The occurrence of AEs documented by our study contrasts with the absence of any event reported in Egypt [23] even though both the treatment regimen and the manufacturer of triclabendazole were the same. While comparison might not be fully appropriate, as in Egypt no active search of events was carried out, such discrepancy selleckchem Ceritinib might be attributable to the lower mean intensity of infection observed in this country (12.2 epg at baseline). Frequency and severity of AEs are however expected to be less important at subsequent rounds of treatment in reason of the progressively decreasing intensity of infection, as shown by experiences from different helminth control interventions implemented across the world [1], [21], [33]. The parasitological cure rate achieved after a single administration of triclabendazole at 10 mg/kg was high (77.

8%) and consistent with previous reports in the scientific literature for this treatment course [27]�C[29]. ERRs were also considerable, even though lower rates were observed among individuals with a higher intensity of infection at baseline (Table 4). The negative relationship between ERR and baseline intensity of infection has been described in the case of other helminth infections, such as those by Trichuris trichiura: both density-dependent fecundity and reduced bioavailability of triclabendazole per adult worm have been proposed as possible explanatory hypotheses [34], [35]. Finally, only 1.1% of the 90 treated children still had high-intensity infections (��400 epg) at the first parasitological follow-up, compared to 7.8% at baseline.

If we apply to fascioliasis the model described in other helminth infections, that intensity of infection is proportionate to morbidity [1], [2], it can be inferred that morbidity was under control in a very high proportion of children three months after a single administration of triclabendazole 10 mg/kg. Based on the results of the pilot intervention, we conclude that triclabendazole is a safe and efficacious drug when administered to a paediatric population living in a fascioliasis endemic area. These considerations suggest that a population-based drug distribution approach, without individual diagnosis and without direct medical supervision, in a manner comparable with the preventive chemotherapy interventions implemented worldwide against the four major helminth infections, is appropriate and feasible. Notably, triclabendazole was well tolerated across the population examined, including individuals with a high intensity of infection: AEs elicited Anacetrapib were self-limiting, did not require any specialist medical attention and could be managed by the local health staff.