Transactions of the Royal Society of Tropical Medicine and Hygiene
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Trans. R. Soc. Trop. Med. Hyg. · Nov 2015
Randomized Controlled Trial Multicenter StudyThe effect of albendazole treatment on seizure outcomes in patients with symptomatic neurocysticercosis.
Randomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is evidence for a differential effect by seizure type. ⋯ Albendazole treatment may be associated with some symptomatic improvement; however, this association seems to be specific to generalized seizures. Future research is needed to identify strategies to better reduce long-term seizure burden in patients with neurocysticercosis.
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Trans. R. Soc. Trop. Med. Hyg. · May 2014
Randomized Controlled Trial Multicenter StudyDo shoes reduce hookworm infection in school-aged children on Pemba Island, Zanzibar? A pragmatic trial.
A non-blinded, cluster randomised controlled trial to test whether footwear reduces prevalence and intensity of hookworm infection in school-aged children on Pemba Island, Zanzibar. ⋯ Due to contamination, the trial could not conclude that shoes were protective against hookworm infection but the intervention led to behavioural change, and observational data suggest that shoes are protective against hookworm. This trial is registered at ClinicalTrials.gov, NCT01869127.
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Trans. R. Soc. Trop. Med. Hyg. · May 2009
Randomized Controlled Trial Multicenter StudyProviding iron/folic acid tablets free of charge improves compliance in pregnant women in Senegal.
Iron (Fe) deficiency and anemia during pregnancy remain highly prevalent in Senegal because of low compliance with Fe supplementation. Improving women's access to supplements may increase compliance. Six prenatal centers in Dakar were randomly assigned to either a control group in which women received routine prenatal visits, including prescriptions to purchase iron/folic acid tablets (IFA) according to the guidelines of the current Senegalese supplementation program (n=112), or to an intervention group in which women received free IFA (n=109) in addition to routine prenatal care. ⋯ Compliance was 48% and 86% in the control and intervention groups, respectively (P<0.001). After adjustment for confounding, prevalence of anemia was 62% in the control group versus 31% in the intervention group (P<0.001); prevalence of Fe deficiency was 49% and 21% in the control and intervention groups, respectively (P<0.001). Improving access to IFA for pregnant women visiting health centers could dramatically increase their compliance, improve Fe status and decrease the incidence of anemia.
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Trans. R. Soc. Trop. Med. Hyg. · Nov 2008
Randomized Controlled TrialThe efficacy and tolerability of three different regimens of tafenoquine versus primaquine for post-exposure prophylaxis of Plasmodium vivax malaria in the Southwest Pacific.
Tafenoquine is being developed for radical cure and post-exposure prophylaxis of Plasmodium vivax malaria. In an open-label study, 1512 Australian Defence Force personnel received one of three tafenoquine 3 d regimens [400 mg once daily (od), 200 mg twice daily (bid), 200 mg od] or daily primaquine (22.5 mg) plus doxycycline (100 mg) over 14 d in Bougainville and in Timor-Leste for post-exposure prophylaxis. The relapse rate of subjects treated in Bougainville with tafenoquine (n=173) was 1.2% (200 mg bid x 3 d) and 2.3% (400 mg od x 3 d), while primaquine plus doxycycline (n=175) was 3.4%. ⋯ The most frequent adverse events reported across all groups were nausea, abdominal distress and diarrhoea. There was a dose-dependent reduction in adverse events with a reduced dose of tafenoquine, with the lowest dose (total 600 mg over 3 d) producing rates of adverse events equivalent to that of primaquine plus doxycycline. The much shorter dosing regimen of tafenoquine should increase compliance, which is often suboptimal with primaquine after leaving an endemic area. [Australian New Zealand Clinical Trials Registry Number 12607000588493].
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Trans. R. Soc. Trop. Med. Hyg. · Aug 2007
Randomized Controlled Trial Comparative StudyRandomized, controlled, double-blind trial with ivermectin on Loa loa microfilaraemia: efficacy of a low dose (approximately 25 microg/kg) versus current standard dose (150 microg/kg).
Neurological serious adverse events (SAEs) following ivermectin treatment may occur in individuals harbouring high Loa loa microfilarial densities and are of major concern in the context of mass ivermectin distributions organized in Africa for onchocerciasis and lymphatic filariasis control. As those SAEs are induced by the rapid and massive microfilaricidal effect of a standard dose of ivermectin (150 microg/kg), we performed a randomized, controlled, double-blind trial to determine whether ivermectin given as: (a) a single low dose of 1.5mg (i.e. 25 microg/kg for a 60 kg person); or (b) two doses of 1.5mg given at a 2 week interval leads to a more progressive decrease in Loa microfilarial loads compared with the standard dosage. A low dose of ivermectin brought about a significantly smaller decrease in Loa microfilaraemia than the standard dose. ⋯ A second low dose of ivermectin given 15 days after the first dose did not lead to a further decrease in Loa microfilaraemia. Lastly, the variability in the response observed in the group treated with 25 microg/kg suggests that even lower doses would have no effect on a significant number of patients. Ivermectin given at a low dose (