Periodic deworming with pyrantel in an industrial township.

Between June 1986 and September 1987 a population of 100 families was dewormed every 3 months (quarter) by using a single dose of pyrantel. Stool samples were examined by Kato's thick smear method; height (m), weight (kg), hemoglobin concentration (g/dl) and clinical morbidity were recorded before each deworming treatment. Clinical morbidity was recorded in another 100 control families who did not receive anthelmlntics. There were 477 and 490 individuals in the study and the control families respectively. In the study group the prevalence of roundworm was reduced from 10.3% to to 0% and that of hookworm infection was reduced from 2.9% to 0% after 2 quarters. At the end of the 4th quarter the mean hemoglobin rose by 0.1 g/dl (P less than 0.01) and the mean BMI increased by 0.37 (P less than 0.01). There was a significant reduction in the clinical morbidity in the study group compared with the control group (P less than 0.05). There were no side effects reported to pyrantel treatment. Thus quarterly treatment with pyrantel was found to be effective in keeping roundworm and hookworm prevalence at 0% in an industrial township.

Incidence of helminthic infections and comparative study of pyrantel pamoate with levamisole and mebendazole in hospital patients at Barisal, Bangladesh.

A study was carried out to find out the incidence of helminthic infections in hospitalized patients at Sher-e-Bangla Medical College, Barisal and to determine the comparative efficacy of pyrantel pamoate, levamisole, and mebendazole. It was observed that 76.2 per cent of total hospitalized patients were infected with intestinal helminths. Polyparasitism (52.6 per cent) was more frequent than single infection (21.8 per cent). Amongst these, 47.5 per cent was suffering from Asearis lumbricoides (AL), 42.5 per cent from Hookworm (H.W) and 65.8 per cent from trichuris trichura (TT). Out of 255 cases examined separately, 40 per cent was suffering from Enterobious vermicularis (EV) infection. The comparative study showed that mebendazole produced egg negative stool in 90.9 per cent of AL, 95.6 per cent of HW and 86.8 per cent of TT after eight days of treatment. On the other hand, pyrantel pamoate cured AL in 93.3 per cent, HW in 78.5 per cent and TT in 34.2 per cent eases. Levamisole cured 75 per cent AL, 4.1 per cent H.W. and 22.2 per cent TT within the same period.

Clinical trials of broad spectrum anthelmintics against soil-transmitted helminthiasis.

Clinical trials on the three broad spectrum anthelmintics against trichuriasis, ascariasis and hookworm infection were carried out in a rural community in Irosin, Sorsogon. Flubendazole (Fluvermal) appears to be a promising drug against trichuriasis particularly when periodic mass treatment of a community is carried out. Mebendazole (Antiox) also appears to be promising given as single dose during mass treatment of soil-transmitted helminthiasis. As shown in previous studies, oxantel-pyrantel (Quantrel) should be given at 15 mg/kg body weight at 12-hour intervals or 20 mg/kg body weight single dose rather than 10 mg/kg body weight in a single dose when treating trichuriasis.

Oxantel-pyrantel pamoate for the treatment of soil-transmitted helminths.

A mixture of oxantel-pyrantel pamoate was given to 147 primary school children. A single daily dose of 15 mg per kg body weight was administered to cases with Ascaris lumbricoides and Trichuris trichiura infections. The same single daily dose was given for three consecutive days to 10 cases with hookworm infections. The cure rate was 93.7% for ascariasis and the egg reduction rate was 98.2%. A cure rate and an egg reduction rate for trichuriasis was 70.2% and 86.5% respectively. All cases with hookworm infection were cured. Side effects were light and did not cause any anxiety.

Human intestinal parasites in Karakuak, West Flores, Indonesia and the effect of treatment with mebendazole and pyrantel pamoate.

A survey for intestinal parasites and mass-treatment with a combination of mebendazole and pyrantel pamoate were conducted in Karakuak, West Flores in 1977. A total of 198 stool specimens from 104 males and 94 females ranging in age from less than 1 to 70 years were examined and 72% harbored one or more intestinal parasites. Ascaris lumbricoides (43%) and Entamoeba histolytica (21%) were the most common, followed by Entamoeba coli (19%), hookworm (18%), Iodamoeba bütschlii (8%), Giardia lamblia (5%) and Trichuris trichiura (4%). Other intestinal parasites infrequently found were: Entamoeba hartmanni (2%), Chilomastix mesnili (2%), Endolimax nana (1%), Enterobius vermicularis (1%) and a heterophyid sp. (1%). A combination of mebendazole base at 200 mg/day and pyrantel pamoate salt at 60 mg/day for three consecutive days was 100% effective.

Control trial of soil-transmitted helminthic infections with pyrantel pamoate.

Pyrantel pamoate at dosage of 10 mg per kilogramme body weight was given to each villager at 4-6 weeks intervals for three times. The infection rates of hookworms among those who received and did not received the drug decreased from 60.5% pre-treatment to 19.6% after the third treatment and then increased to 32.4% one year after the third treatment. Infection rates of A. lumbricoides and Strongyloides spp. among the villagers who received and did not received the drug decreased from 27.5% pre-treatment to 2.2% after the third treatment and then increased to 20.1% one year later for the former, while the latter decreased from 6.5% pre-treatment to 2.3% after the third treatment and 0.4% one year later. The infection rate of T. trichiura was found to increase as pyrantel pamoate had no effect on this nematode. The authors suggested that to obtain more satisfactory results the anthelmintic drug used must likewise be effective against T. trichiura particularly in areas where this nematode is a public health problem. It was also suggested that the duration of treatment should be prolonged.

Mebendazole and pyrantel pamoate as broad-spectrum anthelmintics.

The efficacy of mebendazole and pyrantel pamoate was studied in two groups of 59 and 58 cases, respectively, of patients with polyparasitosis. Mebendazole had a cure rate of 96%, 82.2%, 71.4% and 66.6% in A. lumbricoides, hookworm, T. trichiura and S. stercoralis, respectively, while the corresponding figures for pyrantel pamoate were 92.6%, 85.7%, 19.4% and 0%. Pyrantel pamoate is considered to have no significant effect on T. trichiura and S. stercoralis. None of the drugs had any effect on T. saginata. Both drugs have been found to be equally effective against enterobiasis by various authors. It is recommended that pyrantel pamoate be the drug of choice in cases of multiple parasitic infections excluding T. trichiura and S. stercoralis whereas those with one or both of these in addition to others should be treated with mebendazole. Mebendazole can be prescribed for patients with clinical evidence of helminthic infections even where stool examination is not possible as it covers almost the whole range of common helminthic infections. The only limitation for poorer patients however is its cost. Pyrantel pamoate has a wider applicability for the poorer patients in spite of the fact that it is ineffective against trichurids and S. stercoralis.