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Single dose piperazine therapy for Ascaris lumbricoides: an unsuccessful method of promoting growth
Insights
Single-dose piperazine citrate treatment for Ascaris lumbricoides infection in Bangladeshi children did not improve growth outcomes. Higher infection intensity correlated with lower cure rates and faster reinfection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Ascariasis, caused by Ascaris lumbricoides, is a prevalent soil-transmitted helminthiasis in children, particularly in developing countries.
- Nutritional status and socioeconomic factors are often intertwined with the prevalence and severity of parasitic infections in children.
- The efficacy of antiparasitic treatments and their impact on child growth remain critical areas of investigation.
Purpose of the Study:
- To evaluate the efficacy of a single-dose piperazine citrate regimen in treating Ascaris lumbricoides infections in Bangladeshi children.
- To assess the impact of Ascaris lumbricoides infection and its treatment on anthropometric measurements and growth indicators.
- To determine the rate of reinfection following treatment across different infection severities.
Main Methods:
- A double-blind, placebo-controlled trial involving 185 Bangladeshi children aged 1.5 to 8 years with varying degrees of Ascaris lumbricoides infection.
- Participants were randomized to receive either piperazine citrate or a placebo, administered twice within a two-week period.
- Cure rates, reinfection rates, and serial anthropometric measurements (weight, height, skinfolds, etc.) were monitored over 11 months.
Main Results:
- Cure rates for piperazine citrate treatment were 53% (low), 31% (moderate), and 36% (heavy) Ascaris lumbricoides infections.
- More severe infections showed lower cure rates and more rapid reinfection, with significant differences observed for up to 5 months post-treatment.
- No significant differences in growth parameters (weight, height, etc.) were found between the treatment and placebo groups.
Conclusions:
- Single-dose piperazine citrate therapy demonstrated limited efficacy in eradicating Ascaris lumbricoides, especially in cases of moderate to heavy infections.
- The treatment did not result in any significant improvements in the anthropometric measurements or growth of the studied children.
- Findings do not support the use of single-dose worm therapy as a strategy to enhance child growth in this population.
Abstract:
One-hundred eighty-five Bangladeshi children age 1 1/2 to 8 yr with no Ascaris lumbricoides infection or with light, moderate, or heavy infection were randomly assigned to treatment of placebo groups, with treatment given in a double-blind fashion. The groups were comparable for nutritional and socioeconomic parameters. Treatment consisted of a single dose of piperazine citrate administered twice within a 2-wk period. The cure rates for the low, moderate, and heavy A. lumbricoides infected subgroups were 53, 31, and 36%, respectively. With more severe infections, worm eradication was more difficult and the rate of reinfection after treatment was more rapid. The rate of reinfection was significantly different for the low A. lumbricoides infected treatment and placebo subgroups for 5 months after treatment, for the moderate treatment and placebo subgroups for 3 months after treatment, and for the heavy A. lumbricoides infected treatment and placebo subgroups there was a difference, although not significant, for 1 month after treatment. Anthropometric measurements were obtained for a period of 11 months. Analysis of covariance revealed no significant difference for change of weight, change of height, weight-for age, weight-for-height, height-for-age, triceps skinfold, midarm circumference, and the abdominal girth to chest circumference ratio between the treatment and placebo groups after drug administration. The results of this study do not support single dose worm therapy as a means to enhance growth.