Cure and reinfection patterns of geohelminthic infections after treatment in communities inhabiting the tropical rainforest of Assam, India

Abstract

Mass de-worming targeted at socio-economically poor communities can be considered as an option for communities living in the tropical forests of Assam who do not have access to safe drinking water and proper sanitation, and consequently have a higher risk of suffering from geohelminthic infection and associated morbidity. A random sample of 265 subjects was included in this study (134 males and 131 females). The chemotherapeutic regimen followed was a single dose of albendazole 400 mg. Stools samples were collected in 10% formol-saline for detection of infection before treatment. Post-treatment stool samples were collected 10 to 14 days after treatment to determine the cure rate. Stool samples were again collected 3 to 6 months post-treatment to study the rate of reinfection. Multiple logistic regression was used to find possible associations between age, sex and treatment failure. The chi-square test was used wherever appropriate. The cure rates for Ascaris lumbricoides, Trichuris trichiura and hookworms were 70.8%, 68.7% and 93.0%, respectively. Logistic regression revealed that age was associated with treatment failure in A. lumbricoides infection. Re-infection rates after 3 months of successful treatment were 19.6% for A. lumbricoides, 30.9% for T. trichiura and 11.3% for hookworms. Six months post-treatment, the prevalence of re-infection was highest with T. trichiura (43.6%); followed by A. lumbricoides (35.3%). The rate of reinfection with hookworms was lower (11.3%) six months post-treatment. The rates of re-infection with A. lumbricoides and T. trichiura was higher in children below 15 years of age, compared with adults. Hookworm reinfection was higher in the adult age group (15 to 39 years). The rates of new infection in previously uninfected subjects were lower compared with the rates for re-infection.