Efficacy Albendazole and Levamisole Against STH on Unguja (ALBvLEV)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00659997
Recruitment Status : Completed
First Posted : April 17, 2008
Last Update Posted : April 17, 2008
Ministry of Health, Tanzania
University of London
Information provided by:
Natural History Museum, United Kingdom

April 10, 2008
April 17, 2008
April 17, 2008
June 2006
September 2006   (Final data collection date for primary outcome measure)
Clearance of STH faecal eggs in patient stool [ Time Frame: 18 days ]
Same as current
No Changes Posted
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Efficacy Albendazole and Levamisole Against STH on Unguja
Longitudinal Study of Efficacy of Standard Albendazole Treatment Versus Levamisole/Pyrantel Pamoate on Soil Transmitted Helminth Infections

Field epidemiological studies undertaken during 2005 in four village locations in Northern Unguja, Zanzibar examined mothers and their pre-school aged children for helminth infections.

The prevalence of Ascaris lumbricoides was found to have remained relatively high despite community-wide treatment with the mass administration of Albendazole (a WHO recommended de-wormer) in coordination with community vitamin A supplementation.

One hypothesis for this is that the children and mothers had Ascaris infections more tolerant to Albendazole that subsequently failed to clear. It is necessary to compare the present drug efficiency of Albendazole (first-line de-wormer) with Levamisole (second-line de-wormer) on STH infections such patients a case-control setting to shed light on the putative resistance of local Ascaris/Trichuris to albendazole.

In so doing, this should clarify whether there is resistance developing towards Albendazole and have possible implications for introducing combination therapies of Levamisole and Albendazole for first line de-worming mothers and their children in the future.

The study was conducted in 10 villages on Unguja Island representative of urban, semi-urban and rural environments. After liaison with the local Shehia (the elected community leader) mothers and their children aged between 6 months and 5 years old were invited to attend a walk-in mobile clinic. In accordance with WHO sample size recommendations of 30 individuals per site and to cater for drop-out/non-compliance, target enrolment was about 50 mother and child pairs at each study village.

Stool specimens were transported to the Helmtin Control Laboratory Unguja laboratory for visual inspection of stool consistency and presence of blood, after which a single Kato-Katz thick smear (41.7mg) was prepared. Eggs of all STH species were counted by inspection at 100x microscopy and expressed as a tally of eggs per gram (EPG). To ensure consistency of egg counts, slides were read by the same two technicians for each study village.

10 Mother and child pairs found positive for Ascaris and/or Trichuris were randomised, by coin tossing, to receive either a single tablet of ALB (400mg) or an appropriate dose of LEV (2.5 mg/kg). A parasitological follow-up took place 18 days after treatment where a requested stool sample was analyzed by a single Kato-Katz thick smear for assessment of STH clearance. In accordance with WHO's 'no survey without service' all attendees were given an additional ALB tablet.

Phase 4
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Treatment
  • Ascariasis
  • Trichuriasis
  • Drug: Albendazole
    Single oral dose of 400mg
  • Drug: Levamisole
    Single oral dose of 2.5mg/kg
  • Active Comparator: 1
    1 Individuals treated with Albendazole
    Intervention: Drug: Albendazole
  • Active Comparator: 2
    Individuals treated with Levamisole
    Intervention: Drug: Levamisole
Stothard JR, Imison E, French MD, Sousa-Figueiredo JC, Khamis IS, Rollinson D. Soil-transmitted helminthiasis among mothers and their pre-school children on Unguja Island, Zanzibar with emphasis upon ascariasis. Parasitology. 2008 Oct;135(12):1447-55. doi: 10.1017/S0031182008004836. Epub 2008 Sep 8.

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Same as current
September 2007
September 2006   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Presently with soil-transmitted helminthiasis

Exclusion Criteria:

  • absence of soil-transmitted helminthiasis
Sexes Eligible for Study: Female
1 Year to 45 Years   (Child, Adult)
Contact information is only displayed when the study is recruiting subjects
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Prof D Rollinson, Natural History Museum
Natural History Museum, United Kingdom
  • Ministry of Health, Tanzania
  • University of London
Not Provided
Natural History Museum, United Kingdom
April 2008

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP