Impact of Anthelmintic Treatment on the Burden of Helminth Infections in Primary Schoolchildren in Biyela Health Zone in Kinshasa, Democratic Republic of the Congo

Abstract

Background: The study evaluated the impact of anthilminthic treatment, given as non-investigational drugs, on helminth infections, anaemia, and hemoglobin (Hb) level in the context of a malaria clinical trial in which Sulfadoxine Pyrimethamine (SP) and SP+Piperaquine (PQ) were also evaluated as an intermittent preventive treatment strategy in schoolchildren in the Democratic Republic of Congo (DRC). Methods: In a nested cohort study, 616 malaria asymptomatic children attending primary schools of Biyela health area were enrolled and follow-up from November 2012 to November 2013. The control group for the nested study was the negative on helminth infections. They received one dose of PZQ and ALB at baseline and then 2 doses of ALB at 4 months intervals. During the 12-months of follow-up, stool and urine samples were collected for helminth infections and finger prick blood for Hb level. Paired test analyses were used to compare the status before and after treatment, and confounding variables for Hb level were tested by multiple linear regression analysis. Results: At baseline, the prevalence of helminth infections and anaemia were 39.2% (95% CI: 34.7-43.7), and 41.8% (95% CI: 37.3-46.3), respectively. Mean Hb level was 11.6g/dl (SD±1.3). After 12-months post-anthelminthic treatment, the prevalence of helminth infections reduced to 7.2% (p<0.001). There was no change in Hb level and anaemia in the control which received only the anthelminthic drug (p=1.00 and p=0.26, respectively) at 12-months postintervention, compared to those who received active antimalarial SP (p=0.02 and p=0.09, respectively) and PQ (p=0.01 and p<0.001, respectively). Similarly, no difference in Hb level was observed among the infected and uninfected schoolchildren with helminths at 12-months after anthelminthic treatment. Conclusion: These findings suggest that anthelminthic treatment reduces significantly the prevalence of helminth infections. There was no impact on anaemia and Hb level due to the use of anthelmintic drugs.