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The Cochrane Database of Systematic... Jan 2016Strongyloidiasis is a gut infection with Strongyloides stercoralis which is common world wide. Chronic infection usually causes a skin rash, vomiting, diarrhoea or... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Strongyloidiasis is a gut infection with Strongyloides stercoralis which is common world wide. Chronic infection usually causes a skin rash, vomiting, diarrhoea or constipation, and respiratory problems, and it can be fatal in people with immune deficiency. It may be treated with ivermectin or albendazole or thiabendazole.
OBJECTIVES
To assess the effects of ivermectin versus benzimidazoles (albendazole and thiabendazole) for treating chronic strongyloides infection.
SEARCH METHODS
We searched the Cochrane Infectious Diseases Group Specialized Register (24 August 2015); the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (January 1966 to August 2015); EMBASE (January 1980 to August 2015); LILACS (August 2015); and reference lists of articles. We also searched the metaRegister of Controlled Trials (mRCT) using 'strongyloid*' as a search term, reference lists, and conference abstracts.
SELECTION CRITERIA
Randomized controlled trials of ivermectin versus albendazole or thiabendazole for treating chronic strongyloides infection.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data and assessed risk of bias in the included trials. We used risk ratios (RRs) with 95% confidence intervals (CIs) and fixed- or random-effects models. We pooled adverse event data if the trials were sufficiently similar in their adverse event definitions.
MAIN RESULTS
We included seven trials, enrolling 1147 participants, conducted between 1994 and 2011 in different locations (Africa, Southeast Asia, America and Europe).In trials comparing ivermectin with albendazole, parasitological cure was higher with ivermectin (RR 1.79, 95% CI 1.55 to 2.08; 478 participants, four trials, moderate quality evidence). There were no statistically significant differences in adverse events (RR 0.80, 95% CI 0.59 to 1.09; 518 participants, four trials, low quality evidence).In trials comparing ivermectin with thiabendazole, there was little or no difference in parasitological cure (RR 1.07, 95% CI 0.96 to 1.20; 467 participants, three trials, low quality evidence). However, adverse events were less common with ivermectin (RR 0.31, 95% CI 0.20 to 0.50; 507 participants; three trials, moderate quality evidence).In trials comparing different dosages of ivermectin, taking a second dose of 200 μg/kg of ivermectin was not associated with higher cure in a small subgroup of participants (RR 1.02, 95% CI 0.94 to 1.11; 94 participants, two trials).Dizziness, nausea, and disorientation were commonly reported in all drug groups. There were no reports of serious adverse events or death.
AUTHORS' CONCLUSIONS
Ivermectin results in more people cured than albendazole, and is at least as well tolerated. In trials of ivermectin with thiabendazole, parasitological cure is similar but there are more adverse events with thiabendazole.
Topics: Albendazole; Animals; Anthelmintics; Humans; Ivermectin; Randomized Controlled Trials as Topic; Strongyloides stercoralis; Strongyloidiasis; Thiabendazole
PubMed: 26778150
DOI: 10.1002/14651858.CD007745.pub3 -
Cureus Jul 2022Strongyloides stercoralis and Trichuris trichiura parasitic infections are two of the many neglected tropical diseases. These parasitic infections are of considerable... (Review)
Review
Strongyloides stercoralis and Trichuris trichiura parasitic infections are two of the many neglected tropical diseases. These parasitic infections are of considerable public health relevance, particularly in resource-limited countries. Moxidectin, a well-established drug in veterinary medicine, is now a Food and Drug Administration (FDA) approved medication for human onchocerciasis. For the past five years, this medication has been under clinical trials to evaluate its efficacy and safetiness in other helminthic infections. Moxidectin might complement the already existing treatment and control of soil-transmitted helminthiasis (STH). Therefore, we systematically reviewed existing human interventional studies to evaluate the efficacy and safety of this medication when administered alone or in combination with other antiparasitic medications in order to achieve a cure.
PubMed: 36000107
DOI: 10.7759/cureus.27074 -
Preventive Veterinary Medicine Dec 2020A variety of antimicrobials and antiparasitics are used to treat British cattle and sheep to ensure animal welfare, a safe food supply, and maintain farm incomes....
A variety of antimicrobials and antiparasitics are used to treat British cattle and sheep to ensure animal welfare, a safe food supply, and maintain farm incomes. However, with increasing global concern about antimicrobial resistance in human and animal populations, there is increased scrutiny of the use of antimicrobials in food-producing animals. This systematic review sought to identify and describe peer and non-peer reviewed sources, published over the last ten years, detailing the usage of, and resistance to, antimicrobials and antiparasitics in sheep and cattle farming systems in Britain as well as identify knowledge gaps. Applying the PRISMA review protocol and guidelines for including grey literature; Scopus, Web of Science, Medline, and government repositories were searched for relevant articles and reports. Seven hundred and seventy titles and abstracts and 126 full-text records were assessed, of which 40 scholarly articles and five government reports were included for data extraction. Antibiotic usage in sheep and cattle in Britain appear to be below the UK average for all livestock and tetracyclines and beta-lactam antibiotics were found to be the most commonly used. However, the poor level of coverage afforded to these species compared to other livestock reduced the certainty of these findings. Although resistance to some antibiotics (using Escherichia coli as a marker) appeared to have decreased in sheep and cattle in England and Wales over a five-year period (2013-2018), levels of resistance remain high to commonly used antibiotics. The small number and fragmented nature of studies identified by this review describing anthelmintic usage, and the lack of available national sales data, prevented the identification of trends in either sheep or cattle. We recommend that additional efforts are taken to collect farm or veterinary level data and argue that extraction of this data is imperative to the development of antimicrobial and antiparasitic resistance strategies in Britain, both of which are needed to reduce usage of these anti-infective agents, curb the development of resistance, and safeguard national agricultural production. Finally, metrics produced by this data should be generated in a way to allow for maximum comparability across species, sectors, and countries.
Topics: Animals; Anti-Infective Agents; Antiparasitic Agents; Cattle; Cattle Diseases; Drug Resistance; Drug Resistance, Bacterial; England; Scotland; Sheep; Sheep Diseases; Wales
PubMed: 33189057
DOI: 10.1016/j.prevetmed.2020.105174 -
Seminars in Arthritis and Rheumatism Apr 2019To characterize levamisole-induced vasculopathy.
OBJECTIVE
To characterize levamisole-induced vasculopathy.
METHODS
We performed a systematic review searching MEDLINE for articles published from 1972 to 2016.
RESULTS
We retrieved 357 references and abstracts and selected 111 articles. Levamisole-induced vasculopathy was reported in 192 patients, with a female predominance (n = 122, 63.5%). Median [interquartile range] age was 44 [38-50]. Skin was the most frequently involved organ (n = 182, 94.8%). Cutaneous lesions were mostly on the face (n = 136, 70.8%), especially the ears. Purpura (n = 131, 68.2%) was the most reported cutaneous lesion. Organ involvement included acute renal failure (n = 24, 12.5%), and pulmonary involvement (n = 20, 10.4%). Anti-neutrophil cytoplasmic antibodies (ANCAs) were found in 167/178 patients (93.8%), with both anti-myeloperoxydase and anti-proteinase 3 specificity reported in 51/118 patients (43.2%). Anti-phospholipid (APL) antibodies were found in 93/137 patients (67.9%). Leukopenia was detected in 69/138 patients (50%). Skin biopsies identified vasculitis and thrombotic vasculopathy in 73/148 (49.3%) and 62/148 (41.9%) patients, respectively. The outcome was favourable in 116/134 patients (86.6%), but relapses were reported in 33 (28.4%), mainly on levamisole re-exposure.
CONCLUSION
Levamisole-induced vasculopathy is characterized by a female predominance, skin involvement, ANCA and/or APL antibody positivity, leukopenia, vasculitis or vascular thrombotic histological lesions, and despite possible systemic involvement, a favourable outcome with levamisole interruption.
Topics: Acute Kidney Injury; Adult; Antibodies, Antineutrophil Cytoplasmic; Antibodies, Antiphospholipid; Antirheumatic Agents; Female; Humans; Leukopenia; Levamisole; Male; Middle Aged; Purpura; Skin; Vasculitis
PubMed: 30166200
DOI: 10.1016/j.semarthrit.2018.07.010 -
Molecular and Biochemical Parasitology Feb 2024The intensive application of anthelmintics in equine has led to considerable resistance in cyathostomins and Parascaris equorum. It has been well documented that... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The intensive application of anthelmintics in equine has led to considerable resistance in cyathostomins and Parascaris equorum. It has been well documented that benzimidazole (BZ) and pyrantel resistance is widespread in cyathostomins and Parascaris equorum. Since no new classes of anthelmintic have been introduced in the last 40 years, it is critical to be aware of the current risk factors of anthelmintic application to avoid further resistance.
OBJECTIVE
To review the factors affecting the level of anthelmintics resistance in equine around the world, type of anthelmintics, mode of application, dosage, nematode species, and location of anthelmintics application were evaluated and summarized.
DESIGN/PROCEDURE
A systematic review and meta-analyses following the PRISMA Framework were conducted to identify, evaluate, and synthesize primary literature reporting the efficacy of anthelmintic drugs in equines. Information on the bibliographic data, anthelmintic drugs, animals, continents, parasite genera, type of anthelmintics, and dosage was collected. Nonparametric tests (Kruskal-Wallis and Mann-Whitney) were used in SPSS (v.27) to investigate the association between variables. Factors that have a significant impact on efficacy have been subjected to binary logistic regression. Six meta-analyses were conducted in Microsoft Excel (2021) to qualify current resistance issues of the three major anthelmintics classes.
RESULTS
The final database was composed of 60 articles published between 1994 and 2022 with a total of 11835 animals. Anthelmintic class as well as anthelmintic active principle selection did have a significant effect on resistance (P < 0.01), whilst no correlation of the type of anthelmintics, mode of application, and dosage with efficacy were found. Anthelmintics resistance in ascarid was significantly more severe than in strongyle (P < 0.01). Macrocyclic lactone (ML) class and the benzimidazole and probenzimidazole (BP) class have the lowest efficacy against ascarid and strongyle, respectively (67.83% and 69.85%). The effect of location (by continent) also had a significant influence on the resistance of the ML class (P < 0.01). The resistance of the BP class which is the most prevalently applied was demonstrated in all six continents. Binary logistic regression revealed that parasite genera and drug class independently influenced the presence of drug resistance. The forest plots included in this study did not show a significant difference over time.
CONCLUSION
Current evidence indicated that anthelmintics resistance of ML and BP class were common in ascarid and strongyle. A combination of anthelmintics may reduce anthelmintics resistance, but multi-drug resistance may be a concern. Customerised anthelmintics strategy could help reduce resistance.
Topics: Animals; Anthelmintics; Benzimidazoles; Drug Resistance; Feces; Horse Diseases; Horses; Ivermectin; Lactones; Nematoda
PubMed: 38030084
DOI: 10.1016/j.molbiopara.2023.111600 -
Infectious Diseases of Poverty Jul 2018Soil transmitted helminth (STH) infections still remain a notable health problem in resource-limited countries due to difficulties in the implementation of control... (Review)
Review
BACKGROUND
Soil transmitted helminth (STH) infections still remain a notable health problem in resource-limited countries due to difficulties in the implementation of control measures. In Nigeria for instance, despite several community-based and provincial reports, national data on prevalence, burdens and risk zones (RZs) for STH infections are lacking.
METHODS
The present study employed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to determine the prevalence, distribution and RZs for STH infections among Nigerian children through a meta-analysis of data published between 1980 and 2015. Pooled prevalence estimate (PPE) was determined by the random-effects model while heterogeneity was evaluated using the Cochran's Q-test.
RESULTS
A total of 18 901 of the 34 518 Nigerian children aged 0-17 years examined across 19 Nigerian states during the period under review were infected with one or more species of STHs. The overall PPE for STH infections was 54.8% (95% CI: 54.2-55.3). PPEs for sub-groups ranged between 13.2% (95% CI: 11.5-15.1) and 80.9% (95% CI: 80.0-81.7). Highest PPEs for STH infections were observed among children within community settings (59.0%, 95% CI: 57.7-60.4) and school-aged children (54.9%, 95% CI: 54.3-55.5). Ascaris lumbricoides was the most prevalent species (44.6%, 95% CI: 44.0-45.2). Over 36% (15/41) of the studies were published from south-western Nigeria. South-western region was the only high risk zone (HRZ) for STH infections while the rest of the regions were low risk zones (LRZs).
CONCLUSIONS
STH infections involving Ascaris lumbricoides, Strongyloides stercoralis, Trichuris trichiura and hookworms are highly prevalent across Nigeria. Strategic use of anthelmintics, health education and adequate sanitation, taking into account this epidemiologic information will help in the control of these infections in Nigeria.
Topics: Animals; Child Health; Helminthiasis; Helminths; Humans; Nigeria; Prevalence; Soil
PubMed: 29983115
DOI: 10.1186/s40249-018-0451-2 -
The Pan African Medical Journal 2023Schistosomes are parasitic diseases caused by flatworms (schistosomes or bilharzia), transmitted in the urine or in the faeces, and involving intermediate hosts... (Meta-Analysis)
Meta-Analysis Review
Schistosomes are parasitic diseases caused by flatworms (schistosomes or bilharzia), transmitted in the urine or in the faeces, and involving intermediate hosts (freshwater molluscs). Their recrudescence in endemic areas is no longer in question and remains a crucial public health problem in the world in general and in West Africa in particular. In order to eradicate bilharzia, many control strategies and policies have been implemented on both sides. The objective of this systematic literature review is to synthesize the existing evidence on control strategies implemented by West African countries. To achieve this, data were collected from PubMed, Direct Science, Web of Sciences, Google Scholar, PloS and Banque de Données de Santé Publique (BDSP), using appropriate keywords. Academic articles and theses written in French or English that evaluated the analysis of a bilharzia situation in West Africa were selected. Sixteen scientific papers were selected for the study, ten of which were used for a meta-analysis. The systematic review revealed that bilharzia is still an endemic disease in West Africa. Clearly, it continues to wreak havoc on the population, especially among school children. Rural areas are the most affected by the disease. Strategies to control bilharzia are based on preventive and curative treatment of the infection with chemotherapy and vector control of soil molluscs (host and vector of bilharzia eggs). Praziquantel is the main known antibilharzian. Also, the species most frequently found in analyses are S. haematobiumand S. mansonii. This review has allowed to evaluate the control strategies carried out and to deduce the strengths and weaknesses, in order to define the perspectives for the efficiency of the anti-bilharzia control for the eradication of bilharzia in the endemic zones of West Africa.
Topics: Child; Humans; Schistosomiasis; Africa, Western; Praziquantel
PubMed: 37034484
DOI: 10.11604/pamj.2023.44.35.33766 -
PLoS Neglected Tropical Diseases Mar 2016In 2012 the World Health Assembly adopted resolution WHA65.21 on elimination of schistosomiasis, calling for increased investment in schistosomiasis control and support... (Review)
Review
Schistosomiasis Prevalence and Intensity of Infection in Latin America and the Caribbean Countries, 1942-2014: A Systematic Review in the Context of a Regional Elimination Goal.
BACKGROUND
In 2012 the World Health Assembly adopted resolution WHA65.21 on elimination of schistosomiasis, calling for increased investment in schistosomiasis control and support for countries to initiate elimination programs. This study aims to analyze prevalence and intensity of Schistosoma mansoni infection in children in Latin America and the Caribbean countries and territories (LAC), at the second administrative level or lower.
METHODOLOGY
A systematic review of schistosomiasis prevalence and intensity of infection was conducted by searching at PubMed, LILACS and EMBASE. Experts on the topic were informally consulted and institutional web pages were reviewed (PAHO/WHO, Ministries of Health). Only SCH infection among children was registered because it can be a 'proxi-indicator' of recent transmission by the time the study is conducted.
PRINCIPAL FINDINGS
One hundred thirty two full-text articles met the inclusion criteria and provided 1,242 prevalence and 199 intensity of infection data points. Most of them were from Brazil (69.7%). Only Brazil published studies after 2001, showing several 'hot spots' with high prevalence. Brazil, Venezuela, Suriname and Saint Lucia need to update the epidemiological status of schistosomiasis to re-design their national programs and target the elimination of Schistosoma mansoni transmission by 2020. In Antigua and Barbuda, Dominican Republic, Guadeloupe, Martinique, Montserrat and Puerto Rico schistosomiasis transmission may be interrupted. However the compilation of an elimination dossier and follow-up surveys, per WHO recommendations, are needed to verify that status. Hence, the burden of subtle SCH chronic infection may be still present and even high in countries that may have eliminated transmission. Heterogeneity in the methodologies used for monitoring and evaluating the progress of the schistosomiasis programs was found, making cross-national and chronological comparisons difficult.
CONCLUSIONS
There is a need for updating the schistosomiasis status in the historically endemic countries and territories in LAC to address the required public health interventions for control and elimination programs or to verify the elimination of transmission of Schistosoma mansoni. Improved reporting and standardization of the monitoring and evaluation methodologies used are recommended, while using available WHO guidelines. Meeting a regional elimination goal will require additional and improved epidemiological data by age group and sex.
Topics: Anthelmintics; Disease Eradication; Humans; Latin America; Praziquantel; Schistosomiasis
PubMed: 27007193
DOI: 10.1371/journal.pntd.0004493 -
American Journal of Clinical Dermatology Feb 2016Cutaneous lichen planus (CLP) is an inflammatory dermatosis. Its chronic relapsing course and frequently spontaneous regression hamper the assessment of treatment... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Cutaneous lichen planus (CLP) is an inflammatory dermatosis. Its chronic relapsing course and frequently spontaneous regression hamper the assessment of treatment effectiveness.
OBJECTIVE
To evaluate the efficacy of available treatment modalities for CLP.
DATA SOURCES
PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov registry.
METHODS
We performed a systematic review of the current literature. All randomized controlled trials, nonrandomized case-control studies, and cohort studies with more than one treatment arm were included. The primary outcomes were complete response and time to complete response. The secondary outcomes were partial response, relapse, time to relapse, reduction of itch, the adverse event rate, and withdrawal due to adverse events.
DATA SYNTHESIS
Sixteen studies met the inclusion criteria, of which 11 were randomized controlled trials. Most trials had a small sample size. In the rare studies in which variants other than generalized or classic lichen planus were included, they could not be analyzed separately. Body-of-evidence quality ranged from very low to moderate. Acitretin, sulfasalazine, and griseofulvin were associated with increased overall response rates in comparison with placebo. Narrow-band ultraviolet B radiation (NBUVB) was more effective than 6 weeks' low-dose prednisolone in achieving a complete response, and prednisolone was more effective than enoxaparin. Hydroxychloroquine was more effective than griseofulvin in achieving an overall response. Betamethasone valerate 0.1% ointment had comparable efficacy to calcipotriol ointment. Methotrexate was effective, with a nonsignificant difference in the complete response rate in comparison with oral betamethasone. In nonrandomized controlled trials, oral psoralen plus ultraviolet A photochemotherapy (PUVA) had comparable efficacy to a PUVA bath and NBUVB. Psoralen plus sunlight exposure (PUVASOL) and betamethasone dipropionate 0.05% cream were effective relative to a short course of oral metronidazole.
CONCLUSIONS
Several effective treatment options are available for CLP. Further well-designed studies are warranted to investigate the efficacy of topical glucocorticoids-the current first-line therapy-as well as other treatment modalities, and the treatment of different variants of CLP.
Topics: Acitretin; Administration, Cutaneous; Anti-Inflammatory Agents, Non-Steroidal; Antifungal Agents; Calcitriol; Dermatologic Agents; Enoxaparin; Female; Fibrinolytic Agents; Ficusin; Glucocorticoids; Griseofulvin; Humans; Keratolytic Agents; Lichen Planus; Male; Non-Randomized Controlled Trials as Topic; PUVA Therapy; Photochemotherapy; Photosensitizing Agents; Randomized Controlled Trials as Topic; Sulfasalazine; Treatment Outcome
PubMed: 26507510
DOI: 10.1007/s40257-015-0160-6 -
Journal of Parasitic Diseases :... Dec 2022Strongyloidiasis could be a significant global health issue undervalued in several countries, which is caused by spp. Challenges stemming from the use of anthelmintic... (Review)
Review
Strongyloidiasis could be a significant global health issue undervalued in several countries, which is caused by spp. Challenges stemming from the use of anthelmintic chemotherapy, such as the development of resistance, the progressive cost of medicines, environmental toxicity of chemicals, and residuals in beast products have increased interest in promoting alternative means of control for the use of plant-based parasite control methods. A study on herbal extracts may offer a less expensive yet equally effective alternative for the prevention and treatment of helminthic multi-resistance. We systematically searched the Web of Sciences, PubMed/MEDLINE, and Scopus databases to explore original publications related to medicinal plants and in English on September 29, 2021. The keywords of medicinal plant, traditional medicine, plant extract, herbal medicine, herbal extract, natural drug, , strongyloidiasis, infection, and helminth were used in our search. Researchers can make use of this review as a quick reference. In this study, we have summarized recent advancements and published investigations on herbal and naturally derived medicines in treating strongyloidiasis undertaken by several researchers worldwide. These medicinal herbs, as well as the active and significant compounds they contain, such as alkaloids, phenolic derivatives, tannins, and terpenes, have been outlined in recent articles. Various studies on herbal remedies to treat strongyloidiasis have been undertaken to date, but further research is still required on moderately effective and low harmful substances.
PubMed: 36457765
DOI: 10.1007/s12639-022-01532-z