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Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India
INTRODUCTION: Hookworm infection is a leading cause of iron deficiency anemia and malnutrition in resource-poor settings. Periodic mass deworming with anthelminthic drugs remains the cornerstone of hookworm control efforts worldwide. Reinfection following treatment occurs, reflecting the human host&...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389336/ https://www.ncbi.nlm.nih.gov/pubmed/28424794 http://dx.doi.org/10.1016/j.conctc.2016.12.002 |
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author | Sarkar, Rajiv Rose, Anuradha Mohan, Venkata R. Ajjampur, Sitara S.R. Veluswamy, Vasanthakumar Srinivasan, Rajan Muliyil, Jayaprakash Rajshekhar, Vedantam George, Kuryan Balraj, Vinohar Grassly, Nicholas C. Anderson, Roy M. Brooker, Simon J. Kang, Gagandeep |
author_facet | Sarkar, Rajiv Rose, Anuradha Mohan, Venkata R. Ajjampur, Sitara S.R. Veluswamy, Vasanthakumar Srinivasan, Rajan Muliyil, Jayaprakash Rajshekhar, Vedantam George, Kuryan Balraj, Vinohar Grassly, Nicholas C. Anderson, Roy M. Brooker, Simon J. Kang, Gagandeep |
author_sort | Sarkar, Rajiv |
collection | PubMed |
description | INTRODUCTION: Hookworm infection is a leading cause of iron deficiency anemia and malnutrition in resource-poor settings. Periodic mass deworming with anthelminthic drugs remains the cornerstone of hookworm control efforts worldwide. Reinfection following treatment occurs, reflecting the human host's inability to acquire immunity following exposure to an untreated reservoir of infection. This cluster randomized trial will evaluate the effectiveness of a modified, population-based, mass deworming strategy in reducing hookworm infection in an endemic southern Indian population. METHODS: Forty five tribal villages were randomized into three groups: one received annual treatment; the second received two rounds of treatment at 1-month intervals; and the third received four rounds of treatment – two rounds 1 month apart at the beginning, followed by another two after 6 months. Stool samples collected through cross-sectional parasitological surveys pre- and post-intervention, and at 3-monthly intervals for a period of 1 year were tested for presence of hookworm ova. Long-term effectiveness of treatment will be assessed through another survey conducted 2 years after the last treatment cycle. RESULTS: From a population of 11,857 individuals, 8681 (73.2%) were found to be eligible and consented to participate, out-migration being the primary reason for non-participation. Baseline stool samples were obtained from 2082 participants, with 18.5% having hookworm infection, although majority were low intensity infections (<2000 eggs per gram of feces). DISCUSSION: This study will help identify the optimal mass deworming strategy that can achieve the greatest impact in the shortest period of time, particularly in settings where long-term program sustainability is a challenge. |
format | Online Article Text |
id | pubmed-5389336 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-53893362017-04-17 Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India Sarkar, Rajiv Rose, Anuradha Mohan, Venkata R. Ajjampur, Sitara S.R. Veluswamy, Vasanthakumar Srinivasan, Rajan Muliyil, Jayaprakash Rajshekhar, Vedantam George, Kuryan Balraj, Vinohar Grassly, Nicholas C. Anderson, Roy M. Brooker, Simon J. Kang, Gagandeep Contemp Clin Trials Commun Article INTRODUCTION: Hookworm infection is a leading cause of iron deficiency anemia and malnutrition in resource-poor settings. Periodic mass deworming with anthelminthic drugs remains the cornerstone of hookworm control efforts worldwide. Reinfection following treatment occurs, reflecting the human host's inability to acquire immunity following exposure to an untreated reservoir of infection. This cluster randomized trial will evaluate the effectiveness of a modified, population-based, mass deworming strategy in reducing hookworm infection in an endemic southern Indian population. METHODS: Forty five tribal villages were randomized into three groups: one received annual treatment; the second received two rounds of treatment at 1-month intervals; and the third received four rounds of treatment – two rounds 1 month apart at the beginning, followed by another two after 6 months. Stool samples collected through cross-sectional parasitological surveys pre- and post-intervention, and at 3-monthly intervals for a period of 1 year were tested for presence of hookworm ova. Long-term effectiveness of treatment will be assessed through another survey conducted 2 years after the last treatment cycle. RESULTS: From a population of 11,857 individuals, 8681 (73.2%) were found to be eligible and consented to participate, out-migration being the primary reason for non-participation. Baseline stool samples were obtained from 2082 participants, with 18.5% having hookworm infection, although majority were low intensity infections (<2000 eggs per gram of feces). DISCUSSION: This study will help identify the optimal mass deworming strategy that can achieve the greatest impact in the shortest period of time, particularly in settings where long-term program sustainability is a challenge. Elsevier 2016-12-10 /pmc/articles/PMC5389336/ /pubmed/28424794 http://dx.doi.org/10.1016/j.conctc.2016.12.002 Text en © 2016 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Sarkar, Rajiv Rose, Anuradha Mohan, Venkata R. Ajjampur, Sitara S.R. Veluswamy, Vasanthakumar Srinivasan, Rajan Muliyil, Jayaprakash Rajshekhar, Vedantam George, Kuryan Balraj, Vinohar Grassly, Nicholas C. Anderson, Roy M. Brooker, Simon J. Kang, Gagandeep Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India |
title | Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India |
title_full | Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India |
title_fullStr | Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India |
title_full_unstemmed | Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India |
title_short | Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India |
title_sort | study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern india |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389336/ https://www.ncbi.nlm.nih.gov/pubmed/28424794 http://dx.doi.org/10.1016/j.conctc.2016.12.002 |
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