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WithdrawnNCT02597556Updated Dec 15, 2016

The Impact of Anthelmintic Treatment on the Incidence of Diarrheal Disease in Vietnamese School Children

A Phase 4 interventional study of Albendazole and Placebo in Intestinal Helminthiasis and Diarrhea, sponsored by Oxford University Clinical Research Unit, Vietnam. Withdrawn at 1 site in Vietnam. Open to participants aged 6 Years to 15 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2016-12-15.

Sponsored by Oxford University Clinical Research Unit, Vietnam · Phase 4, Interventional, and Treatment

Why this study was withdrawn
The prevalence of worm infections in the site is significantly lower than expected
Phase
Phase 4
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
6 Years to 15 Years
Sex
All
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Study summary

Cheap and effective drugs called 'anthelmintics' are routinely administered to children in developing countries to eliminate infections by parasitic helminths. However, the effects of anthelmintic treatment on other pathogens (e.g., bacteria, viruses, protozoa) remain unknown. The aim of this study is to investigate the impact of anthelmintic treatment on the incidence of viral- and bacterial-induced diarrhea in school children in southern Vietnam. Diarrheal disease remains a substantial cause of morbidity and mortality in children in Vietnam, and these children are typically co-infected with intestinal helminths. As helminths and diarrheal pathogens infect the same intestinal niche, anthelmintic treatments may alter host immune responses and the composition of the gut microbiota in ways that affect infection and disease risks caused by diarrheal pathogens.

This study will recruit 350 helminth-infected and 350 helminth-uninfected children aged 6-15 years. Recruited children will be randomized to receive either anthelmintic or placebo treatment once every three months and will be monitored for incidences of diarrheal disease for 12 months. At the 12-month time point, all children will receive anthelmintic treatment. Blood and stool samples will be collected throughout the study and used for evaluation of anemia and host immune responses, and for classification of gut microbes and parasite detection, respectively. The interventional study proposed here will provide an important first test of whether anthelmintic treatments have any indirect effects on infections caused by diarrheal pathogens.

Read the detailed description

This study is a randomized, double-blind, placebo-controlled trial to evaluate the effects of 400 mg albendazole treatment against placebo on the incidence of diarrheal disease caused by viral and bacterial pathogens in school children in southern Vietnam. Children will be enrolled from three primary schools in Cu Chi district in Ho Chi Minh City, Vietnam. Children will be screened for infections by the four most common soil-transmitted helminths, Ascaris lumbricoides, Trichuris trichiura, Necator americanus, and Ancylostoma duodenale. Infected and uninfected individuals will be recruited into the study and randomized to either receive albendazole treatment once every three months for 12 months, or to placebo once every three months for 9 months, after which albendazole treatment will be given at month 12, in accordance with the current deworming schedule in Cu Chi district. A questionnaire regarding the participant's demographics, his/her daily habits, and potential sources of infection will be administered at baseline. Weekly active and passive surveillance of diarrheal cases will be conducted throughout the study, and a health questionnaire will be administered during all cases of diarrhea and at the end of the study.

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Conditions studied

  • Intestinal Helminthiasis
  • Diarrhea

Keywords

  • Albendazole
  • Ancylostoma duodenale
  • Ascariasis lumbricoides
  • Coinfection
  • Diarrhea
  • Helminths
  • Necator americanus
  • Microbiota
  • Trichuris trichiura
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In context

Diarrhea

865 studies on the registry are indexed under Diarrhea; 77 are open to participants now.

Browse Diarrhea studies →

Lead sponsor

Oxford University Clinical Research Unit, Vietnam is the lead sponsor of 37 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
6 Years to 15 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Between 6-15 years of age
  • Written informed consent from a parent or guardian
  • Written assent from children >10 years of age

Exclusion criteria

Exclusion Criteria:

  • Subjects who do not fulfill any component of the inclusion criteria
  • Subjects that are both hookworm-positive and anemic, as defined by the WHO guidelines
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Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
0 participants (actual)

Study arms

  • Active comparator
    Albendazole

    Albendazole will be administered as a single 400mg chewable tablet at 0, 3, 6, 9, and 12 months.

    Drug: Albendazole

  • Placebo comparator
    Placebo

    Matching Placebo will be administered as a single chewable tablet at 0, 3, 6, and 9 months. At month 12, all participants will receive a single 400mg Albendazole tablet.

    Drug: Placebo

Interventions

  • A single 400mg dose of Albendazole administered at 0, 3, 6, 9, and 12 months.

  • DrugPlacebo

    Matching placebo tablet administered at 0, 3, 6, and 9 months. At month 12, all participants will receive a single dose of 400mg Albendazole.

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What researchers measure

Primary outcomes

  1. Incidence of diarrheal disease assessed by 12 months of weekly active and passive case surveillance

    Incidence of diarrhea will be defined according to WHO guidelines as three or more loose stools in a 24-hour period or at least one bloody/mucoid stool. To be considered a new episode of diarrhea, at least three intervening days of normal stools without other gastrointestinal symptoms need to have passed between diarrhea occurrences.

    Time frame: 12 months

Secondary outcomes

  1. Prevalence and intensity of soil-transmitted helminth infections by real-time PCR and microscopy

    Time frame: Baseline, 0.5, 3, 6, 6.5, 9, and 12 months, and during and two weeks after diarrhea cases

  2. Prevalence and intensity of enteric viruses and bacteria that cause diarrhea assessed by real-time PCR and the Luminex xTAG Gastrointestinal Pathogen Panel

    Time frame: Time Frame: Baseline, 3, 6, 9, and 12 months, and during and two weeks after diarrhea cases

  3. Changes in fecal microbiota composition by Illumina sequencing

    Time frame: Baseline, 0.5, 3, 6, 6.5, 9, and 12 months, and during and two weeks after diarrhea cases

  4. Changes in blood cytokine (Th1, Th2, TH17, and Treg) levels by bead-based immunoassays

    Time frame: Baseline, 6, and 12 months of study

  5. Antibody isotype response to helminth and diarrheal antigens by ELISA

    Time frame: Baseline, 6, and 12 months

  6. Mean z-scores (height-for-age, weight-for-age, weight-for-height)

    Time frame: Baseline and 12 months

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Study locations

1 site
  • Cu Chi, Viet Nam
    Ho Chi Minh City, 700000, Vietnam
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References and documents

Publications

  • Blackwell AD, Martin M, Kaplan H, Gurven M. Antagonism between two intestinal parasites in humans: the importance of co-infection for infection risk and recovery dynamics. Proc Biol Sci. 2013 Aug 28;280(1769):20131671. doi: 10.1098/rspb.2013.1671. Print 2013 Oct 22. PubMed 23986108 ↗
  • Ezenwa VO, Jolles AE. Epidemiology. Opposite effects of anthelmintic treatment on microbial infection at individual versus population scales. Science. 2015 Jan 9;347(6218):175-7. doi: 10.1126/science.1261714. PubMed 25574023 ↗
  • Ferrari N, Cattadori IM, Rizzoli A, Hudson PJ. Heligmosomoides polygyrus reduces infestation of Ixodes ricinus in free-living yellow-necked mice, Apodemus flavicollis. Parasitology. 2009 Mar;136(3):305-16. doi: 10.1017/S0031182008005404. Epub 2009 Jan 21. PubMed 19154651 ↗
  • Knowles SC, Fenton A, Petchey OL, Jones TR, Barber R, Pedersen AB. Stability of within-host-parasite communities in a wild mammal system. Proc Biol Sci. 2013 May 15;280(1762):20130598. doi: 10.1098/rspb.2013.0598. Print 2013 Jul 7. PubMed 23677343 ↗
  • Pedersen AB, Antonovics J. Anthelmintic treatment alters the parasite community in a wild mouse host. Biol Lett. 2013 May 8;9(4):20130205. doi: 10.1098/rsbl.2013.0205. Print 2013 Aug 23. PubMed 23658004 ↗
  • Nacher M. Worms and malaria: resisting the temptation to generalize. Trends Parasitol. 2006 Aug;22(8):350-1; author reply 351-2. doi: 10.1016/j.pt.2006.06.003. Epub 2006 Jun 23. No abstract available. PubMed 16798090 ↗
  • Rousham EK. An increase in Giardia duodenalis infection among children receiving periodic Anthelmintic treatment in Bangladesh. J Trop Pediatr. 1994 Dec;40(6):329-33. doi: 10.1093/tropej/40.6.329. PubMed 7853436 ↗
  • Taylor-Robinson DC, Maayan N, Soares-Weiser K, Donegan S, Garner P. Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin, and school performance. Cochrane Database Syst Rev. 2015 Jul 23;2015(7):CD000371. doi: 10.1002/14651858.CD000371.pub6. PubMed 26202783 ↗
  • Leung JM, Hong CT, Trung NH, Thi HN, Minh CN, Thi TV, Hong DT, Man DN, Knowles SC, Wolbers M, Hoang Nle T, Thwaites G, Graham AL, Baker S. The impact of albendazole treatment on the incidence of viral- and bacterial-induced diarrhea in school children in southern Vietnam: study protocol for a randomized controlled trial. Trials. 2016 Jun 6;17(1):279. doi: 10.1186/s13063-016-1406-1. PubMed 27266697 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 15, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02597556
Lead sponsor
Oxford University Clinical Research Unit, Vietnam
Collaborators
Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, Ho Chi Minh Preventive Medicine Centre, Vietnam, Princeton University, Cu Chi Health Department
Responsible party
Sponsor
First posted
Nov 5, 2015
Start date
Feb 2016
Primary completion
May 2016
Completion
May 2016
Last update
Dec 15, 2016

Study contacts

Stephen Baker, PhD
principal investigator · Oxford University Clinical Research Unit
Nghia Ho Dang Trung, PhD, MD
principal investigator · Pham Ngoc Thach University of Medicine
Andrea Graham, PhD
principal investigator · Princeton University, USA
Jacqueline Leung, MA
study director · Princeton University, USA

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Dec 2016. You cannot join it, but the record below documents what was studied.

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