Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Failure of Repeated MDA with Albendazole for Trichuriasis Control in Schoolchildren of the Yangon Region, Myanmar

  • Hong, Sooji (Institute of Parasitic Diseases, Korea Association of Health Promotion) ;
  • Jung, Bong-Kwang (Institute of Parasitic Diseases, Korea Association of Health Promotion) ;
  • Song, Hyemi (Institute of Parasitic Diseases, Korea Association of Health Promotion) ;
  • Cho, Jaeeun (Institute of Parasitic Diseases, Korea Association of Health Promotion) ;
  • Sohn, Woon-Mok (Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University School of Medicine) ;
  • Hong, Sung-Jong (Convergence Research Center for Insect Vectors, Incheon University) ;
  • Ryu, Jin-Youp (Bureau of Health Examination and Management, Korea Association of Health Promotion) ;
  • Kim, Hyun-Seung (Bureau of Health Examination and Management, Korea Association of Health Promotion) ;
  • Jeong, Mun-Hyoo (Bureau of Health Examination and Management, Korea Association of Health Promotion) ;
  • Htoon, Thi Thi (National Health Laboratory) ;
  • Tin, Htay Htay (National Health Laboratory) ;
  • Chai, Jong-Yil (Institute of Parasitic Diseases, Korea Association of Health Promotion)
  • Received : 2021.10.26
  • Accepted : 2021.11.19
  • Published : 2021.12.31
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Abstract

Soil-transmitted helminth (STH) infections are still a considerable challenge in Myanmar. We undertook a control program for STH infections (especially Trichuris trichiura) among schoolchildren in Myanmar using mass drug administration (MDA) and health education. Around 1,700 schoolchildren from 15 primary schools in 3 suburban districts (Shwe Pyi Thar, Twantay, and Kyauktan) of the Yangon Region were subjected in this study during 2017-2019. All of the schoolchildren in each school were orally administered albendazole (400 mg in a single dose) 2, 3, and 4 times a year in 2017, 2018, and 2019, respectively. The results revealed that the egg positive rate of any intestinal helminths (including STH) was reduced from 37.6% (649/1,724) in 2017 to 22.8% (352/1,542) in 2019. The egg positive rate of Ascaris lumbricoides was decreased remarkably from 23.3% (402/1,724) in 2017 to 3.6% (56/1,542) in 2019. However, that of T. trichiura was only slightly reduced from 26.9% (464/1,724) in 2017 to 20.2% (312/1,542) in 2019. The intensity of infection with A. lumbricoides and T. trichiura was both more or less reduced, and the proportion of light infection cases with A. lumbricoides and T. trichiura increased from 35.6% in 2017 to 64.3% in 2019 and from 70.3% in 2017 to 81.7% in 2019, respectively. The results indicated that repeated MDAs (2-4 times a year for 3 years) using albendazole on schoolchildren in Myanmar failed to control T. trichiura infection. For a successful control of trichuriasis in Myanmar, new MDA strategies, using a modified albendazole regimen (multiple daily doses for 2 or 3 days) or an alternative anthelmintic drug, such as oxantel pamoate, is strongly recommended.

Keywords

Acknowledgement

The project team would like to thank the staff in National Health Laboratory, Yangon, Myanmar for their kind assistance in this STH control project. Special thanks to KOICA for providing the grant and technical support for this project (KOICA 2017-045).

References

  1. World Health Organization. Bench Aids for the Diagnosis of Intestinal Parasites. 2nd ed. Geneva, Switzerland. World Health Organization. 2019.
  2. Gabrielli AF, Montresor A, Chitsulo L, Engels D, Savioli L. Preventive chemotherapy in human helminthiasis: theoretical and operational aspects. Trans R Soc Trop Med Hyg 2011; 105: 683-693. https://doi.org/10.1016/j.trstmh.2011.08.013
  3. Zeng XJ, Jiang WS, Xie SY, Chen YD, Gu XN, Ge J, Hanga CQ, Lia ZJ, Chena H. Effect of integrated control intervention on soil-transmitted helminth infections in Jiangxi province in southeast China. Acta Trop 2019; 194: 148-154. https://doi.org/10.1016/j.actatropica.2019.04.001
  4. Tun A, Myat SM, Gabrielli AF, Montresor A. Control of soil-transmitted helminthiasis in Myanmar: results of 7 years of deworming. Trop Med Int Health 2013; 18: 1017-1020. https://doi.org/10.1111/tmi.12130
  5. Htoon TT, Tun T, Oo KY, Thein W, Tin HH, Chai JY, Yong TS, Sohn WM. Status of infection with soil-transmitted helminths among primary school children in three selected townships of Yangon Region. Myanmar Heal Sci Res J 2015; 27: 221-226.
  6. Chai JY, Sohn WM, Hong SJ, Jung BK, Hong S, Cho S, Park JB, Kim IS, Kim S, Lee KH, Jeoung HG, Htoon TT, Tin HH. Effect of mass drug administration with a single dose of albendazole on Ascaris lumbricoides and Trichuris trichiura infection among schoolchildren in Yangon Region, Myanmar. Korean J Parasitol 2020; 58: 195-200. https://doi.org/10.3347/kjp.2020.58.2.195
  7. Ministry of Immigration and Population, Myanmar. The 2014 Myanmar Population and Housing Census: Highlights of the Main Results. Census Report Vol 2. Nay Pyi Taw, Myanmar. Ministry of Immigration and Population, Myanmar. 2015, pp 1-47.
  8. World Health Organization. Guideline: Preventive Chemotherapy to Control Soil-Transmitted Helminth Infections in at-Risk Population Groups. Geneva, Switzerland. World Health Organization, 2017.
  9. Dunn JC, Bettis AA, Wyine NY, Lwin AMM, Tun A, Maung NS, Anderson RM. Soil-transmitted helminth reinfection four and six months after mass drug administration: results from the delta Region of Myanmar. PLoS Negl Trop Dis 2019; 13: e0006591-16. https://doi.org/10.1371/journal.pntd.0006591
  10. Moser W, Schindler C, Keiser J. Efficacy of recommended drugs against soil transmitted helminths: systematic review and network meta-analysis. BMJ 2017; 358: j4307. http://doi.org/10.1136/bmj.j4307
  11. Chai JY, Jung BK, Hong SJ. Albendazole and mebendazole as anti-parasitic and anti-cancer agents: an update. Korean J Parasitol 2021; 59: 1-37. https://doi.org/10.3347/kjp.2021.59.3.189
  12. Moser W, Schindler C, Keiser J. Drug combinations against soil-transmitted helminth infections. Adv Parasitol 2019; 103: 91-115. https://doi.org/10.1016/bs.apar.2018.08.002
  13. Diawara A, Halpenny C, Churcher TS, Mwandawiro C, Kihara J, Kaplan RM, Streit TG, Idaghdour Y, Scott ME, Basanez MG, Prichard RK. Association between response to albendazole treatment and β-tubulin frequencies in soil-transmitted helminths. PLoS Negl Trop Dis 2013; 7: e2247. https://doi.org/10.1371/journal.pntd.0002247