Simultaneous administration of praziquantel, ivermectin and albendazole, in a community in rural northern Ghana endemic for schistosomiasis, onchocerciasis and lymphatic filariasis.

ABSTRACT

OBJECTIVES: To compare (i) side effects associated with the simultaneous adminstration of praziquantel, albendazole and ivermectin with side affects associated with albendazole and ivermectin only and (ii) coverage by volunteers distributing three or two drugs. METHODS: Two-arm comparative study in northern Ghana integrated praziquantel distribution into an existing lymphatic filariasis and onchocerciasis control programme using Community Directed Distributors. The control arm continued to distribute only ivermectin and albendazole. Dosages of ivermectin and praziquantel were based on height. Treatment was directly observed, and all two/three drugs were co-administered. Adverse effects were recorded based on passive surveillance. Parasitological, anthropometric and haematological data were collected at baseline. RESULTS: Prevalence of Schistosoma haematobium infection among 1001 (boys 47.9% girls 52.1%) school-age children (6-15 years) [intervention 30.0% (CI 23.1-34.2); control 23.0% (CI 18.9-27.0)], mean haemoglobin, weight and age were similar among the intervention and control groups. While 1676 (99.1%) compounds in the control area were visited and 15,020 (96.58%) people were treated, only 1375 (88.5%) compounds in the intervention area were visited and 8454 (80.97%) people treated (P < 0.001). The numbers of adverse effects were similar (intervention 50/6896; control 130/15,020). The most reported adverse effects was headache (intervention 14/50; control 13/130), followed by body weakness, which was reported more from the intervention group (intervention 13/50, 95% CI 14.6-40.3; control 6/130, 95% CI 1.7-9.8]. Sixty-six per cent (6896/10,441) of the eligible population received praziquantel. CONCLUSIONS: Reported adverse events were mild and managed at the subdistrict level with no cases of hospitalization; intensive health education will, however, be required to improve coverage.