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Soil-transmitted helminth (STH) infection is still a health problem in Indonesia. Vitamin A deficiency (VAD) is often found together with STH. The effect of the deworming program on the vitamin A status of primary school children is unknown. The objective of this study was to evaluate the effect of albendazole on serum retinol concentrations in primary school children.
An experimental study of pre-post test design without control was carried out on 118 children from grades 3-5 at one primary school in North Jakarta, from July to September 2014. Flotac examination was used to determine STH infections and high performance liquid chromatography was performed to measure serum retinol concentration. Stool and blood samples were taken twice: before and three weeks after treatment with albendazole 400 mg single dose for three consecutive days given to all children either infected or uninfected. Paired t-test was used to analyze the data.
Of the 118 children, the prevalence of STH was 71.2%. The prevalence of low retinol serum (<1.05 mmol/L) was 17 (17.2%) and of mild VAD was 2 (2.0%). Albendazole given in 3 consecutive days could not increase serum retinol concentrations (p=0.055). Serum retinol concentration significantly increased after albendazole treatment in children with low retinol serum at baseline (p=0.001).
In children with low serum retinol concentration, treatment with albendazole increased retinol concentration. Integrated deworming and vitamin A supplementation strategies should be evaluated in this population.
World Health Organization. Eliminating STH as a public health problem in children. Geneva: World Health Organization;2012.
Knoop S, Steinman P, Keiser J, et al. Nematode infections soil-transmitted helminths and Trichinella: Infect Dis Clin N Am 2012;26:341-58.
Pullan RL, Smith JL, Jasrasaria R, et al. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasites Vectors 2014;7:37. doi: 10.1186/1756-3305-7-37.
Albonico M, Allen H, Chitsulo L, et al. Controlling soil-transmitted helminthiasis in pre-school age children through preventive chemotherapy. PLoS Negl Trop Dis 2008;2: e126. doi: 10.1371/journal.pntd.0000126.
World Health Organization. Preventive chemotherapy in human helminthiasis. World Health Organization. 2006.
Al-Mekhlafi HM, Anuar TS, Al-Zabedi EM, et al. Does vitamin A supplementation protect schoolchildren from acquiring soil-transmitted helminthiasis? A randomized controlled trial. Parasites Vectors 2014;7:367. doi: 10.1186/1756-3305-7-367.
Hurst RJ, Else K. Retinoic acid signalling in gastrointestinal parasite infections: lessons from mouse models. Parasite Immunol 2012;34:351–9.
Bethony J, Brooker S, Albonico M, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 2006;367: 1521-32.
Brooker S, Clements AC, Bundy DA. Global epidemiology, ecology and control of soil-transmitted helminth infections. Adv Parasitol 2006;62:221-61.
Long KZ, Rosado JL, Montoya Y, et al. Effect of vitamin A and zinc supplementation on gastrointestinal parasitic infections among Mexican children. Pediatrics 2007;120:e846–e855.
Payne LG, Koski KG, Ortega-Barria E, et al. Benefit of vitamin A supplementation on Ascaris reinfection is less evident in stunted children. J Nutr 2007;137:1455–9
Haque R, Ahmed T, Wahed MA, et al. Low-dose ß-carotene supplementation and deworming improve serum vitamin A and ß-carotene concentration in preschool children of Bangladesh. J Health Popul Nutr 2010;28:230-37.
Albonico M, Allen H, Chitsulo L, et al. Controlling Soil-Transmitted Helminthiasis in Pre-School-Age Children through Preventive Chemotherapy. PLoS Negl Trop Dis 2008;2: e126. doi: 10.1371/journal.pntd.0000126.
Tanumihardjo SA, Permaesih D, Muhilal. Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions. Eur J Clin Nutr 2004;58:1223-30. doi: 10.1038/sj.ejcn. 1601953.
Rajagopal S, Hotez PJ, Bundy DAP. Micronutrient supplementation and deworming in children with geohelminth infections. PLOS Negl Trop Dis 2014;8:e2920. doi:10.1371/journal.pntd.0002920.
World Health Organization. Serum retinol concentrations for determining the prevalence of vitamin A deficiency in populations. Geneva: World Health Organization; 2011.
Surin J. The burden of moderate-to-heavy soil-transmitted helminth infections among rural Malaysian aborigines: an urgent need for an integrated control programme. Parasites Vectors 2011;4:242.
World Health Organization. Soil-transmitted helminthiases. Eliminating soil-transmitted helminthiases as a public health problem in children: Progress Report 2001–2010 and Strategic Plan 2011–2020. Geneva: World Health Organisation; 2012.
Yap P, Utzinger J, Hattendorf J, et al. Influence of nutrition on infection and re-infection with soil-transmitted helminths: a systematic review. Parasites Vectors 2014;7:229. doi:10.1186/1756-3305-7-229.
Haque R, Ahmed T, Wahed MA, et al. Low-dose â-carotene supplementation and deworming improve serum vitamin A and â-carotene concentrations in preschool children of Bangladesh. J Health Popul Nutr 2010;28:230-7.
Awasthi S, Peto R, Read S, et al. Population deworming every 6 months with albendazole in 1 million pre-school children in North India: DEVTA, a clusterrandomized trial. Lancet 2013; 381:1476–86.
World Health Organization. How to add deworming to vitamin A distribution. Geneva: World Health Organization;2004.