Children are more likely than adults to become infected, as exemplified by their higher levels of prevalence of infection, and to develop mechanical AEs following treatment, because of the smaller size of their bile ducts and thus higher likelihood of blockage. Consequently, Tofacitinib Citrate mw they are considered both the group at highest risk and the one most sensitive for detection of AEs following treatment. All children attending the primary school and the junior high school of Huacullani were considered eligible for enrolment in the study. Study design A Scientific Committee formed by the Ministerio de Salud y Deportes, the Servicio Departamental de Salud of La Paz, the Universidad Mayor de San Andr��s and the PAHO/WHO was established with the aim of developing a protocol and supervising the implementation of the pilot intervention.

The protocol consisted of five consecutive study phases: baseline data collection; treatment; monitoring of AEs at day 0, day 7 and day 30; first parasitological follow-up 3 months after treatment, with further treatment of any cases still positive; and second parasitological follow-up 2 months after the first follow-up (Figure 1). After a few preparatory meetings, field activities started in April 2008, and were completed in November 2008. Figure 1 Study flow diagram. Baseline data collection Each participating child was given a plastic numbered container on the day of the survey and was asked to return it with a fresh stool sample. A single Kato-Katz thick smear [26], [27] was prepared from each stool sample.

The Kato-Katz test was chosen as �C in spite of its recognized low sensitivity �C it is the standard technique used for assessing burden of helminth infections at community level [1], and also allows a quantitative assessment of the severity (intensity) of the infection, through a measurement of egg density in the faecal sample. Each individual was therefore classified as egg-positive or negative, and intensity of infection (number of eggs per gram of faeces, epg) was assessed in all positive individuals. Prevalence of infection and mean intensity of infection were thus calculated. Treatment All children who tested positive to the Kato-Katz technique were considered eligible for treatment. Triclabendazole (Egaten, Novartis Pharma AG, Basel, Switzerland) was administered at an approximate dose of 10 mg/kg, in a single administration, based on the schema presented in Table 1.

Children with an intensity of infection Drug_discovery ��300 epg were hospitalized at the Ovidio Aliaga Ur��a Children’s Hospital in La Paz before receiving treatment. This precautionary measure was justified by the consideration that individuals infected with a large number of worms are more likely to develop both systemic and mechanical AEs following treatment and might therefore require specialist medical attention and care.