A Comparative Trial of a Single-Dose Ivermectin Versus Three Days of Albendazole for Treatment of Strongyloides Stercoralis and Other Soil-Transmitted Helminth Infections in Children

TLDR

To compare a single dose of ivermectin with a three‑day course of albendazole for treating Strongyloides stercoralis and other soil‑transmitted helminths in children. A randomized trial in rural Zanzibar administered 200 µg/kg ivermectin once versus 400 mg/day albendazole for three days. The study found ivermectin cured 83 % of Strongyloides infections versus 45 % with albendazole, both drugs were highly effective against Ascaris lumbricoides, but ivermectin was ineffective against hookworms and cured only 11 % of Trichuris trichiura (vs 43 % with albendazole), with egg‑load reductions of 59 % and 92 % respectively; no severe side effects were observed, indicating ivermectin is safe and effective for S.

Abstract

A randomized trial carried out in rural Zanzibar comparing a single dose of 200 micrograms/kg of ivermectin and 400 mg/day for three days of albendazole for treatment of strongyloidiasis and other intestinal nematodes is described. In 301 children with Strongyloides stercoralis infection, treatment with ivermectin or albendazole resulted in cure rates of 83% and 45%, respectively. While both drugs were very effective against Ascaris lumbricoides, Trichuris trichiura was cured only in 11% (ivermectin) and 43% (albendazole) of the subjects, although the mean eggload was reduced by 59% and 92%, respectively. Ivermectin was ineffective against hookworms, while albendazole resulted in a cure rate of 98%. No severe side effects were recorded and mild side effects were of transient nature for both treatments. Therefore, ivermectin provides a safe and a highly effective single dose treatment for S. stercoralis and A. lumbricoides, while it is not an alternative for the treatment of T. trichiura and hookworm infections.