Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Debbie Humphries

Second Advisor

Michael Cappello

Abstract

Background: In endemic settings unable to support economic growth, inexpensive anthelminthics, such as albendazole, are the cornerstone for hookworm infection treatment and control. However, the overall efficacy of albendazole against hookworm may be reduced after periodic chemotherapy. (Hotez et al., 2004) In addition, there are few studies exploring the role of nutritional status as a potential host factor influencing drug response and the constituents of diet has often been overlooked when determining anthelminthic efficacy, despite previous accounts of nutrient content of a meal or consumed food item affecting drug metabolism. Evaluating nutritional status as a potential host factor may partly explain the wide variability of drug efficacy. (Vercruysse et al., 2011)

Methodology: Ghanaian school children that met inclusion criteria were selected from five communities previously identified as having high prevalence of hookworm infection. After enrolling 141 eligible school-age children for baseline assessment, those positive for hookworm infection were treated with single-dose 400 mg albendazole. Nutritional status and dietary data were assessed to identify modifiable host factors affecting treatment response.

Principal Findings: Our results showed that the efficacy of single-dose oral albendazole for curing hookworm infection was significantly reduced for children with lower dietary diversity and protein intake on treatment day. In addition, children with higher dietary diversity scores within the same reference period were 3.08 times more likely than those with lower scores to experience the highest egg reduction rates (p-value 0.0430).

Conclusion: The cross-sectional study provides new data on the nutritional status and dietary patterns of children in the Kintampo North Municipality and elucidates the potential role of modifiable host factors in affecting response to treatment.

Comments

This is an Open Access Thesis.

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