The Impact of Anthelmintic Treatment on the Incidence of Diarrheal Disease in Vietnamese School Children

NCT ID: NCT02597556

Last Updated: 2016-12-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-29

Study Completion Date

2016-05-31

Brief Summary

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Cheap and effective drugs called 'anthelmintics' are routinely administered to children in developing countries to eliminate infections by parasitic helminths. However, the effects of anthelmintic treatment on other pathogens (e.g., bacteria, viruses, protozoa) remain unknown. The aim of this study is to investigate the impact of anthelmintic treatment on the incidence of viral- and bacterial-induced diarrhea in school children in southern Vietnam. Diarrheal disease remains a substantial cause of morbidity and mortality in children in Vietnam, and these children are typically co-infected with intestinal helminths. As helminths and diarrheal pathogens infect the same intestinal niche, anthelmintic treatments may alter host immune responses and the composition of the gut microbiota in ways that affect infection and disease risks caused by diarrheal pathogens.

This study will recruit 350 helminth-infected and 350 helminth-uninfected children aged 6-15 years. Recruited children will be randomized to receive either anthelmintic or placebo treatment once every three months and will be monitored for incidences of diarrheal disease for 12 months. At the 12-month time point, all children will receive anthelmintic treatment. Blood and stool samples will be collected throughout the study and used for evaluation of anemia and host immune responses, and for classification of gut microbes and parasite detection, respectively. The interventional study proposed here will provide an important first test of whether anthelmintic treatments have any indirect effects on infections caused by diarrheal pathogens.

Detailed Description

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This study is a randomized, double-blind, placebo-controlled trial to evaluate the effects of 400 mg albendazole treatment against placebo on the incidence of diarrheal disease caused by viral and bacterial pathogens in school children in southern Vietnam. Children will be enrolled from three primary schools in Cu Chi district in Ho Chi Minh City, Vietnam. Children will be screened for infections by the four most common soil-transmitted helminths, Ascaris lumbricoides, Trichuris trichiura, Necator americanus, and Ancylostoma duodenale. Infected and uninfected individuals will be recruited into the study and randomized to either receive albendazole treatment once every three months for 12 months, or to placebo once every three months for 9 months, after which albendazole treatment will be given at month 12, in accordance with the current deworming schedule in Cu Chi district. A questionnaire regarding the participant's demographics, his/her daily habits, and potential sources of infection will be administered at baseline. Weekly active and passive surveillance of diarrheal cases will be conducted throughout the study, and a health questionnaire will be administered during all cases of diarrhea and at the end of the study.

Conditions

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Intestinal Helminthiasis Diarrhea

Keywords

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Albendazole Ancylostoma duodenale Ascariasis lumbricoides Coinfection Diarrhea Helminths Necator americanus Microbiota Trichuris trichiura

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Albendazole

Albendazole will be administered as a single 400mg chewable tablet at 0, 3, 6, 9, and 12 months.

Group Type ACTIVE_COMPARATOR

Albendazole

Intervention Type DRUG

A single 400mg dose of Albendazole administered at 0, 3, 6, 9, and 12 months.

Placebo

Matching Placebo will be administered as a single chewable tablet at 0, 3, 6, and 9 months. At month 12, all participants will receive a single 400mg Albendazole tablet.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Matching placebo tablet administered at 0, 3, 6, and 9 months. At month 12, all participants will receive a single dose of 400mg Albendazole.

Interventions

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Albendazole

A single 400mg dose of Albendazole administered at 0, 3, 6, 9, and 12 months.

Intervention Type DRUG

Placebo

Matching placebo tablet administered at 0, 3, 6, and 9 months. At month 12, all participants will receive a single dose of 400mg Albendazole.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Between 6-15 years of age
* Written informed consent from a parent or guardian
* Written assent from children \>10 years of age

* Subjects that are both hookworm-positive and anemic, as defined by the WHO guidelines
Minimum Eligible Age

6 Years

Maximum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam

OTHER

Sponsor Role collaborator

Ho Chi Minh Preventive Medicine Centre, Vietnam

UNKNOWN

Sponsor Role collaborator

Princeton University

OTHER

Sponsor Role collaborator

Cu Chi Health Department

UNKNOWN

Sponsor Role collaborator

Oxford University Clinical Research Unit, Vietnam

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephen Baker, PhD

Role: PRINCIPAL_INVESTIGATOR

Oxford University Clinical Research Unit

Nghia Ho Dang Trung, PhD, MD

Role: PRINCIPAL_INVESTIGATOR

Pham Ngoc Thach University of Medicine

Andrea Graham, PhD

Role: PRINCIPAL_INVESTIGATOR

Princeton University, USA

Jacqueline Leung, MA

Role: STUDY_DIRECTOR

Princeton University, USA

Locations

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Cu Chi, Viet Nam

Ho Chi Minh City, , Vietnam

Site Status

Countries

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Vietnam

References

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Blackwell AD, Martin M, Kaplan H, Gurven M. Antagonism between two intestinal parasites in humans: the importance of co-infection for infection risk and recovery dynamics. Proc Biol Sci. 2013 Aug 28;280(1769):20131671. doi: 10.1098/rspb.2013.1671. Print 2013 Oct 22.

Reference Type BACKGROUND
PMID: 23986108 (View on PubMed)

Ezenwa VO, Jolles AE. Epidemiology. Opposite effects of anthelmintic treatment on microbial infection at individual versus population scales. Science. 2015 Jan 9;347(6218):175-7. doi: 10.1126/science.1261714.

Reference Type BACKGROUND
PMID: 25574023 (View on PubMed)

Ferrari N, Cattadori IM, Rizzoli A, Hudson PJ. Heligmosomoides polygyrus reduces infestation of Ixodes ricinus in free-living yellow-necked mice, Apodemus flavicollis. Parasitology. 2009 Mar;136(3):305-16. doi: 10.1017/S0031182008005404. Epub 2009 Jan 21.

Reference Type BACKGROUND
PMID: 19154651 (View on PubMed)

Knowles SC, Fenton A, Petchey OL, Jones TR, Barber R, Pedersen AB. Stability of within-host-parasite communities in a wild mammal system. Proc Biol Sci. 2013 May 15;280(1762):20130598. doi: 10.1098/rspb.2013.0598. Print 2013 Jul 7.

Reference Type BACKGROUND
PMID: 23677343 (View on PubMed)

Pedersen AB, Antonovics J. Anthelmintic treatment alters the parasite community in a wild mouse host. Biol Lett. 2013 May 8;9(4):20130205. doi: 10.1098/rsbl.2013.0205. Print 2013 Aug 23.

Reference Type BACKGROUND
PMID: 23658004 (View on PubMed)

Nacher M. Worms and malaria: resisting the temptation to generalize. Trends Parasitol. 2006 Aug;22(8):350-1; author reply 351-2. doi: 10.1016/j.pt.2006.06.003. Epub 2006 Jun 23. No abstract available.

Reference Type BACKGROUND
PMID: 16798090 (View on PubMed)

Rousham EK. An increase in Giardia duodenalis infection among children receiving periodic Anthelmintic treatment in Bangladesh. J Trop Pediatr. 1994 Dec;40(6):329-33. doi: 10.1093/tropej/40.6.329.

Reference Type BACKGROUND
PMID: 7853436 (View on PubMed)

Taylor-Robinson DC, Maayan N, Soares-Weiser K, Donegan S, Garner P. Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin, and school performance. Cochrane Database Syst Rev. 2015 Jul 23;2015(7):CD000371. doi: 10.1002/14651858.CD000371.pub6.

Reference Type BACKGROUND
PMID: 26202783 (View on PubMed)

Leung JM, Hong CT, Trung NH, Thi HN, Minh CN, Thi TV, Hong DT, Man DN, Knowles SC, Wolbers M, Hoang Nle T, Thwaites G, Graham AL, Baker S. The impact of albendazole treatment on the incidence of viral- and bacterial-induced diarrhea in school children in southern Vietnam: study protocol for a randomized controlled trial. Trials. 2016 Jun 6;17(1):279. doi: 10.1186/s13063-016-1406-1.

Reference Type DERIVED
PMID: 27266697 (View on PubMed)

Related Links

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http://www.oucru.org

Oxford University Clinical research Unit

Other Identifiers

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16EN

Identifier Type: -

Identifier Source: org_study_id