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Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador
BACKGROUND: Establishment of efficient control programs for strongyloidiasis, the infection by Strongyloides stercoralis, is among the World Health Organization (WHO) targets for 2030. Ivermectin is a drug of choice for strongyloidiasis, but its weight-based administration can be unfeasible in remot...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9883947/ https://www.ncbi.nlm.nih.gov/pubmed/36709311 http://dx.doi.org/10.1186/s40249-023-01054-7 |
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author | Buonfrate, Dora Anselmi, Mariella Prandi, Rosanna Marquez, Monica Mazzi, Cristina Montresor, Antonio |
author_facet | Buonfrate, Dora Anselmi, Mariella Prandi, Rosanna Marquez, Monica Mazzi, Cristina Montresor, Antonio |
author_sort | Buonfrate, Dora |
collection | PubMed |
description | BACKGROUND: Establishment of efficient control programs for strongyloidiasis, the infection by Strongyloides stercoralis, is among the World Health Organization (WHO) targets for 2030. Ivermectin is a drug of choice for strongyloidiasis, but its weight-based administration can be unfeasible in remote areas. We evaluated a WHO tablet pole for administration of ivermectin in school-age children living in remote villages in Ecuador. METHODS: Children were enrolled in 16 villages in Esmeraldas Province of Ecuador, between July 2021 and June 2022. The pole identified four height intervals corresponding to ivermectin doses going from one to four tablets. For each child, we calculated the dose (µg/kg) administered with both weight-based and pole-based administration. Results were classified as follows: optimal dose, acceptable, overdose, underdose. Agreement between the two methods for estimating the number of tablets was assessed with Cohen’s kappa coefficient. Estimations were reported with 95% confidence intervals (CIs). RESULTS: Total of 778 children (47.3% female) were enrolled, with median age of 9.59 years (interquartile range: 7.42‒11.22). Optimal dose was achieved for a higher proportion of children when assessed with weight (37.9%) than with pole (25.7%). Underdose and overdose were more frequent with the pole (8.3% and 19.2% children, respectively) than with the weight-based (3.7% and 6.0%, respectively) administration. Agreement between weight-based and pole-based administration was moderate: 0.56 (95% CI 0.51, 0.61). The two methods indicated the same number of tablets in 71.6% (95% CI 0.684, 0.748) cases. CONCLUSIONS: In our setting, the tablet pole could be a valid alternative. The tool needs further evaluation in different populations. GRAPHICAL ABSTRACT: [Image: see text] |
format | Online Article Text |
id | pubmed-9883947 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-98839472023-01-29 Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador Buonfrate, Dora Anselmi, Mariella Prandi, Rosanna Marquez, Monica Mazzi, Cristina Montresor, Antonio Infect Dis Poverty Short Report BACKGROUND: Establishment of efficient control programs for strongyloidiasis, the infection by Strongyloides stercoralis, is among the World Health Organization (WHO) targets for 2030. Ivermectin is a drug of choice for strongyloidiasis, but its weight-based administration can be unfeasible in remote areas. We evaluated a WHO tablet pole for administration of ivermectin in school-age children living in remote villages in Ecuador. METHODS: Children were enrolled in 16 villages in Esmeraldas Province of Ecuador, between July 2021 and June 2022. The pole identified four height intervals corresponding to ivermectin doses going from one to four tablets. For each child, we calculated the dose (µg/kg) administered with both weight-based and pole-based administration. Results were classified as follows: optimal dose, acceptable, overdose, underdose. Agreement between the two methods for estimating the number of tablets was assessed with Cohen’s kappa coefficient. Estimations were reported with 95% confidence intervals (CIs). RESULTS: Total of 778 children (47.3% female) were enrolled, with median age of 9.59 years (interquartile range: 7.42‒11.22). Optimal dose was achieved for a higher proportion of children when assessed with weight (37.9%) than with pole (25.7%). Underdose and overdose were more frequent with the pole (8.3% and 19.2% children, respectively) than with the weight-based (3.7% and 6.0%, respectively) administration. Agreement between weight-based and pole-based administration was moderate: 0.56 (95% CI 0.51, 0.61). The two methods indicated the same number of tablets in 71.6% (95% CI 0.684, 0.748) cases. CONCLUSIONS: In our setting, the tablet pole could be a valid alternative. The tool needs further evaluation in different populations. GRAPHICAL ABSTRACT: [Image: see text] BioMed Central 2023-01-28 /pmc/articles/PMC9883947/ /pubmed/36709311 http://dx.doi.org/10.1186/s40249-023-01054-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Short Report Buonfrate, Dora Anselmi, Mariella Prandi, Rosanna Marquez, Monica Mazzi, Cristina Montresor, Antonio Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador |
title | Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador |
title_full | Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador |
title_fullStr | Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador |
title_full_unstemmed | Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador |
title_short | Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador |
title_sort | use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in ecuador |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9883947/ https://www.ncbi.nlm.nih.gov/pubmed/36709311 http://dx.doi.org/10.1186/s40249-023-01054-7 |
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