@article{article,
  keywords = {Albendazole, cure rate, Effectiveness, egg reduction rate, Kenya, Mass drug administration, school-aged children, Soil-transmitted helminthiasis},
  author = {Okoyo C and Chepchieng G and Kemunto E and Araka S and Masaku J and Njenga S and Mwandawiro C},
  title = {Assessment of the programmatic effectiveness of single-dose albendazole against soil-transmitted helminthiasis in school-age children following seven rounds of annual mass drug administration in selected counties of Kenya},
  abstract = {<p><strong>Background</strong></p>

<p>Soil-transmitted helminthiasis infections are targeted for elimination as a public health problem by 2030 under the Kenya Master Plan for neglected tropical diseases (2023-2027) and the Kenya health policy (2014-2030). Preventive chemotherapy via mass drug administration remains the primary control strategy. This study aimed to determine the programmatic effectiveness of albendazole among school-age children attending primary schools in Kisii, Narok, and Vihiga Counties that have participated in the National School-Based Deworming Programme since 2012.</p>

<p><strong>Methods</strong></p>

<p>A prospective longitudinal study comprising repeated cross-sectional surveys was conducted between March and July 2019. Counties were purposively selected based on sustained high infection prevalence (\&amp;gt;30\%) or low relative reduction in prevalence (\&amp;lt;50\%) in the 2018 national evaluation survey. Primary schools with historical prevalence exceeding 30\% were sampled, and children were screened using the Kato-Katz technique at baseline. Baseline-positive children (n = 573) were enrolled and monitored across three sequential post-treatment follow-up rounds. Cure rates and egg reduction rates were evaluated against baseline using weighted Poisson regression models with robust variance estimation, with non-linear parameter transformations and 95\% confidence intervals derived using delta method.</p>

<p><strong>Results</strong></p>

<p>At Follow-up 1, albendazole demonstrated high effectiveness against Ascaris lumbricoides, achieving a cure rate of 94.80\% (95\% CI: 92.61-97.00\%) and an egg reduction rate of 95.54\% (95\% CI: 92.36-98.71\%), surpassing the World Health Organization performance benchmark (\&amp;gt;=95\%). For Trichuris trichiura, the cure rate was 65.41\% (95\% CI: 56.49-74.34\%) and an egg reduction rate of 53.79\% (95\% CI: 15.95-91.62\%), with lower egg reductions observed in specific subgroups. For hookworm, initial cure rate was 76.74\% (95\% CI: 26.84-126.63\%) and egg reduction rate was 99.40\% (95\% CI: 97.89-100.90\%). Over subsequent monitoring, cure and egg reduction rates fluctuated, reflecting local environmental re-exposure and transmission dynamics.</p>

<p><strong>Conclusions</strong></p>

<p>Single-dose albendazole demonstrated high initial effectiveness against Ascaris lumbricoides at the first follow-up, meeting the (\&amp;gt;=95\%) World Health Organization egg reduction threshold. However, observed treatment effectiveness fluctuated across subsequent survey rounds without re-treatment, and Trichuris trichiura exhibited a sub-optimal response with subgroup variations that failed to meet threshold. Overall, while single-dose albendazole maintains robust effectiveness against roundworm, its localized programmatic effectiveness against whipworm remains limited in these persistent transmission foci.</p>
},
  year = {2026},
  journal = {Frontiers in Tropical Diseases},
  volume = {7},
  pages = {1 - 18},
  month = {10/2026},
  publisher = {Frontiers Media SA},
  issn = {2673-7515},
  url = {https://www.frontiersin.org/journals/tropical-diseases/articles/10.3389/fitd.2026.1926584/pdf},
  doi = {10.3389/fitd.2026.1926584},
  language = {ENG},
}