Albendazole ameliorates aerobic glycolysis in myofibroblasts to reverse pulmonary fibrosis.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic and lethal lung disorder for which effective treatments remain limited. Recent investigations revealed a potential link between altered glucose metabolism and the activation of fibroblasts, the key cells responsible for generating and depositing extracellular matrix proteins within the lung interstitium during IPF development. METHOD: In this study, we aimed to investigate the potential therapeutic impact of albendazole on fibroblast to myofibroblast transition in IPF. We assess albendazole's effectiveness in attenuating the activation of fibroblasts. We focused on elucidating the mechanism underlying albendazole's impact on TGF-ß1-induced aerobic glycolysis in both lung tissues and fibroblasts obtained from patients with IPF and other lung fibrosis types. Furthermore, the antifibrotic effects of oral administration of albendazole were investigated in mouse models of pulmonary fibrosis induced by BLM or SiO2. Human precision-cut lung slices were employed to evaluate the impact of albendazole following TGF-ß1 stimulation. RESULT: In this work, we demonstrated that albendazole, a first-line broad-spectrum anthelmintic drug, effectively attenuated fibroblast to myofibroblast transition through alleviating TGF-ß1-induced aerobic glycolysis dependent on the LRRN3/PFKFB3 signaling pathway. Additionally, LRRN3 expression was downregulated in both lung tissues and fibroblasts from patients with IPF and other types of lung fibrosis. Importantly, the levels of LRRN3 correlated with the progression of the disease. Notably, oral administration of albendazole exerted potent antifibrotic effects in mouse models of pulmonary fibrosis induced by BLM or SiO2, and in human precision-cut lung slices after TGF-ß1 stimulation, as evidenced by improvements in lung morphology, reduced myofibroblast formation, and downregulation of α-SMA, collagen type 1 and Fibronectin expression in the lungs. CONCLUSION: Our study implies that albendazole can act as a potent agonist of LRRN3 during fibroblast to myofibroblast differentiation and its oral administration shows potential as a viable therapeutic approach for managing IPF.

Coverage of community-wide mass drug administration platforms for soil-transmitted helminths in Benin, India, and Malawi: findings from the DeWorm3 project.

BACKGROUND: Soil-transmitted helminths (STH) affect approximately 1.5 billion people globally. The current STH control strategy is annual or twice-annual preventive chemotherapy, typically school-based deworming targeting children and women of reproductive age. Mathematical modeling suggests that it may be possible to interrupt STH transmission through high-coverage community-wide mass drug administration (cMDA). DeWorm3 is a cluster randomized trial testing cMDA for prevalence reduction and transmission interruption. The purpose of this study is to describe coverage of cMDA in study clusters over time and correlates of coverage at individual and cluster levels. METHODS: From 2018-2020, DeWorm3 delivered six rounds of cMDA with 400 mg albendazole at sites in Benin, India, and Malawi. We report coverage, treatment uptake, and directly observed therapy across all rounds. Factors associated with coverage at the cluster level were identified using binomial generalized estimating equations, while factors associated with non-treatment at the individual level were identified using binomial mixed-effects models. RESULTS: Coverage was high across all clusters and rounds, exceeding the WHO target of 75% in all sites and across all rounds (78% to 95%); cluster-level coverage tended to increase over time. Younger, unmarried, and migratory adults were more likely to be untreated at all sites; adult males were more likely to be untreated in Benin and Malawi. Among children, girls were more likely to be untreated, as were non-school-attending and migratory children. Higher adult education was associated with greater odds of non-treatment among adults, but lower odds among children in the household. Belonging to a less wealthy or minority language-speaking household was associated with non-treatment among both adults and children. CONCLUSIONS: It is possible to deliver community-wide MDA with high coverage. Unique individual and community-level factors influence treatment across settings, and these may be addressed through targeted programming. TRIAL REGISTRATION: Field Studies on the Feasibility of Interrupting the Transmission of Soil-transmitted Helminths (STH), NCT03014167.

Application of Box-Behnken design in the optimization and development of albendazole-loaded zein nanoparticles as a drug repurposing approach for colorectal cancer management.

Colorectal cancer (CRC) is the second cancer worldwide representing a major global health challenge. Numerous effective anticancer drugs have been developed in the last decade, yet the problem remains due to their low therapeutic index and nonspecificity. A new anticancer therapeutic paradigm is based on repurposing and nanoformulating drugs. Albendazole (ALB), a popular anthelmintic agent, was recently repurposed against CRC cells. In this study zein, an amphiphilic protein, was used to formulate nanoparticles (NPs) loaded with ALB. Box-Behnken design was selected to optimize the loaded NPs, the concentrations of polyvinyl alcohol, acetic acid, and the weight of zein were the independent variables. The dependent variables were the particle size, polydispersity index, and zeta potential. The optimized formula displayed a size of 84.3 ± 0.41 nm, PDI 0.13 ± 0.012, and a zeta potential of 42.5 ± 2.35 mV. ALB was successfully encapsulated into zein NPs and the release study revealed a desirable pH-responsive drug release behavior, that was negligible release during the first 2 h at pH 1.2 and progressive in the simulated colon environment reaching 71.1 ± 0.34 % at 6 h and 92.4 ± 1.11 % at 24 h. The anticancer effect of the loaded NPs on the human HCT116 cells showed favorable effects at 1 µM concentration with a significant decrease in the IC50 at days 2 and 3 upon loading albendazole into zein NPs. Zein nanoparticles proved to be prospective nanocarriers that could be used for the delivery of repurposed drugs in CRC treatment.

Uncommon clinical presentation by a common pathogen.

A 10-year-old girl presented to the outpatient department with a complaint of burning micturition for the past 1 week, which did not resolve with over-the-counter medication. Urine culture came out to be sterile, while on follow-up, the patient complained of severe itching in the perianal region. Microscopic examination of urine wet mount revealed a planoconvex helminthic egg and the case is discussed further.

Treatment approach in bilateral pulmonary hydatid cysts: analysis of 107 consecutive cases.

Objective: Bilateral pulmonary involvement is observed in around 14% of cases of pulmonary hydatid cysts and the treatment can be challenging. This study evaluates the clinical characteristics and treatment strategies used for cases of bilateral pulmonary hydatid cysts. Materials and methods: A retrospective examination was conducted on 107 consecutive cases of bilateral pulmonary hydatid cysts treated in our clinic between January 2003 and December 2023. Results: Out of the 107 cases analyzed, 57 (53.3%) were male and 50 (46.7%) were female. Surgical intervention was performed for pulmonary hydatid cysts in 92 cases (86.0%), while medical treatment was prescribed for the remaining 15 cases (14.0%). Bilateral thoracotomies were consecutively conducted in 77 cases; in 11 cases, thoracotomy was carried out on one side and contralateral hydatid cysts were treated medically. Three cases underwent sternotomy, and one underwent bilateral thoracotomy during a single session. One case experienced postoperative hemorrhage, three cases had prolonged air leakage, two cases had empyema, one case had a wound infection, and one case had a recurrence of hydatid cyst. For bilaterally operated cases, albendazole treatment commenced after the second operation and was carried out in two 15-day cycles. Patients who declined, or were not eligible for surgery, were treated with albendazole for an extended period. Conclusions: Consecutive bilateral thoracotomy, followed by two cycles of albendazole therapy, is a highly effective treatment for patients with bilateral pulmonary hydatid cysts. In cases with widespread involvement, ruptured small cysts, or serious comorbidities, long-term medical treatment including albendazole administration may be applied.

Albendazole nanosuspension coated granules for the rapid localized release and treatment of colorectal cancer.

Albendazole (ABZ), an anthelmintic drug, has been repurposed to treat various types of cancers. However, poor solubility of ABZ, resulting in low bioavailability, limits its application. Nanosuspension is a versatile method for enhancing the dissolution of hydrophobic molecules, but a successful drying has been the biggest challenge in the field. The objective of this research is to formulate and optimize ABZ nanosuspension (NS) coated granules for rapid delivery of ABZ for the treatment of colorectal cancer. ABZ NS was prepared by dual centrifugation method using Kollidon® VA64 and sodium lauryl sulphate (SLS) as stabilizers. The processing method was optimized to obtain a stable nanosuspension with particle size < 300 nm. The optimized ABZ NS was coated on microcrystalline cellulose (MCC) to form the nano-coated granules (NCG) and filled in EUDRACAP® for colon targeted delivery. The ABZ NS and NCG achieved ∼ 60 % and ∼55 % drug release, respectively, in presence of bile salt at colonic pH. Half-maximal inhibitory concentration (IC50) of ABZ NS was found to be 1.18 ± 0.081 µM and 3.59 ± 0.080 µM in two colorectal cancer cell lines: HCT 116 and HT-29, respectively. In addition, In vitro 3D tumor assay revealed that ABZ NS has superior tumor growth inhibition activity compared to the control and pure ABZ. The preparation of ABZ NCG in EUDRACAP® could be a promising approach to achieve colon targeted delivery and to repurpose ABZ for the treatment of colorectal cancer.

Murine Extraparenchymal Neurocysticercosis: Appropriate Model for Evaluating Anthelminthic and Anti-Inflammatory Treatment Schedules.

BACKGROUND: Experimental models of neurocysticercosis (NCC) are helpful for an improved understanding of the pathophysiological mechanisms of human diseases and for testing novel therapeutic approaches. Controlling inflammation without reducing the effectiveness of anthelmintics is an important challenge in treating neurocysticercosis. This study investigates the effects of currently used drugs (Albendazole and Dexamethasone) in treating murine extraparenchymal NCC. METHODS: Twenty-two rats were inoculated with Taenia crassiceps in the subarachnoid space. The animals underwent magnetic resonance imaging to ascertain the success of infection 3 months after inoculation. The infected animals were randomly assigned to one of the three groups (five rats each): control (no treatment), Albendazole (ABZ), or Albendazole + Dexamethasone (ABZ + DXM) for 14 days. The animals were subsequently euthanised for morphological assessment 2 weeks after the end of treatment. RESULTS: Macroscopically integrated cysts were found in all animals. The ABZ + DXM animals demonstrated lower ventricular sizes, lymphocyte infiltration rates, and immunopositivity for IL-6, with statistical differences in lymphocytes within the arachnoid region. CONCLUSIONS: This experimental model, which has previously shown similarities to human infections, is also helpful in reproducing the morphological changes upon treatment with Albendazole and Dexamethasone.

Orbital hydatid cyst and its successful treatment: A case report from Afghanistan.

Purpose: This study aims to underscore the rarity of intraorbital hydatid disease caused by Echinococcus granulosus, emphasizing the importance of comprehensive exploration and documentation for effective management. Observations: Clinical presentations include proptosis, visual deterioration, ocular motility disruptions, and chemosis. A case study of an 8-year-old boy with a retroorbital hydatid cyst successfully resected through a right transcaruncular orbitotomy approach is presented, highlighting surgical complexities and the efficacy of pre and post-operative albendazole therapy. Conclusion and Importance: The successful excision and management of the intraorbital hydatid cyst underscore the significance of accurate diagnosis and precise surgical intervention. This case emphasizes the importance of expanding knowledge about this rare manifestation, contributing to enhanced diagnostic and treatment strategies for optimal outcomes in managing global health concerns.

Two Case Reports of Isolated Intramuscular Cysticercosis: An Uncommon Pediatric Pseudotumor.

Taenia solium, the pig tapeworm, produces larvae that cause cysticercosis, a common parasitic disease of the human nervous system including the brain. The disease is native to countries like Central and South America, Eastern Europe, Africa, India, and Indonesia. Cysticercosis is endemic in North India, particularly in Bihar, Uttar Pradesh, and Punjab. Asymptomatic cysts may have a history of trauma, while lower extremity involvement is less common. Isolated muscle involvement typically has no lethal consequences. Two cases, both pediatric, were diagnosed with intramuscular cysticercosis without involvement of the brain parenchyma. The patients received oral prednisolone therapy for seven days, followed by albendazole for 28 days. The swellings decreased in size and no new swellings or symptoms appeared during the two- and four-week follow-ups. At a three-month follow-up, the swellings completely resolved. Neurocysticercosis is a commonly encountered infection of the human central nervous system and one of the major causes of acquired epilepsy globally. Most cases are asymptomatic and go undiagnosed, with the first case likely due to trauma. Diagnosis is often delayed or overlooked due to vague clinical symptoms. Clinical differential diagnoses for intramuscular cysticercosis include lipomas, epidermoid cysts, neuromas, neurofibromas, pseudoganglia, sarcomas, myxomas, pyomyositis, cold abscess, and tuberculous lymphadenitis. High-resolution ultrasound is the most accurate method for diagnosing intramuscular cysticercosis, as it is quick, simple, and less expensive. Muscular cysticercosis sonographic patterns can be categorized into four types: first degree, uneven, irregular, and calcified. Magnetic resonance imaging (MRI) is the most accurate way to diagnose intramuscular cysticercosis, as it can show live scolex, cysts, and degenerating cysts. In every case, there is edema to varied degrees, with fluid-filled lesions without peripheral enhancement visible in early stages and peripheral rim augmentation and perilesional edema observed in later stages.

Evaluation of the In-Vitro Effects of Albendazole, Mebendazole, and Praziquantel Nanocapsules against Protoscolices of Hydatid Cyst.

Cystic echinococcosis still remains a serious health and economic problem worldwide. The etiologic agent is Echinococcus granulosus sensu lato, giving origin to a fluid-filled cystic lesion. Therapy faces several challenges. Nanodrugs have shown promise as chemotherapeutics against hydatid cysts. The present study evaluated a highly safe lipid nano-polymeric capsule for its superior efficacy and ability to overcome drug resistance. Nanocapsule drugs were formulated into six groups: Albendazole, mebendazole, praziquantel, albendazole + mebendazole, albendazole + praziquantel, and praziquantel + mebendazole. The protoscolicidal effects of these six groups were assessed at 10, 60, and 120 min in three concentrations (1, 0.5, and 0.25 mg/mL). Drug formulations were evaluated via zeta potential, droplet size, solubility, particle size analyzer (PSA), and scanning electron microscopy. According to the PSA results, the mean size of the albendazole nanocapsules was 193.01 nm, mebendazole was 170.40 nm, and praziquantel was 180.44 nm. Albendazole + mebendazole showed the greatest protoscolicidal activity at a concentration of 1 mg/mL after 120 min. In contrast, each drug's 0.25 mg/mL single-dose times showed the least protoscolicidal activity after 120 min. With the right application of nanotechnology, it is possible to produce safe and effective drugs, such as the polymeric combination of albendazole and mebendazole, which has promising implications.

Studies on absorption mechanism and pharmacokinetic properties of albendazole-bile acid conjugate: In vivo and in vitro.

PURPOSE: To improve the oral bioavailability of albendazole (ABZ), a series of albendazole-bile acid conjugates (ABCs) were synthesized. ABC's transmembrane transport mechanism and in vivo pharmacokinetic properties were preliminarily studied. METHODS: The transmembrane transport mechanism of ABCs was studied using the Caco-2 monolayer cell model and intestinal perfusion model. The concentration of ABCs and ABZ were evaluated using High-Performance Liquid Chromatography (HPLC) and HPLC-Mass Spectrometry (HPLC-MS/MS). RESULTS: Compared to ABZ, better permeability was observed for different types and concentrations of ABCs using the Caco-2 monolayer cell model, with ABC-C8 showing the highest permeability. The transmembrane transport of ABCs was affected by ASBT inhibitors, indicating an ASBT-mediated active transport mechanism. Additionally, introducing cholic acid resulted in ABZ no longer being a substrate for P-gp, MRP2, and BCRP, effectively reversing ABZ efflux. In vivo unidirectional intestinal perfusion results in rats showed that ABCs altered the absorption site of ABZ from the jejunum to the ileum. The absorption efficiency of ABCs in each intestinal segment was higher than that of ABZ, and the transmembrane transport efficiency decreased with increasing concentrations of ASBT inhibitors. This further confirmed the presence of both passive diffusion and ASBT-mediated active transport mechanisms in the transport of ABCs. The solubility of ABCs in gastric juice and pharmacokinetics in rats showed that ABZ-C4 exhibited enhanced solubility. Moreover, ABCs significantly increased oral bioavailability compared to ABZ, with ABC-C4 showing an approximately 31-fold increase in bioavailability. CONCLUSION: The transmembrane transport mechanism of ABCs involves a combination of ASBT-mediated active transport and passive diffusion. Moreover, the incorporation of BAs successfully reverses the efflux of ABZ by efflux proteins. Among the synthesized conjugates, ABC-C4 demonstrated superior dissolution behavior both in vitro and in vivo.

Safety Profile of Mass Administration of Albendazole Among School Children (6-19 Years): A Prospective Active Surveillance Study.

BACKGROUND: Infections with Soil-transmitted Helminths (STHs) impact about 24% of the global population. A disproportionate number of individuals, particularly those from low socioeconomic backgrounds, live in emerging nations. In India, between the ages of one and fourteen, almost 220 million children are susceptible to intestinal worm infestations caused by parasites. The National Deworming Day (NDD) initiative was started by the Indian government in February 2015 as a part of the National Health Mission to address this problem. Though the adverse effects of albendazole in routine therapy are known, the mass administration of the medicine in children as part of a public health program has not been adequately studied. OBJECTIVE: This study aimed to determine the occurrence, type, and severity of adverse drug reactions resulting from mass administration of albendazole in school children aged 6-19 years in a district of northern India. METHODS: Twenty specified clusters were randomly chosen from a total of 96 clusters in the district to participate in this prospective, descriptive, observational study that was carried out in Karnal, Haryana. Both a passive approach and an active adverse drug reaction reporting system were used in the study. The six-step process known as Deb's Active Surveillance & Assisted Reporting System was employed in our study. Adverse drug reactions were recorded using the suspected Adverse Drug Reaction (ADR) reporting form of the Pharmacovigilance Programme of India (PvPI). RESULTS: Twenty clusters with a combined total of 94 schools and 12,751 students were observed during the study. In this study, there were more female participants (N = 8,060; 63.21%) than male participants (N = 4,691; 36.78%). A total of 29 ADRs were reported. All reported ADRs were mild in nature. It was discovered that there were 1.37 incidences for every 1000 individuals. As illustrated in Fig. (1), the most frequently reported Adverse Drug Reactions (ADRs) were vomiting (N = 10), nausea (N = 4), abdominal pain (N = 2), and headache (N = 1). The majority of ADRs were categorized as probable (N=18; 62.06%), followed by possible (N=11; 37.93%). CONCLUSION: An active surveillance system alongside voluntary passive reporting during the mass administration of medicines can help evaluate the safety profile of the medicinal products. The occurrence of ADRs following mass administration of albendazole in school children was found to be only 1.37 incidences for every 1000 recipients, being mild in nature, with vomiting being the most common.

Osteoarticular hydatid disease: Epidemiological features, diagnosis and treatment.

Osteoarticular hydatid disease is a very rare disease. Its diagnosis is challenging and often late because of the nonspecific clinical and radiological features. Through this study, we aim to describe the epidemiological, clinical and radiological features of a series of patients diagnosed with osteoarticular hydatid disease. Ten patients were included. The average age was 40,5 years [25-75]. The onset of symptoms was progressive in all cases with a mean diagnosis delay of 11 months [1-48]. Most frequent locations were spinal (n=7), pelvic (n=3) and costal (n=3). Hydatid serology was positive in seven screened patients. Seven patients underwent surgery and all of them received albendazole postoperatively with an average of 8 monthly courses. Total remission was reported in only one patient. There was no significant difference in the clinical outcome based on the number of albendazole courses. The diagnosis of osteoarticular hydatid disease is often challenging because of its progressive onset and nonspecific clinical signs. Epidemiological setting, immunological screening and imaging features contribute to an earlier diagnosis. Its management requires both surgery and long-term antiparasitic treatment.

Baseline gut microbiota diversity and composition and albendazole efficacy in hookworm-infected individuals.

Soil-transmitted helminth (STH) infections account for a significant global health burden, necessitating mass drug administration with benzimidazole-class anthelmintics, such as albendazole (ALB), for morbidity control. However, ALB efficacy shows substantial variability, presenting challenges for achieving consistent treatment outcomes. We have explored the potential impact of the baseline gut microbiota on ALB efficacy in hookworm-infected individuals through microbiota profiling and machine learning (ML) techniques. Our investigation included 89 stool samples collected from hookworm-infected individuals that were analyzed by microscopy and quantitative PCR (qPCR). Of these, 44 were negative by microscopy for STH infection using the Kato-Katz method and qPCR 21 days after treatment, which entails a cure rate of 49.4%. Microbiota characterization was based on amplicon sequencing of the V3-V4 16S ribosomal RNA gene region. Alpha and beta diversity analyses revealed no significant differences between participants who were cured and those who were not cured, suggesting that baseline microbiota diversity does not influence ALB treatment outcomes. Furthermore, differential abundance analysis at the phylum, family and genus levels yielded no statistically significant associations between bacterial communities and ALB efficacy. Utilizing supervised ML models failed to predict treatment response accurately. Our investigation did not provide conclusive insights into the relationship between gut microbiota and ALB efficacy. However, the results highlight the need for future research to incorporate longitudinal studies that monitor changes in the gut microbiota related to the infection and the cure with ALB, as well as functional metagenomics to better understand the interaction of the microbiome with the drug, and its role, if there is any, in modulating anthelmintic treatment outcomes in STH infections. Interdisciplinary approaches integrating microbiology, pharmacology, genetics and data science will be pivotal in advancing our understanding of STH infections and optimizing treatment strategies globally.

Application potential of albendazole as an aquatic animal drug based on its safety, efficacy, and residue profiles.

The number of available drugs for treating aquatic animals is insufficient, given the occurrence of a variety of parasites and difficulties in developing appropriate treatments, such as vaccines or immunostimulants. Consequently, repurposing livestock drugs for treating aquatic animals is a viable alternative. Several studies have demonstrated that albendazole (ABZ) is a good anthelmintic for humans and animals such as ruminants, poultry, and honeybees. Therefore, we investigated the toxicological studies, metabolic and residue depletion studies, and efficacy trials of ABZ in aquatic animals to identify its application potential as a drug for aquatic animals. ABZ was depleted within 24 h in the muscle tissues of hybrid striped bass, rainbow trout, and tilapia. In muscle tissue with adhering skin obtained from tilapia and largemouth bass, a significant quantity of the amino-sulfone metabolite of ABZ (ABZ-SO2NH2) was present, while no ABZ-SO2NH2 was detected in hybrid striped bass, channel catfish, and patinga. Fish exposed only to high doses of ABZ showed reduced red blood cell counts and hemoglobin levels and increased lymphocytes. Such signs of toxicity have also been observed in human patients and animal studies. At a dose of 100 mg/L, ABZ showed 100% efficacy in eels. In addition, albendazole sulfoxide (ABZSO) demonstrated efficacies of 96.1% and 100% in pirapatinga and ray-finned fish, respectively, at a dose 500 mg/L. ABZ was also highly effective in treating an intracellular parasite E. hepatopenaei in white shrimp. The application of ABZ in aquatic animals under the low-dose and short-term conditions is considered a reasonable solution to manage parasite infections. The types and residual periods of degradation products differed among fish species, suggesting dissimilar metabolic pathways. With a high demand for new alternative veterinary drugs in aquaculture by fish farmers, this review offers important evidence for considering the use of ABZ in Korean farmed fish, taking food safety issues into account.

[Hepatotoxicity due to albendazole: safe alternatives for echinococcosis therapy]. / Hepatotoxizität durch Albendazol: sichere Alternativen bei Echinokokkosetherapie.

Infection with Echinococcus multilocularis leads to the clinical manifestation of alveolar echinococcosis. This is characterized by the formation of alveolar liver tumours, which usually disintegrate necrotically in the course of the disease. Pseudocysts are formed. Especially in the early stages, curative resection followed by long-term treatment with albendazole is recommended. However, the majority of patients are not amenable to curative surgery. In these cases, albendazole therapy is the first-choice treatment. We present a rare case of albendazole-associated hepatitis in a patient with inoperable Echinococcus multilocularis infection, with a favourable outcome following a change in treatment to mebendazole.

Neurocysticercosis: An Uncommon Cause of New-Onset Seizure in the United States.

Neurocysticercosis is predominantly a disease in tropical countries. However, with increasing migration, it is now more frequently reported in developed countries as well. We are reporting a case of new-onset seizures due to underlying neurocysticercosis in a 31-year-old male migrant patient. Initial imaging revealed two cystic lesions in the left parietal lobe and another small lesion in the right parietal lobe. The imaging findings were highly suggestive of neurocysticercosis. Our case highlights the important issue of neurocysticercosis as an etiology for new-onset seizures in the United States.

Cutaneous larva migrans, a neglected tropical disease of skin, with severe secondary eczematization at an unusual location.

Cutaneous larva migrans (CLM), commonly referred to as creeping eruption, is an infectious condition caused by various types of hookworms. It primarily affects the superficial layers of the skin owing to the absence of hyaluronidases and proteases. Typically, the distal lower extremities are the most commonly affected areas. The presence of distinctive lesions characterized by erythematous, winding, or serpentine tracks, slightly elevated from the skin surface, is indicative of the condition. Diagnosis primarily relies on clinical observation. Dermoscopy reveals multiple segmented yellowish-linear regions corresponding to pustules along the larval path. Treatment typically involves the use of topical and oral ivermectin, oral albendazole, and topical thiabendazole cream.

Efficacy of albendazole against soil-transmitted helminth infections in Ethiopia: a systematic review and meta-analysis.

Soil-transmitted helminths (STH) are neglected parasites more prevalent in the tropics. Periodic mass distribution of albendazole, is one key strategy to control STHI in endemic areas. However, benzimidazoles have low efficacy against STHI, and there is a lack of information on the magnitude of the problem in Ethiopia. Articles were searched from PubMed using MeSH words, Google Scholar, Web of science, EMBASE and Scopus database to retrieve the data published and available until December 30, 2022. Totally, 107 published articles were retrieved. Only studies conducted in English that reported the efficacy of albendazole against STHI in any year and studies with more than fifty positive cases were included in the present study. The efficacy of albendazole was estimated by its cure rate and egg reduction rate. Excel software was used to extract the name of the authors, the total sample size, number of cured participants, treatment assessment time, STH parasite involved, the study area, and the year of publication. The pooled efficacy of albendazole against STHs was analyzed using comprehensive meta-analysis version 2.2 software. A total of 14 studies (13 for hookworm, 12 for Ascaris lumbricoides, and 12 for Trichuris trichiura) fulfilled the inclusion criteria for the present systematic review and meta-analysis. The total positives for hookworm, A. lumbricoides, and T. trichiura were 1253 (24.9%), 1570 (29.5%), and 1647 (30.6%), respectively. The overall pooled efficacy of albendazole was 92.2% (95% CI 86.2-98.9%) against hookworm, 97.7% (95% CI 96.3-98.6%) against A. lumbricoides, and 38.6% (95% CI 31.0-46.9%) against T. trichiura. In subgroup analysis, the efficacy of albendazole against hookworm was 93.4% (95% CI 85.1-97.2%) in Oromia, 96.7% (95% CI 93.8-98.2%) in Sidama, and 77.2% (95% CI 64.4-86.4%) in Amhara region. Its heterogeneity was high (I2 = 89.418). The efficacy of albendazole against A. lumbricoides was 98.3% (95% CI 97.0-99.0%) in Oromia and 96.63% (95% CI 93.2-98.3%) in Sidama region. Its heterogeneity was moderate (I2 = 41.5%). Albendazole efficacy against T. trichiura was 39.0% (95% CI 30.4-48.5%) in Oromia and 37.8% (95% CI 21.8-56.9%) in Sidama region with high heterogeneity (I2 = 90.6%). In the present review, albendazole is effective against hookworm and A. lumbricoides but less effective against T. trichiura. Albendazole should therefore be used as a treatment option in hookworm and A. lumbricoides endemic areas. However, alternative drugs should be sought for T. trichiura.