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The optimal timing of post-treatment sampling for the assessment of anthelminthic drug efficacy against Ascaris infections in humans

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Abstract
The egg reduction rate (ERR) is the current standard mean to assess the efficacy of drugs against human soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura and hookworm). Although the timing of post-treatment sampling is pivotal for a readily interpretation of drug efficacy, there is lack empirical data that allows recommending the optimal time point for a follow-up egg counting. In the present study, we re-analyzed both the kinetics of worm expulsion and egg output for Ascaris lumbricoides following a single oral dose of albendazole in a series of studies previously conducted in Kenyan communities. The results indicate that it takes up to 10 days post-treatment before the expulsion of both adult male and female Ascaris worms is completed, approximately 20% of the worms being expelled between day 7 and 10 post-treatment. The sequential analysis of the egg out put, indicated a poor ERR (89.4%) at day 7 post-treatment, but a 100% ERR at day 14 and 21 post-treatment. Based on our findings we recommend to wait at least 14 days after an albendazole treatment before conducting the follow-up egg count. Any sampling before this time point may result in biased ERR estimates, due the release of residual eggs from moribund or degenerating worms.
Keywords
Ascaris lumbricoides, Worm expulsion, Egg reduction rate, Anthelmintic resistance, Albendazole

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Chicago
Levecke, Bruno, Alice V Easton, Piet Cools, Marco Albonico, Shaali Ame, John S Gilleard, Jennifer Keiser, et al. 2018. “The Optimal Timing of Post-treatment Sampling for the Assessment of Anthelminthic Drug Efficacy Against Ascaris Infections in Humans.” International Journal for Parasitology-drugs and Drug Resistance 8 (1): 67–69.
APA
Levecke, B., Easton, A. V., Cools, P., Albonico, M., Ame, S., Gilleard, J. S., Keiser, J., et al. (2018). The optimal timing of post-treatment sampling for the assessment of anthelminthic drug efficacy against Ascaris infections in humans. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE, 8(1), 67–69.
Vancouver
1.
Levecke B, Easton AV, Cools P, Albonico M, Ame S, Gilleard JS, et al. The optimal timing of post-treatment sampling for the assessment of anthelminthic drug efficacy against Ascaris infections in humans. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE. 2018;8(1):67–9.
MLA
Levecke, Bruno, Alice V Easton, Piet Cools, et al. “The Optimal Timing of Post-treatment Sampling for the Assessment of Anthelminthic Drug Efficacy Against Ascaris Infections in Humans.” INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 8.1 (2018): 67–69. Print.
@article{8548671,
  abstract     = {The egg reduction rate (ERR) is the current standard mean to assess the efficacy of drugs against human soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura and hookworm). Although the timing of post-treatment sampling is pivotal for a readily interpretation of drug efficacy, there is lack empirical data that allows recommending the optimal time point for a follow-up egg counting. In the present study, we re-analyzed both the kinetics of worm expulsion and egg output for Ascaris lumbricoides following a single oral dose of albendazole in a series of studies previously conducted in Kenyan communities. The results indicate that it takes up to 10 days post-treatment before the expulsion of both adult male and female Ascaris worms is completed, approximately 20\% of the worms being expelled between day 7 and 10 post-treatment. The sequential analysis of the egg out put, indicated a poor ERR (89.4\%) at day 7 post-treatment, but a 100\% ERR at day 14 and 21 post-treatment. Based on our findings we recommend to wait at least 14 days after an albendazole treatment before conducting the follow-up egg count. Any sampling before this time point may result in biased ERR estimates, due the release of residual eggs from moribund or degenerating worms.},
  author       = {Levecke, Bruno and Easton, Alice V and Cools, Piet and Albonico, Marco and Ame, Shaali and Gilleard, John S and Keiser, Jennifer and Montresor, Antonio and Prichard, Roger and Vlaminck, Johnny and Vercruysse, Jozef},
  issn         = {2211-3207},
  journal      = {INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE},
  keyword      = {Ascaris lumbricoides,Worm expulsion,Egg reduction rate,Anthelmintic resistance,Albendazole},
  language     = {eng},
  number       = {1},
  pages        = {67--69},
  title        = {The optimal timing of post-treatment sampling for the assessment of anthelminthic drug efficacy against Ascaris infections in humans},
  url          = {http://dx.doi.org/10.1016/j.ijpddr.2017.12.004},
  volume       = {8},
  year         = {2018},
}

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