesions. No side-effects were encountered in spite of repetition of the course in some cases. The drug was well tolerated by all the patients included in the present study.
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The difference of mean nymph burden between the drug treated groups and control group was not statistically significant (P > 0.05) with mean nymph reductions of 8.3%-35.0%. Meanwhile, the appearance of the cyst, the size, colour, morphology and motor activity of nymphs were also similar to that of the control.
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Trichinellosis was diagnosed in 1344 patients, of whom 348 were children (26%) and 996 were adults (74%). The annual average incidence was 8.4 cases per 100,000 in children and 7.7 cases per 100,000 in adults. The mean ages for the children and adults were 11 ± 4.4 years and 38.1 ± 14.2 years, respectively. Myalgias and complications of trichinellosis were detected less frequently in children who also had lower eosinophil counts, leukocyte counts, and erythrocyte sedimentation rates compared with those for adults. Albendazole and mebendazole had comparable efficacies in adult patients; however, albendazole proved to be a better choice than mebendazole for the treatment of children.
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The overall prevalence (and intensity) in these sentinel sites pre-MDA of S. mansoni was 69.0% (170.8 epg), hookworm: 41.7% (71.7 epg), Ascaris lumbricoides: 1.8% and Trichuris trichiura: 3.8%. Six months post MDA, the findings were S. mansoni: 38.2% (47.3 epg) and hookworm: 14.5% (8.7 epg), representing a reduction from pre-MDA levels of 44.6% (65.2%) and 72.3% (87.9%) respectively. The proportion of children who were moderately or heavily infected with S. mansoni fell from 35.6% pre MDA to 9.9% post MDA.
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To compare the efficacy of a single dose mebendazole 500 mg from the original manufacturer and a formulation locally produced by State Pharmaceuticals Manufacturing Corporation of Sri Lanka and albendazole 400 mg in mass treatment of soil-transmitted nematode infections.
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Diseases caused by environmental contamination by micro-organisms, including intestinal helminths and protozoa, are prevalent in developing countries. According to some authors, their strong expansion in some zones of these countries is due primarily to favourable climatic conditions, combined with inadequate hygiene measures and cleaning and the generally low socio-economic level. Progress in disease control has resulted from new studies that improve our understanding of the epidemiology of helminthiases and from the availability of simple tools that are inexpensive and effective against these diseases (chemotherapy with albendazole and mebendazole). On the other hand, surprisingly few such studies have looked at intestinal protozoa, although the WHO reports that approximately 480 million individuals throughout the world are infested by amoebiasis caused by the protozoon Entamoeba histolytica and that 40,000-110,000 people die from it each year. Giardiasis, a cosmopolitan parasitosis, is due to another intestinal protozoon called Giardia intestinalis. To help develop a database on these parasites, we conducted a cross-sectional epidemiological survey in the Man region in western Côte d'Ivoire. Its objectives were to determine the prevalence of intestinal protozoa, to evaluate polyparasitism and to assess the spatial distribution of the pathogenic protozoal species, E. histolytica and G. intestinalis. Overall, 4466 stools samples taken from pupils aged 6 to 16 years of age at 57 different schools were analyzed under an optical microscope by the formol-ether stool concentration method, after preservation in sodium acetate-acetic acid-formalin (SAF). The most common protozoa species in this area were Endolimax nanus (83.8%) and E. coli (74.7%). The regional prevalence of G. intestinalis was 17.5% and of E. histolytica/E. dispar 11.3%. Both species were found in each of the 57 schools. The prevalence of E. histolytica/E. dispar exceeded 15% in six schools, and its spatial distribution was highly disparate. On the other hand, three large areas with substantial G. intestinalis transmission were identified. Polyparasitism of intestinal protozoa is very frequent in these areas; 80.2% of pupils carried at least 2 species. This work confirms the presence and breadth of protozoa species in the Man region. Understanding the spatial distribution of the principal areas where pathogenic protozoa species are transmitted may help to develop programmes for disease control that combine chemotherapy and preventive measures.
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We report our experience in the treatment with benzoimidazole carbamates (mebendazole and albendazole) of 337 patients affected by hydatid cysts with different localizations. The treated cysts showed degenerative modifications in 50.6% of the cases after mebendazole treatment and in about 80% after albendazole treatment. Relapses after therapy were observed in 30% of the cases; about 95% of the recurring cysts showed good susceptibility to a further cycle of therapy with benzoimidazole carbamates. Side effects observed with either drug were not severe and always reversible, consisting mainly of abdominal pains and increased levels of transaminases in serum. Among the factors that may influence the therapeutic results are the drug employed, the age of the cysts, the age of the patient, and the localization of the cysts and their morphological characteristics. Moreover, it can be hypothesized that each hydatid cyst has an intrinsic sensitivity to benzoimidazole carbamates.
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The hydatid cyst is an endemic zoonosis in Spain. The central nervous system is seldom affected, the hydatid cyst in cerebellum being very rare. A patient with hydatid cyst affecting the vermis and right cerebellar hemisphere is presented. The case is described and discussed. The use of CT scan is encouraged as the most worthwhile election of diagnosis techniques. We highlight the need for very careful surgical treatment, preserving the hydatid cyst complete, to avoid relapses and to prevent the change of a benign disease to a chronic one with very high mortality.
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The first-ever round of school-based mass drug administration (MDA) with praziquantel together with mebendazole targeting school-aged children in endemic districts was conducted in 2009 by the National Neglected Tropical Diseases Control Program. To evaluate the impact of the treatment regimen, a cross-sectional sentinel site survey was conducted 6 months post-MDA.
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A series of 6 experiments was conducted to test the efficacy of mebendazole in eliminating naturally occurring pinworm infections from mice. Subjects treated with from 40-500 mg/kg of the drug harbored markedly fewer parasites than untreated controls. Treatment at 10 mg/kg appeared to be less effective. No mortality or overt signs of toxicity were observed in any of the experimental subjects.
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The case of a female with disseminated pelvic cystic hydatidosis presenting as ovarian carcinomatosis 2.5 years after repeated abdominal paracentesis is reported. The diagnosis was made during surgery and confirmed by serology and histological examination. Over 100 cysts were removed from the abdominal cavity and wall. Innumerable small cysts studded the viscera; these and larger inaccessible ones were untouched. Medical cure in this patient was achieved with a combination of partial resection and special irrigation, broad spectrum antibiotic for coverage of infectious episodes and high dose long term mebendazole therapy for 25 months. The danger of blind aspiration in patients coming from endemic areas is emphasized.
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A case of Mansonella perstans infection with visual impairment and a retinal lesion is described. After a course of diethylcarbamazine and a further course of mebendazole the symptoms improved and the microfilariae blood concentration decreased. The symptoms and response to antifilarial treatment strongly suggested the intraocular localization of an M. perstans worm.
A study was made of 48 patients from the different departments of the Hospital del Niño, DIF, in which hookworm eggs were demonstrated by qualitative coproparasitoscopic study (CPS). During the study, quantitative CPS was practiced on them by Stoll's dilution and the Harada-Mori technique, for the identification of the hookworm larvae. They were divided into three groups: A, B and C (16 patients in each group); the study was single-blind. The effectiveness of the evaluated drugs was based on the disappearance or diminution of hookworms eggs in the CPS (Stoll) practiced 2 weeks after the drug treatment had finished. The work was done with patients parasitized by Necator americanus (verified by the Harada-Mori technique). The A group was given pyrantel pamoate; the B group, thiabendazole and the C group, mebendazole. The results obtained were statistically processed by means of X2 proportions. There was no significant difference between the three groups when a light to moderate necatoriasis was treated; when a massive infection was involved, there was a significant difference and it was found that the best drug was pyrantel pamoate administered at the dose of 20 mg/kg/day/3 days. There were few side effects in the three groups, but they were not sufficient to cause suspension of the treatment. The cheapest drug was thiabendazole.
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Heavy infection with the geohelminth Trichuris trichiura causes the Trichuris dysentery syndrome (TDS). Growth retardation and anaemia are characteristic of TDS and both are associated with poor development. We have examined the growth and developmental responses to treatment in 19 children aged 27-84 months with TDS. Developmental levels (DQ) were measured with the Griffiths mental development scales. Compared with a control group matched for age, gender and neighbourhood, the TDS children initially had serious deficits in DQ (24 points, p < 0.001). After a year of anthelmintic treatment, the TDS children showed improvement in locomotor development (p < 0.001) compared with the controls. The TDS children also had initial deficits in height-for-age, weight-for-height, mid-upper arm circumference and haemoglobin levels. They caught up rapidly in indices of wasting (weight-for-height and mid-upper arm circumference) and showed steady improvement in height-for-age and haemoglobin levels. Catch-up in height was comparable to that of children recovering from coeliac disease. The importance of continuing prevention after initial treatment is highlighted.
In a single-blind clinical study of mebendazole, a new, broadspectrum anthelmintic, 70 patients with light to severe infections of Trichuris trichiura were treated. Ten subjects received placebos, and 60 received 100 mg mebendazole twice a day for three and four days. The drug was well tolerated by the patients, and no toxic side effects were observed. Egg count comparisons using the McMaster method on feces collected before and one month after treatment indicated a cure rate for trichuriasis of 65.6% and 89.3% and a total egg reduction of 69.5% and 95.9% for three- and four-day regimens, respectively. Patients not cleared showed an egg reduction rate of 31.6% and 76.8% on the three- and four-day regimens, respectively.
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A reversed-phase high-performance liquid chromatography with ultraviolet (UV) detection was developed that can determine 11 benzimidazole (BZDs) and 10 metabolites of albendazole, fenbendazole and mebendazole in bovine milk. Samples were extracted with acetonitrile and purified by mixed-mode cation exchange (MCX) solid phase extraction cartridges. LC separations were performed on a C(18) column with gradient elution using acetonitrile and ammonium acetate solution. The UV-detection was set at 292nm. The method is very sensitive to each analyte with limits of quantification (LOQs) of lower than 10μgkg(-1). The recoveries of the BZDs and their metabolites spiked in milk were more than 78% with between-day relative standard deviation values less than 16% at the concentration of 10, 50 and 100μgkg(-1). The method developed has been successfully applied to monitoring real samples containing BZDs, which demonstrated that it is a simple, fast and robust method, and could be used as a regulatory toll to determine the residues of BZDs in milk.
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Three courses of thiabendazole therapy, including one course given directly into a blind loop of the bowel, failed to eradicate Strongyloides stercoralis from a 55-year-old man who had undergone a Roux-en-Y operation. The patient responded to 1.5 g/day of mebendazole for 14 days, and the infection did not recur. Our case illustrates the difficulty of eliminating S stercoralis from a blind loop of the bowel and indicates that mebendazole therapy used in adequate doses is effective treatment for strongyloidiasis. The lack of toxicity of mebendazole makes it a desirable drug for Strongyloides infestation resistant to thiabendazole therapy.
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From nationwide administrative registers, we identified 718,900 births in Denmark between January 1997 and December 2007 as well as maternal prescription data of anthelmintics and maternal characteristics. Redemption of a prescription for pyrvinium or mebendazole was used to identify exposure.
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A community survey was conducted in Gran Dani Valley, Jayawijaya District, Irian Jaya Province, Indonesia. A total of 537 adults were asked whether they experienced epilepsy, and were physically examined for cysticercosis cysts. Forty-eight percent experienced at least one attack of epilepsy. Men had attacks 2.5 times more often than woman. Cysticercosis cysts were found in 26.5% men having 4.6 times more cysts than women. The cysts were mostly found in the pectoral region. The survey showed a raise cysticercosis in the Highlands of Irian Jaya and is considered a public health problem. Treatment was not available, but improvement of personal and environmental hygiene would be important. Mass de-worming activity should be a part of routine public health service in the district.
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In 2002, Cambodia's Ministry of Health launched a deworming programme to deliver an anthelmintic drug (mebendazole 500 mg) and health education to 75% of its school children twice a year. Cambodia's school population is approximately 2.8 million. The deworming programme was organized into two phases: the first phase (December 2002-March 2003) targeted more than one million school children from 11 provinces; and the second phase (July 2003-January 2004) targeted the entire school population. The cost to treat each child was 12 cents (0.11 USD) during the first phase, 6 cents during the second phase, and 3 cents for re-treatment in areas where the campaign was conducted for the second time. The Cambodian experience demonstrates that, with political commitment, high coverage for deworming is achievable even in a country with minimal resources. Cambodia's deworming programme represents a successful model for other developing countries.
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1. The intestinal metabolism of the benzimidazole, mebendazole (MEB), has been investigated using isolated perfused jejunal segments of rats. Significant absorption and intestinal metabolism of the substance was observed. 2. The metabolites, the reduced alpha-hydroxy-analogue, its glucuronide, and the decarbamoylated 2-amino-analogue, were transported into the resorbate collected at the serosal side or were resecreted into the gut lumen. 3. The intestinal decarbamoylation of mebendazole increased up to 20-fold after pretreatment with 3-methylcholanthrene (MC), and complete re-secretion of this metabolite into the gut lumen led to a total loss of the absorption of mebendazole and metabolites across the gut wall. 4. The results indicate the ability of the gut to metabolize mebendazole by phase I and II reactions. 5. An almost complete loss of bioavailability after induction of the gut enzyme system by MC was observed.
Three hundred and forty primary school children.
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We developed WORMSIM, a new generalized individual-based modelling framework for transmission and control of helminths, and quantified it for hookworm transmission based on published data. We simulated the impact of standard and more intense PC strategies on trends in hookworm infection, and explored the potential additional impact of interventions that improve access to water, sanitation, and hygiene (WASH). The individual-based framework allowed us to take account of inter-individual heterogeneities in exposure and contribution to transmission of infection, as well as in participation in successive PC rounds.
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The interaction of mebendazole (MBZ) with 12-tungstophosphoric acid (TP) has been investigated by using resonance Rayleigh scattering (RRS) and frequency doubling scattering (FDS) combining with absorption spectrum. In pH 1.0 HCl medium, MBZ reacted with TP to form 3:1 ion-association complex. As a result, not only the spectrum of absorption was changed, but also the intensities of RRS and FDS were enhanced greatly. The maximum RRS, FDS and absorption wavelengths are located at 372, 392 and 260 nm, respectively. The increments of scattering intensity (ΔI) and absorption (ΔA) are directly proportional to the concentrations of MBZ in certain ranges. The detection limits (3σ) of RRS, FDS and absorption are 0.56, 0.86 and 130.16 ng/mL, respectively. The sensitivity of RRS method is higher than FDS and absorption methods. The optimum conditions of RRS method and the influence factors were discussed in the paper, in addition, the structure of ion-association complex and the reaction mechanism were investigated. Based on the ion-association reaction and its spectral response, the rapid, simple and sensitive RRS method for the determination of MBZ has been developed.
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Albendazole (ABZ) and mebendazole are the only drugs licensed for treatment of human alveolar echinococcosis. In order to augment the armamentarium against this deadly disease, we tested a series of drugs for their efficacy against Echinococcus multilocularis larvae. E. multilocularis larvae grown intraperitoneally in Mongolian gerbils were transferred into tissue culture. Vesicles budded from the tissue blocks and after 6 weeks, drugs were added, and the effect on the vesicles was observed. We tested the following drugs at various concentrations: ABZ, artemether, caspofungin, itraconazole (ITZ), ivermectin, methiazole (MTZ), miltefosine, nitazoxanide (NTZ), rifampin, and trimethoprim-sulfamethoxazole. ABZ, ITZ, MTZ, and NTZ effectively destroyed parasite vesicles in this in vitro culture system. At high NTZ doses of 10 microg/ml, disintegration of all vesicles was observed after 7 days and was significantly more rapid than with ABZ at equal concentrations (21 days). After drug discontinuation, regrowth of vesicles occurred between 7 and 14 days for all four drugs, indicating a parasitostatic effect. Combination treatment with NTZ-ABZ at concentrations between 1 and 10 microg/ml for either 3 weeks, 3 months, or 6 months yielded no vesicle regrowth during 8 months after drug discontinuation. The treated larval tissue was injected intraperitoneally into gerbils, and no regrowth of larval tissue was observed, suggesting a parasitocidal effect after combined treatment. ITZ, MTZ, and NTZ are potent inhibitors of larval growth, although they proved to be parasitostatic only. The combination of NTZ plus ABZ was parasitocidal in vitro. Animal experiments are warranted for studies of dose, toxicity, and drug interactions.
Toxocariasis could present with ecchymoses due to an acquired bleeding disorder. Awareness of this would help to investigate, diagnose and treat early, and lessen parental anxiety.
In vitro and in vivo experiments were employed in the screening of potential anthelmintic agents against Opisthorchis viverrini infection in hamsters. A few selected groups of compounds tested included those that are commercially available as well as those that are still being tested by various pharmaceutical firms. The compounds tested in the present study were praziquantel, amoscanate, albendazole, flubendazole, metrifonate, metronidazole and benzodiazepine derivatives. Results from both in vitro and in vivo experiments showed that at the dosages employed, praziquantel was the only one that gave complete cure, as judged from faecal egg examination and worm recovery at the time of sacrifice. It was therapeutically effective against different developmental stages of O. viverrini including the metacercariae. Moreover, the drug was also effective as a chemoprophylactic agent when given 6 to 12 hr prior to being exposed to infective metacercariae. Other compounds tested were considerably less active although some might have permanently damaged the fluke reproductive capacity, while others were able to suppress egg-laying capacity only temporarily. Together, results suggests that the ineffectiveness of most agents tested in this study is not related to their inability to attain concentrations high enough to kill or damage the flukes in the biliary system but is most likely due the inherent lack of capacity to kill the flukes.
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To study the effect of consumption of dark green leafy vegetables (DGLV) and sweet pumpkin on serum beta-carotene and retinol concentrations in children treated for Ascaris lumbricoides.
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A simple, reliable, and fast multiresidue method has been developed for the determination of 17 veterinary drugs belonging to several families (macrolides, sulfonamides, and anthelmintics) in cheese at trace levels. Ultra-high-performance LC coupled to MS/MS has been used for the analysis of these compounds in less than 9 min. Veterinary drug residues have been extracted from cheese samples using a QuEChERS (quick, easy, cheap, effective, rugged, and safe)-based extraction procedure without applying any further clean-up step. Matrix-matched calibration was used for quantification and recoveries were calculated at three concentration levels (10, 50, and 100 μg/kg). The obtained values ranged from 70 to 110% for the selected compounds except for tylosin and josamycin at 100 μg/kg (111.7 and 112.7%, respectively). Intra- and interday precision were also evaluated and RSDs were lower than 25% in all the cases. LOQs ranged from 0.3 μg/kg (for thiabendazole, oxfendazole, mebendazole, josamycin, and fenbendazole) to 10.5 μg/kg (abamectin), whereas decision limit and detection capability ranged from 2.3 (thiabendazole) to 11.3 (abamectin) and 4.2 (thiabendazole) to 14.3 μg/kg (abamectin), respectively. Finally, 13 samples were analyzed and traces of thiabendazole were detected in two different cheeses.
A single-blind randomised trial in children with a documented moderate infection of T. trichiura. Ova were counted in stool specimens before and 10 days after treatment by the formal-ether concentration method.
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Mebendazole (MBZ) is an anthelmintic drug which inhibits tubulin polymerization and eventually causes apoptosis in target organisms. Antitumor activity of MBZ has been reported in various cancers. The aim of this study was to investigate the effect of MBZ on cholangiocarcinoma (CCA) cells in vitro and in vivo. MBZ reduced cell proliferation in the KKU-M213 cell line associated with a remarkable enhancement of caspase-3 gene expression and enzyme activity. Oral administration of MBZ slightly reduced the growth rate of subcutaneously xeno-grafted KKU-M213 in nude mice. The TUNEL assay showed an increase of apoptotic cell numbers in the xenograft tumor tissue of MBZ-treated mice. The data obtained in this study suggested that MBZ can suppress CCA cell proliferation via caspase-3 activated apoptosis. Further investigation of the antitumor effects of MBZ might support the use of MBZ as an alternative drug for CCA treatment.