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A mixture of 150 mg mebendazole and 30mg pyrantel pamoate was given on 3 consecutive or near-consecutive days to 70 children infected with one or more of Necator americanus, Ascaris lumbricoides, Strongyloides stercoralis, S. fuelleborni-like and Trichuris trichiura. This treatment had an efficacy of 95 per cent for N. americanus infections, 100 per cent for A. lumbricoides, 57 per cent for Strongyloides spp., and 75 per cent for T. trichiura. The results indicate that the treatment given is effective against the infections of N. americanus and A. lumbricoides but is only partially effective for Strongyloides and T. trichiura infections.
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While the efficacy obtained for FLBZ and R-FLBZ administered as a solution was 94 and 98%, respectively, the efficacies obtained after the treatment with FLBZ suspensions were 38% (FLBZ) and 64% (R-FLBZ).
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A Syrian woman with pulmonary and hepatic Echinococcus granulosus had symptoms of hydatid disease during each of three consecutive pregnancies. We postulate that the decrease in cellular immunity that accompanies pregnancy might allow for increased parasite growth. Obstetricians should be aware of the potential during pregnancy for rapid progression and complications of hydatid disease.
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Intestinal infection due to the pinworm Enterobius vermicularis is the most prevalent helminthiasis in Europe and North America. Humans are the only known reservoir and young children are most often affected. The disease is highly contagious and is transmitted via the faecal-oral route. Insufficient hand hygiene, contaminated bed linens and clothes may play a role in transmission. Clinical symptoms often encompass severe nocturnal anal pruritus, when female worms deposit an abundance of eggs in the perianal region. The infection is diagnosed by applying an adhesive tape on the perianal region, followed by microscopic examination. Serious complications, such as extraintestinal infections, occur only rarely. Infections of the female genital tract and the peritoneum are described in the literature, also in pregnant women. We describe a case of a pregnant patient in the 33 (rd) week of gestation with intense anal pruritus in whom an enteral pinworm infection was diagnosed. The patient was successfully treated with mebendazole, an anthelminthic agent. Analysis of the data currently available for the administration of mebendazole during pregnancy did not show an elevated rate of congenital anomalies. However, further studies still have to be performed.
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A parasitological study was carried out on 381 apparently healthy subjects from Camiri, Boyuibe, Gutierrez. Intestinal parasites and non-pathogenic protozoa were present in 78.7% of the population sampled; multiple infections were observed in 67.7% of the parasitized individuals. The protozoon most commonly found was Entamoeba coli (in 40.7% of specimens), followed by Giardia intestinalis (30.7%), Iodamoeba bütschlii (10%), Chilomastix mesnili (8.7%). Other protozoon parasites also present were Enteromonas hominis (3.4%), Retortamonas intestinalis (2.4%), Cryptosporidium (2.1%), Endolimax nana (2.1%), Balantidium coli (1.8%) and Pentatrichomonas hominis (0.8%). The helminths observed were hookworms (28.6%), Trichuris trichiura (19.7%), Ascaris lumbricoides (9.7%), Hymenolepis nana (8.7%), Trichostrongylus (5.5%), Strongyloides stercoralis (1.8%), Taenia (5 cases) and Enterobius (6 cases). Prevalence for nematodes is probably underestimated in the 3-9 years age group because of a mebendazole treatment given 5 weeks before the survey, under a Program of P D C of the Ministry of Health. The sample from Camiri was found to be the most parasitized (84.1%). An extraordinarily high infection rate was found in two urban institutions, as well as in Itanambicua, a rural community close to Camiri. No significant differences were observed in parasitic prevalence between rural and urban environments. Exposure to contamination with human and animal faeces, overcrowding and poor sanitation habits are some of the factors responsible for the parasitic situation evidenced.
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Praziquantel is the drug of choice for clonorchiasis. Since clonorchiasis is endemic in most river basins, praziquantel has been widely used for 30 years in Korea. A 54-year-old Korean woman suffered from hypersensitive reactions, such as nausea, dyspnea, rash, and urticaria after taking the first dose of praziquantel to treat clonorchiasis. She ingested one dose again and the same symptoms appeared, and she was treated at a clinic with anti-histamines. She tried one more dose with anti-histamines but found the same symptoms. Later, she was found to pass eggs of Clonorchis sinensis and medicated with flubendazole. The hypersensitive reaction to praziquantel is rare but occurs. This is the 5th case report in the world.
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Monogeneans which parasitize fish are still treated by bathing the fish in solutions of simple chemicals or staining dyes. In the early 1960s an insecticide, trichlorphon, replaced to a large extent the formerly used simple chemicals. Its success was greater specificity against monogeneans and other ectoparasites, and to its great tolerance by the fish. The fact that the number of important monogenean species (i.e. Pseudodactylogyrus anguillae, P. bini, Gyrodactylus salaris) which cannot be treated sufficiently with simple chemicals or even trichlorphon is increasing, led to the need for systemically acting, novel chemotherapeutics. In laboratory and small scale trials praziquantel, levamisole, mebendazole and toltrazuril have been tested for efficacy against a broad spectrum of monogenean species.
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Using a STH transmission mathematical model, we evaluated the potential impact of co-administering ivermectin with albendazole or mebendazole to treat T. trichiura within a preventive chemotherapy programme targeting children (2-15 year olds). We evaluated the impact in terms of reduction in prevalent infections, mean worm burden, and prevalence of heavy infections.
The results of this meta-analysis suggest that expanding deworming programmes community-wide is likely to reduce the prevalence of soil-transmitted helminths in the high-risk group of school-aged children, which could lead to improved morbidity outcomes. These findings are in support of recent calls for re-evaluation of global soil-transmitted helminth control guidelines.
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The proliferative response of lymphocytes to Con A and enzyme-linked absorbent assay were used to determine the levels of cellular and humoral immunity of mice infected with ip 2000 protoscolices of Echinococcus granulosus for 2, 4 or 8 months and treated twice with ip BCG 0.2 mg/mouse at an interval of 10 d, or with ip cyclophosphamide (Cy) 10 mg/(kg.d) x 5 d. The results showed that the immune levels of the host were stimulated by BCG, but depressed by Cy significantly. When the mice were treated with ip mebendazole (Meb) 25 mg/(kg.d) x 10 d in combination with ip BCG 0.2 mg/mouse on d 3 before Meb treatment and on d 7 after the beginning of Meb treatment, or with ip Cy 10 mg/(kg.d) x 5 d before Meb treatment, the inhibition rates of cyst weight and the alterations of germinal layers induced by the drugs were similar to those of corresponding groups treated with Meb alone. Cy also exhibited an apparent effect on mice infected with protoscolices for 2 months. Even so, no apparent synergic effect was seen after combined treatment with Cy and Meb. The results suggest that the effect of Meb on secondary cysts of E granulosus was not affected by the host immune level.