OBJECTIVE: Elimination eforts for lymphatic flariasis are underway in the Philippines using mass drug administration (MDA) of diethylcarbamazine and albendazole as one of the main strategies. This cost analysis was done to determine the MDA implementation cost and provide useful information to the control programme on how to best utilize limited resources.

METHODS: This cost analysis study was conducted in the province of Sorsogon, Philippines in 2004. The study was done from a program perspective. Cost data for 2003 was obtained retrospectively via key informant interviews and records review using a standardized guide from a multi-country cost analysis study of flariasis elimination programs. Cost fgures were classifed as either economic or fnancial costs and expressed in real terms using 2002 as base year. Sensitivity analysis was likewise performed.

RESULTS: The total economic cost and cost per person treated with MDA were estimated at US$223,549.55 (Php12,116,385.48) and US$0.40, respectively. The fnancial costs were less than half of the economic costs. The main cost driver was drug distribution. The highest economic and fnancial costs were incurred at the national (54.5%) and municipal (74.4%) levels, respectively. High variation in costs of MDA activities was observed.

CONCLUSION: This cost analysis provides reasonable estimates which may be used to assist government and other stakeholders in program planning and resource generation for flariasis elimination programs in endemic areas.

Diethylcarbamazine ; Albendazole ; Philippines ; Mass Drug Administration ; Costs And Cost Analysis ; Health Resources ; Lymphatic Vessel ; Elephantiasis, Filarial

OBJECTIVETo explore and compare the clinical effect and safety of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) in the treatment of cystic echinococcosis (CE1, CE2, and CE3).

METHODSA total of 269 cases treated with cystic echinococcosis (CE) in Xinjiang Medical University the First Affiliated Hospital from 1998 to 2008 were reviewed. 51 cases were excluded and 218 cases were enrolled in this research by retrospective case-control method. Among 110 cases were treated with L-ABZ and 108 cases were treated with T-ABZ for short-term (3 months) and long-term courses (6 months) respectively. The effects and safety of the two medicines were compared by analyzing the clinical symptoms, imaging check and serologic test results.

RESULTSIn short-term effect evaluation, the total effective rates and curative rates of L-ABZ group and T-ABZ group were 77.9% and 49.1% vs 28.4% and 13.9%, respectively. The effects of L-ABZ group was better than that of T-ABZ group, with remarkable difference in total effective rates and curative rates (x2 value was 19.581, 6.877, respectively, P is less than 0.05). In long-term effect evaluation, the total effective rates and curative rates of L-ABZ and T-ABZ group were 81.7% and 49.0% vs 47.6% and 20.6%, respectively. There was significant difference between L-ABZ group and T-ABZ group in total effective rates and curative rates (x2 value was 20.977, 15.049, respectively, P is less than 0.05). In T-ABZ group the short-term curative rates were 50.0% (15/30), 8.8% (8/91) and 33.3% (7/21) respectively in CE1, CE2, and CE3, the short-term total effective rates were 56.7% (17/30), 35.2% (32/91) and 61.9% (13/21) respectively in CE1, CE2, and CE3. The long-term curative rates were 58.3% (7/12), 28.6% (12/42) and 70.0% (7/10) respectively in CE1, CE2 and CE3, the long-term total effective rates were 75.0% (9/12), 69.0% (29/42) and 100.0% (10/10) respectively in CE1, CE2, and CE3. When compared with CE2, differences existed in CE1 (x2 = 24.887, 4.329; P is less than 0.05) and CE3 groups (x2 = 8.860, 5.076; P is less than 0.05) in terms of short-term effects. In L-ABZ group, the short-term curative rates were 47.4% (18/38), 12.2% (12/98) and 61.5% (8/13) respectively in CE1, CE2 and CE3, the short-term total effective rates were 92.1% (35/38), 65.3% (64/98) and 92.3% (12/13) respectively in CE1, CE2 and CE3, the long-term curative rates were 79.3% (23/29), 35.9% (23/64) and 50.0% (3/6) respectively in CE1, CE2 and CE3, the long-term total effective rates were 96.6% (28/29), 84.4% (54/64) and 100% (6/6) respectively in CE1, CE2 and CE3. When compared with CE2, there were significant differences in CE1 (x2 = 19.648, 9.930; P is less than 0.05) and CE3 groups (x2 = 18.880, 3.876; P is less than 0.05) in terms of short-term effect. In L-ABZ and T-ABZ groups, the drug-related adverse effects were 11.1% (12/108) and 12.7% (14/110) respectively without significant difference (x2 = 0.155, P is more than 0.05).

CONCLUSIONL-ABZ and T-ABZ were both effective anti-echinococcosis drugs without dominant side-effects. The clinical effect of L-ABZ was better than that of T-ABZ.

Adolescent ; Adult ; Aged ; Albendazole ; administration & dosage ; adverse effects ; therapeutic use ; Echinococcosis ; drug therapy ; Female ; Humans ; Liposomes ; administration & dosage ; Male ; Middle Aged ; Retrospective Studies ; Tablets ; administration & dosage ; Young Adult

OBJECTIVETo improve the clinician's awareness of angiostrongyliasis.

METHODSThe clinical and laboratory data as well as the epidemiological information concerning 18 patients with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis were analyzed.

RESULTSAll patients had a history of eating raw fresh water snail (Ampularium canaliculatus) before the onset of the disease. Incubation period ranged from 1 to 25 days. The major symptoms of the patients had severe headache and pain in the trunk and limbs. Increased eosinophlic count in peripheral blood and cerebrospinal fluid was noted. Tested by enzyme-linked immunoadsorbent assay (ELISA), sera were specifically IgG-antibody positive against Angiostrougylus cantonensis antigen, but were negative against other parasitic antigens such as Paragonimus westermani, Cysticerus, Cellulosae hominis, Echinococcus granulosus and Trichinella spiralis. Abnormal spotty signals were found in 2 cases with brain magnetic resonance imaging. Electroencephalogram (EEG) showed slow alpha rhythm. All the patients were effectively treated with combined administration of albendazole and dexamethazone.

CONCLUSIONSAngiostrongyliasis is one of the common causes leading to eosinophilic meningoencephalitis. To our knowledge, Wenzhou is the first small outbreak site of angiostrongyliasis discovered in Chinese mainland.

Adult ; Albendazole ; administration & dosage ; Angiostrongylus cantonensis ; Animals ; Dexamethasone ; administration & dosage ; Eosinophilia ; etiology ; Female ; Humans ; Male ; Meningoencephalitis ; etiology ; Middle Aged ; Prognosis ; Strongylida Infections ; complications ; drug therapy

We present a case of ocular toxocariasis treated successfully with oral albendazole in combination with steroids. A 26-year-old male visited the authors' clinic with the chief complaint of flying flies in his right eye. The fundus photograph showed a whitish epiretinal scar, and the fluorescein angiography revealed a hypofluorescein lesion of the scar and late leakage at the margin. An elevated retinal surface and posterior acoustic shadowing of the scar were observed in the optical coherence tomography, and Toxocara IgG was positive. The patient was diagnosed with toxocariasis, and the condition was treated with albendazole (400 mg twice a day) for a month and oral triamcinolone (16 mg for 2 weeks, once a day, and then 8 mg for 1 week, once a day) from day 13 of the albendazole treatment. The lesions decreased after the treatment. Based on this study, oral albendazole combined with steroids can be a simple and effective regimen for treating ocular toxocariasis.
Adult ; Albendazole/administration & dosage/*therapeutic use ; Anthelmintics/administration & dosage/therapeutic use ; Anti-Inflammatory Agents/administration & dosage/therapeutic use ; Eye Diseases/*drug therapy/*parasitology ; Humans ; Male ; Toxocariasis/*drug therapy ; Triamcinolone/administration & dosage/*therapeutic use

OBJECTIVETo evaluate the clinical efficacy of a new formulation of albendazole emulsion (AbzE) in cases of liver cystic hydatidosis.

METHODSTwo regimens of AbzE (10 mg.kg(-1).d(-1) and 12.5 mg.kg(-1).d(-1)) were given to 212 patients with liver cystic hydatidosis in courses ranging from 3 months to more than one year. Assessment of drug efficacy was essentially based on imaging signs with ultrasonography as the main tool. Assessments were performed at the end of different courses and in the follow-up study of 1 - 4 years after the cessation of therapy.

RESULTSAt the end of therapeutic courses, the overall cure rate of the 212 cases was 74.5%, with a 99.1% effective rate. In the follow-up study, the cure rate was 83.1%, effective rate was 89.3%, ineffective rate was 0.6%, and recurrence rate was 10.2%. The highest cure rate was observed in cases receiving AbzE 12.5 mg.kg(-1).d(-1) for 9 months. Retreatment of recurrent cases with AbzE obtained satisfactory results.

CONCLUSIONSAbzE surpassed other currently used antihydatidosis drugs or formulations with its promising efficacy and mild side effects, and could be recommended as a drug of choice in the treatment of cystic hydatidosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Albendazole ; administration & dosage ; adverse effects ; Child ; Child, Preschool ; Echinococcosis, Hepatic ; drug therapy ; Emulsions ; Female ; Humans ; Male ; Middle Aged

We report here a case of strongyloidiasis in a 72-year-old diabetic patient (woman) accompanied by gastrointestinal stromal tumor receiving imatinib therapy, first diagnosed as hypereosinophilic syndrome and treated with steroids for uncontrolled eosinophilia. She suffered from lower back pain and intermittent abdominal discomfort with nausea and diagnosed with gastrointestinal stromal tumor. After post-operative imatinib treatment eosinophilia persisted, so that steroid therapy was started under an impression of hypereosinophilic syndrome. In spite of 6 months steroid therapy, eosinophilia persisted. Stool examination was performed to rule out intestinal helminth infections. Rhabditoid larvae of Strongyloides stercoralis were detected and the patient was diagnosed as strongyloidiasis. This diagnosis was confirmed again by PCR. The patient was treated with albendazole for 14 days and her abdominal pain and diarrhea improved. This case highlights the need for thorough investigation, including molecular approaches, to test for strongyloidiasis before and during steroid therapies.
Aged ; Albendazole/administration & dosage ; Animals ; Diabetes Mellitus, Type 2/complications ; Eosinophilia/complications/*drug therapy ; Female ; Gastrointestinal Stromal Tumors/complications/*drug therapy ; Humans ; Imatinib Mesylate/*administration & dosage ; Steroids/*administration & dosage ; Strongyloides stercoralis/genetics/isolation & purification/physiology ; Strongyloidiasis/*drug therapy/parasitology

AIMTo prepare the target drug delivery systems(TDDS), albendazole polybutycyanocrylate nanoparticles (ABZ-PBCA-NP), its pharmaceutical characters and tissue distributions were simultaneously investigated.

METHODSAlbendazole nanoparticles were prepared with the emulsification-polymerization method and the drug-load mechanism of polybutycyanocrylate nanoparticles was studied with the equal-tempaerature adsorption principle. The dialyse dynamic of albendazole from ABZ-PBCA-NP was investigated in four formulations in vitro. The tissue distribution of albendazole in different drug vehicles was studied with isotope labelling experiment.

RESULTSABZ-PBCA-NP and ABZ-PVP-PBCA-NP fit to the Higuchi and bi-exponent function in vitro respectively. The drug loaded in nanoparticles was abide by the Langmuir adsorption equation. Targeting index of albendazole in liver and spleen in mice are 11.4 and 3.9 after ig 3H-ABZ-PBCA-NP. The bioavailability of albendazole nanoparticle and suspension are 76.0% and 36.9% respectively.

CONCLUSIONThe absorptive capability of drug was enhance when 4% PVP was added into the nanoparticle, and its release time was lengthen. At the same time, the nanoparticles vehicles increase the albendazole bioavailability.

Albendazole ; administration & dosage ; pharmacokinetics ; Animals ; Anthelmintics ; administration & dosage ; pharmacokinetics ; Biological Availability ; Drug Carriers ; Drug Delivery Systems ; Enbucrilate ; chemistry ; Female ; Liver ; metabolism ; Male ; Mice ; Nanotechnology ; Particle Size ; Spleen ; metabolism ; Technology, Pharmaceutical ; methods ; Tissue Distribution

Albendazole is an orally administered broad-spectrum benzimidazole anthelmintic used against helminthiasis, hydatid cyst disease and neurocysticercosis. The objectives of this investigation are to develop a sustained release drug delivery system for albendazole, and to target its delivery to colon. Albendazole matrix tablets containing varying proportions of single and binary blends of four polymers; polyacrylic acid (carbopol 971), ethylcellulose (Etcell), eudragit L100-55 (EUD), and sodium carboxymethyl cellulose (CMC) were prepared by a modified wet granulation technique of kneading, extrusion and compaction. In vitro release profiles of albendazole was sequentially determined in simulated gastric fluid (SGF), simulated intestinal fluid (SIF) without enzymes and in rat caecal content medium (RCCM) at 37 degrees C. The in vitro drug release from matrix tablets containing CMC and Etcell as single polymers showed initial burst effect in the first 2 h (>20% and 50% respectively), followed by a slow release in SIF. However, matrix tablets containing polymer blends showed that no appreciable drug release occurred up to 5 h. Drug release from tablets containing polymer blends in the dissolution medium containing rat caecal material suddenly increased to > or =30% after 5 h (RCCM), and reaching up to 90% in 24 h. Albendazole matrix tablets containing carbopol 971, Etcell, EUD, and CMC as single polymers and as blends were formulated for oral use. Drug release from the tablet matrices containing carbopol alone, binary blends of carbopol/Etcell, and CMC/EUD were found to be very slow and dependent on polymer concentration. Matrix tablets containing blends of these polymers formulated using kneading, extrusion and compaction technique could provide sustained drug release and can be utilized in the colonic delivery of albendazole.
Acrylic Resins ; chemistry ; Administration, Oral ; Albendazole ; administration & dosage ; pharmacokinetics ; Animals ; Anthelmintics ; administration & dosage ; pharmacokinetics ; Carboxymethylcellulose Sodium ; chemistry ; Cellulose ; analogs & derivatives ; chemistry ; Colon ; metabolism ; Delayed-Action Preparations ; Drug Carriers ; chemistry ; Drug Compounding ; Drug Delivery Systems ; In Vitro Techniques ; Male ; Rats ; Tablets ; Technology, Pharmaceutical ; methods

We encountered an indigenous case of intestinal capillariasis with protein-losing enteropathy in the Republic of Korea. A 37-year-old man, residing in Sacheon-si, Gyeongsangnam-do, admitted to the Gyeongsang National University Hospital (GNUH) due to long-lasting diarrhea, abdominal pain, anasarca, and weight loss. He recalled that he frequently ate raw fish, especially the common blackish goby (Acanthogobius flavimanus) and has never been abroad. Under the suspicion of protein-losing enteropathy, he received various kinds of medical examinations, and was diagnosed as intestinal capillariasis based on characteristic sectional findings of nematode worms in the biopsied small intestine. Adults, juvenile worms, and eggs were also detected in the diarrheic stools collected before and after medication. The clinical symptoms became much better after treatment with albendazole 400 mg daily for 3 days, and all findings were in normal range in laboratory examinations performed after 1 month. The present study is the 6th Korean case of intestinal capillariasis and the 3rd indigenous one in the Republic of Korea.
Adult ; Albendazole/administration & dosage ; Animals ; Anthelmintics/administration & dosage ; Biopsy ; Capillaria/cytology/drug effects/*isolation & purification ; Diarrhea ; Enoplida Infections/drug therapy/parasitology/*pathology ; Feces/parasitology ; Female ; Helminthiasis/drug therapy/parasitology/*pathology ; Humans ; Intestinal Diseases, Parasitic/drug therapy/parasitology/*pathology ; Intestines/parasitology/pathology ; Male ; Protein-Losing Enteropathies/drug therapy/parasitology/*pathology ; Republic of Korea ; Treatment Outcome