Albendazole Treatment Improves Work Capacity in Women Smallholder Farmers Infected with Hookworm: A Double-Blind Randomized Control Trial
| Autor: | Clint Trout, Maurice Masoda, Sarah K. Wendel, Carmine Bozzi, Christian Salmon, Jean-Maurice Salumu, Naomi Abaca Uvon, Lisa M. Harrison, Phil Nieburg, Debbie Humphries, Michael Cappello, Margaret Salmon |
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| Rok vydání: | 2018 |
| Předmět: |
Ancylostomatoidea
medicine.medical_specialty 030231 tropical medicine Albendazole Placebo law.invention Treatment and control groups Deworming Hookworm Infections 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial law Virology Internal medicine Heart rate medicine Animals Humans 030212 general & internal medicine Hookworm infection Farmers biology business.industry Articles biology.organism_classification Confidence interval Infectious Diseases Female Parasitology Power Psychological business medicine.drug |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 98:1419-1426 |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | An estimated 4.7 billion people live in regions exposed to soil-transmitted helminths, intestinal parasites that have significant impacts on the health of women smallholder farmers. The goal of this trial was to determine whether treatment with albendazole impacts the work capacity of these farmers. This is a prospective double-blind, randomized effectiveness trial. Participants (N = 250) were randomly selected from safe motherhood groups in the Democratic Republic of Congo. Prevalence/intensity of hookworm infection, hemoglobin, and demographics was obtained. At study (Time = 0), participants were randomized into treatment (albendazole 400 mg) and placebo (similar placebo tablet) groups. A step test was administered as a proxy metric for work capacity. Work capacity was defined as ∆heart rate before and after 3 minutes of step testing, in beats per minute. At study (time = 7 months), the step test was repeated and work capacity remeasured. The ∆work capacity (time = 0 minus time = 7 months) was the primary outcome. Investigators/field assistants were blinded to who was enrolled in groups, hookworm status, and step test results. Regression showed highly significant interactive effects of hookworm status and treatment group relative to ∆work capacity after controlling for resting pulse rate and age (P < 0.002). Estimated marginal means for work capacity (WC) for each of four groups (hookworm positive plus placebo, hookworm positive plus treatment, hookworm negative plus placebo, and hookworm negative plus treatment) showed women who were hookworm positive and received treatment decreased heart rate by 9.744 (95% confidence interval [CI]: 6.42, 13.07) beats per minute (increased WC), whereas women who were hookworm positive and received placebo saw a nonsignificant decrease of 0.034 (95% CI: −3.16, 3.84) beats per minute. Treatment with albendazole was associated with improved aerobic work capacity posttreatment. Given modest costs of drug distributions, risk benefits of periodic deworming warrants further study in larger controlled trials. |
| Databáze: | OpenAIRE |
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