Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation.

Bibliographic Details
Title: Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation.
Authors: Clare E F Dyer, Naomi E Clarke, Dinh Ng Nguyen, H M P Dilrukshi Herath, Sze Fui Hii, Russell Pickford, Rebecca J Traub, Susana Vaz Nery
Source: PLoS Neglected Tropical Diseases, Vol 16, Iss 10, p e0010767 (2022)
Publisher Information: Public Library of Science (PLoS), 2022.
Publication Year: 2022
Collection: LCC:Arctic medicine. Tropical medicine
LCC:Public aspects of medicine
Subject Terms: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
More Details: Preventive chemotherapy (PC), consisting of the regular distribution of anthelmintics to populations or groups of populations at risk, is the primary tool used to control soil-transmitted helminth (STH) infections. This strategy, whilst cost-effective, raises the concern of potential emergence of drug resistance. The efficacy of anthelmintics against STH infections is measured using cure rate (CR) and egg reduction rate (ERR), using microscopy-based techniques such as the Kato-Katz thick smear. However, Kato-Katz has low sensitivity, especially for low-intensity infections, and requires fresh samples that need to be processed quickly. Realtime quantitative PCR (qPCR), which is more sensitive, is emerging as a "gold standard" for STH diagnostics given its higher sensitivity (important in low prevalence settings) and ability to differentiate hookworm species, while sodium nitrate flotation (SNF) may provide a low-cost more sensitive and practical alternative to Kato-Katz in the field. In this study, we examined the efficacy of a locally manufactured brand of albendazole 400 mg ("Alzental") against hookworm in Đắk Lắk province, Vietnam, using both qPCR and SNF. For qPCR, formulae to convert qPCR cycle threshold (Ct) values into eggs per gram of faeces (EPG) were utilised to determine efficacy calculations, and these values directly compared with efficacy values generated using SNF. Factors associated with CR and ERR were examined, and Alzental tablet quality was assessed by comparing with an Australian TGA-approved equivalent "Eskazole" tablet. We observed a CR and ERR of 64.9% and 87.5% respectively using qPCR, and 68.4% and 67.6% respectively using SNF. The tablet composition of Alzental was comparable to Eskazole in terms of active albendazole drug concentration with no evidence of impurities. This study demonstrates that the efficacy of Alzental against hookworm is within the range of previously reported studies for albendazole 400 mg. The study also demonstrates the value of qPCR and SNF as alternatives to standard Kato-Katz methodology for assessment of anthelmintic efficacy.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1935-2727
1935-2735
Relation: https://doaj.org/toc/1935-2727; https://doaj.org/toc/1935-2735
DOI: 10.1371/journal.pntd.0010767
Access URL: https://doaj.org/article/507b297974334bab8f84a7015caffa2e
Accession Number: edsdoj.507b297974334bab8f84a7015caffa2e
Database: Directory of Open Access Journals
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More Details
ISSN:19352727
19352735
DOI:10.1371/journal.pntd.0010767
Published in:PLoS Neglected Tropical Diseases
Language:English