The effect of albendazole toward anemia in children with soil-transmitted helminths infection in a remote and endemic area

Saleha Sungkar, Fitry B.J. Tambunan, Meutia N. Gozali, Gladys Kusumowidagdo, Sri Wahdini



Background: Soil-transmitted helminths (STH) infections lead to nutritional disorder and anemia among children. Albendazole 400 mg is used to control STH, although it has a low cure rate for Trichuris trichiura. The effectiveness of albendazole could be increased by giving a dose of 400 mg for 3 consecutive days. The aim of the study was to investigate the effectiveness of the triple-dose albendazole 400 mg course in decreasing STH and anemia prevalence.

Methods: This study used an experimental comparative design conducted in July 2016 and January 2017 in Perobatang Village, Southwest Sumba, Indonesia. Children aged 1–15 years were asked to collect fecal samples to be examined using a Kato-Katz method. Hemoglobin level (Hb) was tested using a rapid test diagnostic strip. STH positive subjects were given 400 mg of albendazole for 3 days witnessed by the researchers. Six months after, the stool samples and Hb levels were re-examined (post-test).

Results: From the 156 subjects examined (pretest), the prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm were 65.4%, 55.8%, and 15.4%, respectively, and the prevalence of anemia was 71.2%. On post-test, the prevalence of A. lumbricoides, T. trichiura, and hookworm decreased to 8.3%, 12.8%, and 0%, respectively, and the prevalence of anemia decreased to 25%. There was a significant difference in the prevalence of STH infection and anemia before and after the administration of triple-dose albendazole (p=0.001).

Conclusion: The triple-dose albendazole is effective in reducing the prevalence of STH and anemia in children with STH infection.


albendazole; anemia; soil-transmitted helminths; triple dose

Full Text:



  1. WHO. Intestinal worm. Geneva: WHO; 2016. Accessed 20 June 2016. Available from:
  2. Steinmann P, Utzinger J, Du Z, Jiang J, Chen J, Hattendorf J, et al. Efficacy of single-dose and triple dose albendazole and mebendazole against STH and Taenia sp: a randomized controlled trial. PLoS ONE. 2011;6(9): e25003.
  3. WHO [Internet]. Preventive chemotherapy in human helminthiasis. Geneva: WHO; 2006 [cited Jun 2016]. Available from: 9241547103_eng.pdf
  4. Indonesian Central Bureau of Statistics [Internet]. Income per capita by city 2013-2014 [cited 20 June 2016]. Jakarta: Indonesian Central Bureau of Statistics; 2013. Available from:
  5. Edegnika AA, Zinsou JF, Issifou S, Ateba-Ngoa U, Kassa RF, Feugap EN, et al. Randomized controlled assessor-blind clinical trial to assess the efficacy of single-versus repeated-dose albendazole to treat A. lumbricoides, T. trichiura, and hookworm infection. Antimicrob Agents Chemother. 2014;58(6):2535–40.
  7. Speich B, Moser W, Ali SM, Ame SM, Albonico M, Hattendorf J, et al. Efficacy and reinfection with soil-transmitted helminths 18-weeks post-treatment with albendazole-ivermectin, albendazole-mebendazole, albendazole-oxantel pamoate and mebendazole. Parasit Vectors. 2016;9:123.
  8. Tun A, Myat SM, Gabrielli AF, Montresor A. Control of soil-transmitted helminthiasis in Myanmar: results of 7 years of deworming. Trop Med Int Health. 2013;18(8):1017–20.
  10. Maakaron JE [Internet]. Anemia: practice essentials, pathophysiology, etiology [cited: Nov 2017] Available from:
  11. Hoffbrand AV, Moss PAH. Erithropoiesis and general aspects of anemia. In: Hoffbrand AV, Moss PAH, editors. Hoffbrand's essential haemology. 7th Ed. London: Wiley; 2016.
  12. Centers for Disease Control and Prevention [Internet]. Parasites-hookworm. Atlanta: CDC; 2013 [cited June 2016]. Available from:
  13. Haburchak D. Hookworm. Medscape [Internet]. Updated: Feb 24, 2016 [cited June 2016]. Available from:
  14. Centers for Disease Control and Prevention [Internet]. Trichuriasis. Atlanta: CDC; 2016. [cited June 2016]. Available from:
  15. Centers for Disease Control and Prevention [Internet]. Ascariasis. Atlanta: CDC; 2013. [cited June 2016]. Available from:
  16. Smith JL, Brooker S. Impact of hookworm infection and deworming on anemia in non-pregnant population: a systemic review. Trop Med Int Health. 2010;15(7):776–95.
  17. Casey GJ, Montresor A, Cavalli-Sforza LT, Thu H, Phu LB, Tinh TT, et al. Elimination of iron deficiency anemia and STH infection: evidence from a 44 month iron-folic acid and deworming program. PLoS Negl Trop Dis. 2013;7(4):e2146.

Copyright (c) 2018 Saleha Sungkar, Fitry B.J. Tambunan, Meutia N. Gozali, Gladys Kusumowidagdo, Sri Wahdini

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All articles and issues in Medical Journal of Indonesia have unique DOI number registered in Crossref.