Transactions of the Royal Society of Tropical Medicine and Hygiene
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Trans. R. Soc. Trop. Med. Hyg. · Sep 2006
Randomized Controlled TrialA randomized, double-blind, placebo-controlled trial of antivenom for local effects of green pit viper bites.
Although systemic administration of antivenom can promptly reverse coagulopathy, efficacy on local effects of viper venom remains to be determined. Currently, there has been no proven specific treatment for snakebite patients with severe local effects. This study is a randomized, double-blind, placebo-controlled trial. ⋯ The plasma venom levels were not different at presentation but lower in the antivenom group 24h after intervention (P = 0.033). These data suggest that intravenous antivenom could accelerate local oedema resolution in humans. However, the degree is not clinically significant, and, therefore, general use is not recommended.
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Trans. R. Soc. Trop. Med. Hyg. · Apr 2005
Randomized Controlled Trial Clinical TrialPeriodic deworming with albendazole and its impact on growth status and diarrhoeal incidence among children in an urban slum of India.
This study was undertaken to measure the impact of periodic deworming with albendazole on growth status and incidence of diarrhoea in children aged 2-5 years in an urban setting in India and to assess the feasibility of local health workers implementing the procedures involved. This was a double-blind, placebo-controlled, randomized, community-based intervention trial with 702 children randomly allocated to receive either albendazole or placebo. The two study groups received two doses of albendazole (400 mg) or placebo six months apart. ⋯ The albendazole group also experienced fewer episodes of diarrhoea than their control counterparts (relative risk 1.3, 95% CI 1.07-1.53) with a 28% reduction. The health workers administered the correct dosage satisfactorily and there were no adverse effects. Thus, periodic mass deworming with albendazole would seem to be a safe and effective method that could be adopted at the community level or as an integral part of school health services and could be expected to improve growth and reduce the incidence of diarrhoea in children.
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Trans. R. Soc. Trop. Med. Hyg. · Jan 2004
Case Reports Randomized Controlled Trial Clinical TrialClinical trial of two antivenoms for the treatment of Bothrops and Lachesis bites in the north eastern Amazon region of Brazil.
The efficacies of specific Bothrops atrox-Lachesis and standard Bothrops-Lachesis antivenoms were compared in the north eastern Amazon region of Brazil. The main aim was to investigate whether a specific antivenom raised against the venom of B. atrox, the most important Amazon snake species from a medical point of view, was necessary for the treatment of patients in this region. Seventy-four patients with local and systemic effects of envenoming by Bothrops or Lachesis snakes were randomly allocated to receive either specific (n = 38) or standard (n = 36) antivenoms. ⋯ The incidence of early anaphylactic reactions was 18% and 19%, respectively for specific and standard antivenoms; none was life-threatening. Measurement of serum venom concentrations by enzyme immunoassay (EIA) confirmed that both antivenoms cleared venom antigenaemia effectively. EIA also revealed that one patient had been bitten by Lachesis muta, although the clinical features in this case were not distinctive.
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Trans. R. Soc. Trop. Med. Hyg. · Sep 2003
Randomized Controlled Trial Clinical TrialArtesunate plus sulfadoxine-pyrimethamine for uncomplicated malaria in Kenyan children: a randomized, double-blind, placebo-controlled trial.
Plasmodium falciparum has developed resistance to almost all routinely used antimalarial drugs. Sulfadoxine-pyrimethamine (SP) has replaced chloroquine as first-line treatment of uncomplicated malaria infection in Kenya but resistance to SP is already reported. The addition of artemisinin derivatives to SP may delay the development of drug resistance, improve cure rates, and reduce transmission. ⋯ Parasite clearance and gametocyte carriage were reduced significantly in both combination groups compared with SP alone. Three days of artesunate were required to reduce significantly the risk of treatment failure by day 28. However, the high background rate of parasitological failure with SP may make this combination unsuitable for widespread use in Kenya.
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Trans. R. Soc. Trop. Med. Hyg. · Mar 2001
Randomized Controlled Trial Clinical TrialAlbendazole therapy and reduced decline in haemoglobin concentration during pregnancy (Sierra Leone).
WHO recommends that anthelmintic treatment be included in strategies to improve maternal nutrition in areas where hookworms are endemic and anaemia is prevalent. At present, few countries have adopted this recommendation, partly owing to the lack of data to support the adverse effects of hookworms on maternal health. A longitudinal study was conducted on 125 women in Sierra Leone (in 1995/96) to measure the impact of single-dose albendazole (400 mg) and daily iron-folate supplements (36 mg iron and 5 mg folate) on haemoglobin and serum ferritin concentration during pregnancy. ⋯ The corresponding value for iron-folate supplements was 13.7 g/L haemoglobin (P < 0.001). The effects of albendazole and iron-folate supplements were additive. These findings lend support to WHO's recommendation for anthelmintic treatment during pregnancy.