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Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation
Preventive chemotherapy (PC), consisting of the regular distribution of anthelmintics to populations or groups of populations at risk, is the primary tool used to control soil-transmitted helminth (STH) infections. This strategy, whilst cost-effective, raises the concern of potential emergence of dr...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668116/ https://www.ncbi.nlm.nih.gov/pubmed/36315591 http://dx.doi.org/10.1371/journal.pntd.0010767 |
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author | Dyer, Clare E. F. Clarke, Naomi E. Nguyen, Dinh Ng Herath, H. M. P. Dilrukshi Hii, Sze Fui Pickford, Russell Traub, Rebecca J. Vaz Nery, Susana |
author_facet | Dyer, Clare E. F. Clarke, Naomi E. Nguyen, Dinh Ng Herath, H. M. P. Dilrukshi Hii, Sze Fui Pickford, Russell Traub, Rebecca J. Vaz Nery, Susana |
author_sort | Dyer, Clare E. F. |
collection | PubMed |
description | Preventive chemotherapy (PC), consisting of the regular distribution of anthelmintics to populations or groups of populations at risk, is the primary tool used to control soil-transmitted helminth (STH) infections. This strategy, whilst cost-effective, raises the concern of potential emergence of drug resistance. The efficacy of anthelmintics against STH infections is measured using cure rate (CR) and egg reduction rate (ERR), using microscopy-based techniques such as the Kato-Katz thick smear. However, Kato-Katz has low sensitivity, especially for low-intensity infections, and requires fresh samples that need to be processed quickly. Realtime quantitative PCR (qPCR), which is more sensitive, is emerging as a “gold standard” for STH diagnostics given its higher sensitivity (important in low prevalence settings) and ability to differentiate hookworm species, while sodium nitrate flotation (SNF) may provide a low-cost more sensitive and practical alternative to Kato-Katz in the field. In this study, we examined the efficacy of a locally manufactured brand of albendazole 400 mg (“Alzental”) against hookworm in Đắk Lắk province, Vietnam, using both qPCR and SNF. For qPCR, formulae to convert qPCR cycle threshold (Ct) values into eggs per gram of faeces (EPG) were utilised to determine efficacy calculations, and these values directly compared with efficacy values generated using SNF. Factors associated with CR and ERR were examined, and Alzental tablet quality was assessed by comparing with an Australian TGA-approved equivalent “Eskazole” tablet. We observed a CR and ERR of 64.9% and 87.5% respectively using qPCR, and 68.4% and 67.6% respectively using SNF. The tablet composition of Alzental was comparable to Eskazole in terms of active albendazole drug concentration with no evidence of impurities. This study demonstrates that the efficacy of Alzental against hookworm is within the range of previously reported studies for albendazole 400 mg. The study also demonstrates the value of qPCR and SNF as alternatives to standard Kato-Katz methodology for assessment of anthelmintic efficacy. |
format | Online Article Text |
id | pubmed-9668116 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-96681162022-11-17 Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation Dyer, Clare E. F. Clarke, Naomi E. Nguyen, Dinh Ng Herath, H. M. P. Dilrukshi Hii, Sze Fui Pickford, Russell Traub, Rebecca J. Vaz Nery, Susana PLoS Negl Trop Dis Research Article Preventive chemotherapy (PC), consisting of the regular distribution of anthelmintics to populations or groups of populations at risk, is the primary tool used to control soil-transmitted helminth (STH) infections. This strategy, whilst cost-effective, raises the concern of potential emergence of drug resistance. The efficacy of anthelmintics against STH infections is measured using cure rate (CR) and egg reduction rate (ERR), using microscopy-based techniques such as the Kato-Katz thick smear. However, Kato-Katz has low sensitivity, especially for low-intensity infections, and requires fresh samples that need to be processed quickly. Realtime quantitative PCR (qPCR), which is more sensitive, is emerging as a “gold standard” for STH diagnostics given its higher sensitivity (important in low prevalence settings) and ability to differentiate hookworm species, while sodium nitrate flotation (SNF) may provide a low-cost more sensitive and practical alternative to Kato-Katz in the field. In this study, we examined the efficacy of a locally manufactured brand of albendazole 400 mg (“Alzental”) against hookworm in Đắk Lắk province, Vietnam, using both qPCR and SNF. For qPCR, formulae to convert qPCR cycle threshold (Ct) values into eggs per gram of faeces (EPG) were utilised to determine efficacy calculations, and these values directly compared with efficacy values generated using SNF. Factors associated with CR and ERR were examined, and Alzental tablet quality was assessed by comparing with an Australian TGA-approved equivalent “Eskazole” tablet. We observed a CR and ERR of 64.9% and 87.5% respectively using qPCR, and 68.4% and 67.6% respectively using SNF. The tablet composition of Alzental was comparable to Eskazole in terms of active albendazole drug concentration with no evidence of impurities. This study demonstrates that the efficacy of Alzental against hookworm is within the range of previously reported studies for albendazole 400 mg. The study also demonstrates the value of qPCR and SNF as alternatives to standard Kato-Katz methodology for assessment of anthelmintic efficacy. Public Library of Science 2022-10-31 /pmc/articles/PMC9668116/ /pubmed/36315591 http://dx.doi.org/10.1371/journal.pntd.0010767 Text en © 2022 Dyer et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Dyer, Clare E. F. Clarke, Naomi E. Nguyen, Dinh Ng Herath, H. M. P. Dilrukshi Hii, Sze Fui Pickford, Russell Traub, Rebecca J. Vaz Nery, Susana Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation |
title | Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation |
title_full | Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation |
title_fullStr | Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation |
title_full_unstemmed | Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation |
title_short | Assessing the efficacy of albendazole against hookworm in Vietnam using quantitative PCR and sodium nitrate flotation |
title_sort | assessing the efficacy of albendazole against hookworm in vietnam using quantitative pcr and sodium nitrate flotation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668116/ https://www.ncbi.nlm.nih.gov/pubmed/36315591 http://dx.doi.org/10.1371/journal.pntd.0010767 |
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