Albendazole

On MDA Day, community drug distributors (CDDs) were accompanied by trained research assistants who administered pre-MDA questionnaires to consenting individuals and collected clinical data before drug intake. Baseline sociodemographic, clinical, and medical history, including any comorbidities, concomitant medications, and current clinical symptoms (Pre-MDA events), were collected and recorded before receiving the IA. Ivermectin (Merck Sharpe and Dohme, Haarlem, Netherlands), and albendazole (GlaxoSmithKline, Brentford, UK) tablets were from the national NTD programme (NTDCP). On the MDA day, study participants received a standard dose of Ivermectin based on height (roughly corresponding to 150–200 μg/kg) and albendazole 400 mg as recommended by the WHO [5 ]. MDA was conducted following routine national NTD programme procedures by using CDDs who delivered the medications using the directly observed treatment (DOT) approach at the households. The MDA campaign was led by NTDCP, and the study team had no role in the MDA planning, providing, or administering of the drugs. Study participants were actively followed up for any treatment-associated AEs through house-to-house visits on day one, two and seven following MDA.

Albendazole was provided by Glaxo-Smith-Kline (GSK, Middlesex, UK) as part of the Global Program to Eliminate Lymphatic Filariasis (GPELF). Diethylcarbamazine (DEC) was from GSK-India, which is the same source that provided DEC for the GPELF. The study medication was stored at the two sites in Chennai where the study was conducted in the pharmacy under the control of a pharmacist or nurse. The study staff directly observed subjects as they took the medications.

This protocol was approved by the Liverpool School of Tropical Medicine (ref: LSTM 12.37) and was registered as a project within the Ministry of Health and Social Services (MoHSS) of Namibia. The protocol was reviewed by the MoHSS and implemented following their recommendations. Before selection, school principals received an information leaflet (in local languages) detailing the objectives and procedures of this study. The study was fully explained by a MoHSS officer to those who chose to participate. Before enrolment, informed consent in writing was given by the school principals. After collection of samples, all children were offered a standard doses of PZQ, 40mg/kg (CIPLA, Mumbai, India), and albendazole, or ALB, single 200mg tablet (GSK, Uxbridge, UK), following WHO guidelines [15 ]. All treatment was supervised and confirmed by a MoHSS officer. Participation in these surveys was voluntary. If a child refused to take part in the study, or their parents decided to opt-out, then no treatment was given at the time of the study.