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Targeted chemotherapy for parasite infestations in rural black preschool children.

OBJECTIVE
To investigate whether targeted chemotherapy can reduce parasite prevalence rates in rural black preschool children.


DESIGN
The study consisted of a before/after trial. Stool and urine samples were analysed on four occasions over a 21-week period.


SETTING
Crèches in two rural areas of southern KwaZulu/Natal (coastal and inland).


PATIENTS
Two hundred children of 4-6 years of age attending 19 crèches in the area.


INTERVENTION
Targeted chemotherapy using albendazole for nematode infestations, praziquantel for trematode and cestode infestations and metronidazole for protozoal infections was administered twice at an interval of 14 weeks.


MAIN OUTCOME MEASURE
Prevalence rates.


RESULTS
The prevalence of Ascaris lumbricoides, Trichuris trichiura and Necator americanus infestation decreased significantly after treatment. Reinfestation rates 12 weeks after treatment were 16% for A. lumbricoides, 33% for T. trichiura, 24% for Giardia lamblia and 3% for N. americanus. No reinfestation was noted for Schistosoma haematobium, Hymenolepsis or Taenia species.


CONCLUSION
The study suggests that parasite prevalence rates in children can be reduced by the administration of appropriate chemotherapy at regular intervals. However, the provision of clean water and adequate sewerage facilities remains a high priority for black communities living in rural areas of South Africa.