Albendazole Plus High Dose Ivermectin for Trichuriasis in Pediatric Patients

NCT ID: NCT04041453

Last Updated: 2020-07-29

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

176 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-09

Study Completion Date

2020-03-07

Brief Summary

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There are four species of intestinal worms collectively known as soil-transmitted helminthiasis (STH): Ancylostoma duodenale and Necator americanus (hookworms), Ascaris lumbricoides (roundworms), and Trichuris trichiura (whipworms). These parasites affect over two billion people and contribute to significant morbidity and disability, especially in high risk groups, for example children, agricultural workers and pregnant women. In children, STH are associated with impaired nutritional status evidenced by stunting, thinness and underweight.

As is the case in most Latin America, STH are a public health problem in Honduras. The World Health Organization (WHO) informs that more than 2.5 million children (under 15 years of age) in the country are at risk of infection. To control these infections Honduras has established a national deworming program that operates since 2001 but despite these efforts, the prevalence of STH infections remains unacceptably high. This is especially true in rural communities where prevalence can be as high as 70% of the children population.

Ivermectin (IVM) in combination with albendazole (ALB) has demonstrated the capacity to improve efficacy compared to any of these drugs in monotherapy; the efficacy is however, still inadequate in terms of cure rate, although egg reduction rates are significant.

The purpose of the current trial is to assess the safety and efficacy of 3 experimental regimens for the treatment of infections by Trichuris trichiura in children in comparison with the current standard of practice in Mass Drug Administration (MDA) campaigns. The experimental regimens will explore the effect of multiple day regimens and high dose ivermectin.

Treatment arms:

* Group 1: single dose of ALB 400 mg. (active control arm). N:39
* Group 2: single dose ALB 400mg + IVM 600µg/Kg. N: 57
* Group 3: daily dose ALB 400mg for 3 consecutive days. N:24
* Group 4: daily dose ALB 400mg + IVM 600µg for 3 consecutive days. N:57

Total Study Population: 177

Detailed Description

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Conditions

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Trichuris Infection Helminthiasis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Albendazole 400mg

Albendazole 400mg in single dose

Group Type ACTIVE_COMPARATOR

Albendazole

Intervention Type DRUG

Albendazole will be provided as an active control or in experimental arms for 1 or 3 days with ivermectin.

Albendazole/Ivermectin

Combination of albendazole 400mg + ivermectin 600mcg/kg in single dose.

Group Type EXPERIMENTAL

Ivermectin

Intervention Type DRUG

Ivermectin at 600mcg/kg in addition to albendazole will be provided for 1 or 3 days.

Albendazole

Intervention Type DRUG

Albendazole will be provided as an active control or in experimental arms for 1 or 3 days with ivermectin.

Albendazole 400mg x 3

Albendazole 400mg/day for 3 consecutive days

Group Type EXPERIMENTAL

Albendazole

Intervention Type DRUG

Albendazole will be provided as an active control or in experimental arms for 1 or 3 days with ivermectin.

Albendazole/Ivermectin x 3

Combination of albendazole 400mg/day + ivermectin 600mcg/kg/day for 3 consecutive days

Group Type EXPERIMENTAL

Ivermectin

Intervention Type DRUG

Ivermectin at 600mcg/kg in addition to albendazole will be provided for 1 or 3 days.

Albendazole

Intervention Type DRUG

Albendazole will be provided as an active control or in experimental arms for 1 or 3 days with ivermectin.

Interventions

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Ivermectin

Ivermectin at 600mcg/kg in addition to albendazole will be provided for 1 or 3 days.

Intervention Type DRUG

Albendazole

Albendazole will be provided as an active control or in experimental arms for 1 or 3 days with ivermectin.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Infection with T. trichiura by Kato Katz.
* Body weight \>15kg.
* Accepts participation

Exclusion Criteria

* Albendazole and/or mebendazol treatment in the previous 3 months.
* Allergy to the study drugs
* Acute medical conditions
* Clinical trial participation in the previous 3 months.
* Pregnancy.
Minimum Eligible Age

2 Years

Maximum Eligible Age

14 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Brock University

OTHER

Sponsor Role collaborator

Universidad Nacional del Centro de la Provincia de Buenos Aires

OTHER

Sponsor Role collaborator

Universidad Nacional Autonoma de Honduras

OTHER

Sponsor Role collaborator

Alejandro Krolewiecki

OTHER

Sponsor Role lead

Responsible Party

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Alejandro Krolewiecki

Investigador CIC CONICET

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Alejandro J Krolewiecki, MD, PhD

Role: STUDY_DIRECTOR

IIET - Universidad Nacional de Salta

Locations

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IIET

Orán, Salta Province, Argentina

Site Status

Universidad Autónoma de Honduras

Tegucigalpa, , Honduras

Site Status

Countries

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Argentina Honduras

References

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Matamoros G, Sanchez A, Cimino R, Krolewiecki A, Mejia R. A comparison of the diagnostic capability of Kato-Katz and real-time PCR for the assessment of treatment efficacy of ivermectin and albendazole combination against T. trichiura infections. PLoS Negl Trop Dis. 2024 Nov 19;18(11):e0012677. doi: 10.1371/journal.pntd.0012677. eCollection 2024 Nov.

Reference Type DERIVED
PMID: 39561184 (View on PubMed)

Matamoros G, Sanchez A, Gabrie JA, Juarez M, Ceballos L, Escalada A, Rodriguez C, Marti-Soler H, Rueda MM, Canales M, Lanusse C, Cajal P, Alvarez L, Cimino RO, Krolewiecki A. Efficacy and Safety of Albendazole and High-Dose Ivermectin Coadministration in School-Aged Children Infected With Trichuris trichiura in Honduras: A Randomized Controlled Trial. Clin Infect Dis. 2021 Oct 5;73(7):1203-1210. doi: 10.1093/cid/ciab365.

Reference Type DERIVED
PMID: 33906234 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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01-2019

Identifier Type: -

Identifier Source: org_study_id

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