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. 2024 Aug 30:38:100876.
doi: 10.1016/j.lana.2024.100876. eCollection 2024 Oct.

Mass chemotherapy with niclosamide for the control of Taenia solium: population-based safety profile and treatment effectiveness

Melissa T Wardle  1 , Samantha E Allen  2 , Ricardo Gamboa  3 , Percy Vilchez  3 , Seth E O'Neal  1   3 , Claudio Muro  3 , Andrés G Lescano  4 , Luz M Moyano  3   5 , Guillermo E Gonzalvez  6 , Armando E González  7 , Robert H Gilman  8 , Héctor H García  3   9 ; Cysticercosis Working Group in Peru (CWGP)
Collaborators, Affiliations

Mass chemotherapy with niclosamide for the control of Taenia solium: population-based safety profile and treatment effectiveness

Melissa T Wardle et al. Lancet Reg Health Am. .

Abstract

Background: Mass drug administration (MDA) with niclosamide (NSM) can be used to control taeniasis, the cause of neurocysticercosis. NSM is 84.3% effective against taeniasis and is considered safe as it is not absorbed from the intestinal tract. However, information on its safety and effectiveness during MDA is limited. We evaluated the effectiveness of NSM and reported adverse events (AEs) during a cysticercosis elimination program in Tumbes, Peru.

Methods: Three rounds of NSM at 4-month intervals were offered to 77,397 eligible residents. We revisited all participants in their homes 72 h after each round to collect information regarding AEs. We also collected post-treatment stool samples to diagnose taeniasis after the first round, followed by a second sample at 30 days from those infected to evaluate NSM's effectiveness.

Findings: During implementation, 68,751 individuals were administered at least one dose of NSM (mean age 29 years, SD 20; 52% male), and 65,551 (95.3%) were visited post-treatment. 988 (1.5%) reported experiencing at least one AE. Almost all AEs (99.2%) were of mild intensity, with no severe AEs recorded. Of 211 participants diagnosed with taeniasis, 188 provided a follow-up stool sample 30-days after treatment and 141 were cured (treatment effectiveness 75.0%). Older age and higher coproantigen levels were significantly associated with treatment failure.

Interpretation: MDA with NSM is safe in Taenia solium endemic settings. However, the effectiveness following one dose is lower than expected, which suggests additional treatment may be necessary to enhance the infection control efforts.

Funding: The Bill and Melinda Gates Foundation.

Keywords: Adverse events; Effectiveness; Niclosamide.

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Conflict of interest statement

RG, PV, CM, and LMM were partially supported by the US National Institutes of Health, the Fogarty International Center (TW001140), AGL was supported by Emerge, the Emerging Diseases Epidemiology Research Training of the US National Institutes of Health, the Fogarty International Center (D43 TW007393), and MTW was supported by the National Center for Advancing Translational Sciences of the US National Institutes of Health under award number (TL1TR00237). HG was supported by a Wellcome Trust International Senior Research Fellowship in Public Health and Tropical Medicine. All authors declare no conflicts of interests.

Figures

Fig. 1
Fig. 1
Flow diagram of all residents from 107 villages in Tumbes, Peru who participated in any of the three rounds of mass treatment with oral niclosamide (NMS) and responded to the adverse even questionnaire 72 h after accepting treatment, June 2009–April 2010.
See this image and copyright information in PMC

References

    1. Ndimubanzi P.C., Carabin H., Budke C.M., et al. A systematic review of the frequency of neurocyticercosis with a focus on people with epilepsy. PLoS Negl Trop Dis. 2010;4(11):e870. Preux PM. - PMC - PubMed
    1. Coyle C.M., Mahanty S., Zunt J.R., et al. Neurocysticercosis: neglected but not forgotten. PLoS Negl Trop Dis. 2012;6(5) - PMC - PubMed
    1. World Health Organization . World Health Organization; Geneva: 2020. Ending the neglect to attain the sustainable development goals: a road map for neglected tropical diseases 2021–2030.https://apps.who.int/iris/handle/10665/338565 [cited 2022 Mar 3]. Available from:
    1. Guideline for preventive chemotherapy for the control of taenia solium taeniasis. Pan American Health Organization; 2021. https://iris.paho.org/handle/10665.2/54800 [cited 2022 Jun 13]. Available from: - PubMed
    1. Torres R., JR., Noya G.O., Noya BA de, Mondolfi G.A. Seizures and Praziquantel. A case report. Rev Inst Med trop S Paulo. 1988;30(6):433–436. - PubMed

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