The adverse effects of albendazole and praziquantel in mass drug administration by trained schoolteachers

Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC) conducted stool examinations for soil transmitted helminthiases (STH) and Schistosoma mansoni , among school children in Mwea Division, Central Kenya where both infections are endemic. Mass drug administrations (MDAs) were then conducted in 2004 and 2005 using schoolteachers trained on how to administer treatment, physically and psychologically prepare the children to take the medication, have them eat before treatment, handle minor and refer serious side effects to local health facilities. Local health workers were on standby to help manage severe side effects. This study examined side effects of the drugs and the teachers' preparedness to handle the children when such effects occurred. No serious side effects requiring referral to the health centre occurred and the minor ones observed were temporal. In 2005 children in Mwea schools were treated with albendazole 400mg and praziquantel 40mg/kg body weight while those of Ndia, a neighboring division treated with only albendazole 400mg since there was low S.mansoni prevalence. Monitoring of side effects was done in two schools of Ndia and in three of Mwea through a questionnaire distributed to grade three pupils a week after treatment. Of 73 pupils from Mwea, 49.7% reported incidences of stomachache, vomiting/nausea, headache and dizziness whereas 39.2% of 186 from Ndia experienced incidences of cough, stomachache and headache. This shows that more pupils from Mwea, (albendazole and praziquantel) than from Ndia (albendazole alone) experienced minor side effects. These results show that both drugs have temporary, minor side effects, which can be managed by trained schoolteachers by ensuring that the school children do not swallow the drugs on an empty stomach and rest immediately after swallowing the drugs but should be closely monitored by health personnel. In this study, one trained schoolteacher could administer treatment to three hundred children in one day, which makes the approach cost effective and should be adopted nationally.