How does albenza work?


Albenza (Oral)

Generic Name: albendazole (Oral route)


Medically reviewed by Last updated on Jan 1, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

Commonly used brand name(s)

In the U.S.

  • Albenza

Available Dosage Forms:

  • Tablet

Therapeutic Class: Anthelmintic

Chemical Class: Benzimidazole

Uses for Albenza

Albendazole is used to treat neurocysticercosis, an infection of the nervous system caused by pork tapeworms. This medicine is also used to treat cystic hydatid disease of the liver, lung, and peritoneum, an infection caused by dog tapeworms.

Albendazole is used to treat infections caused by worms. It works by keeping the worm from absorbing sugar (glucose), so that the worm loses energy and dies.

This medicine is available only with your doctor’s prescription.

Before using Albenza

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of albendazole to treat neurocysticercosis in children. However, hydatid disease is uncommon in children.


Although appropriate studies on the relationship of age to the effects of albendazole have not been performed in the geriatric population, no geriatric-specific problems have been documented to date.


Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.


Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter ) medicine.

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bone marrow problems (eg, agranulocytosis, aplastic anemia, granulocytopenia, pancytopenia)—Use with caution. May make these conditions worse.
  • Cysticercosis involving the eye—Patients who are being treated with albendazole for neurocysticercosis should be examined for lesions in the eye. Using this medicine may increase your risk for eye or vision problems.
  • Liver disease or
  • Liver enzymes, elevated—Use with caution. May increase risk for more serious side effects.

Proper use of Albenza

Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

No special preparations (fasting, laxatives, or enemas) or other steps are necessary before, during, or immediately after treatment with albendazole.

Take this medicine with meals, especially with food containing fat, to help your body absorb the medicine better.

You may crush or chew the tablet and swallow it with water.

If you are using this medicine for neurocysticercosis, your doctor will give you additional medicines (eg, seizure medicine or steroids) while you are taking this medicine.

To help clear up your infection completely, take this medicine exactly as directed by your doctor for the full time of treatment. In some infections, additional treatments with this medicine may be needed at 2-week intervals to clear up the infection completely. Do not miss any doses.


The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (tablets):
    • For hydatid disease of the liver, lung, and peritoneum:
      • Adults weighing 60 kilograms (kg) or more—Dose is based on body weight and must be determined by your doctor. The dose is usually 400 milligrams (mg) two times a day, taken with meals for 28 days (1 cycle). This is followed by not taking albendazole for 14 days, for a total of 3 cycles.
      • Adults weighing less than 60 kg—Dose is based on body weight and must be determined by your doctor. The dose is usually 15 mg per kg of body weight per day, divided into two doses, taken with meals for 28 days. This is followed by not taking albendazole for 14 days, for a total of 3 cycles. The dose is usually not more than 800 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For neurocysticercosis:
      • Adults and children weighing 60 kilograms (kg) or more—Dose is based on body weight and must be determined by your doctor. The dose is usually 400 milligrams (mg) two times a day, taken with meals, for 8 to 30 days.
      • Adults and children weighing less than 60 kg—Dose is based on body weight and must be determined by your doctor. The dose is usually 15 mg per kg of body weight per day, divided into two doses, taken with meals, for 8 to 30 days.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using Albenza

It is important that your doctor check your or your child’s progress at regular visits to make sure that the infection is cleared up completely. Blood tests may be needed to check for unwanted effects.

If your symptoms do not improve after you have taken this medicine for the full course of treatment, or if they become worse, check with your doctor.

For women of childbearing age, it is important that you use an effective form of birth control during treatment with this medicine and for at least 1 month after your last dose. Also, your doctor should give you a pregnancy test before you start the medicine to make sure you are not pregnant.

Albendazole can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor right away if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor right away if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

For patients treated for neurocysticercosis, this medicine may increase your risk for increased pressure in the head or seizures. Tell your doctor right away if you have these symptoms.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter ) medicines and herbal or vitamin supplements.

Albenza side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

  • Fever


  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • chest pain
  • chills
  • cough
  • painful or difficult urination
  • pinpoint red spots on the skin
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Incidence not known

  • Blistering, peeling, or loosening of the skin
  • blurred vision
  • dark-colored urine
  • diarrhea
  • general feeling of tiredness or weakness
  • headache
  • itching
  • joint or muscle pain
  • light-colored stools
  • red, irritated eyes
  • seizures
  • stomach pain, continuing
  • tightness in the chest
  • vomiting
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Stomach pain

Less common

  • Nausea


  • Dizziness
  • thinning or loss of the hair

Incidence not known

  • Lack or loss of strength

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 2019 Truven Health Analytics, Inc. All Rights Reserved.

Related questions

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Medical Disclaimer

More about Albenza (albendazole)

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What should I discuss with my healthcare provider before taking albendazole?

You should not use this medicine if you are allergic to albendazole, or to similar drugs such as mebendazole (Vermox).

To make sure albendazole is safe for you, tell your doctor if you have:

  • liver disease; or
  • bone marrow suppression.

It is not known whether this medicine will harm an unborn baby. Albendazole should not be used during pregnancy, unless there is no alternate treatment. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. Use effective birth control to prevent pregnancy while taking this medicine and for at least 1 month after your treatment ends.

You may need to have a negative pregnancy test before starting this treatment.

It is not known whether albendazole passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take albendazole?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take with food.

In a young child (or anyone who is unable to swallow a whole albendazole tablet), the tablet should be crushed or chewed and swallowed with a full glass of water.

You may be given other medicines to prevent certain side effects of albendazole, or certain effects that can result when the parasites die within your body.

Tell your doctor if you have any changes in weight. Albendazole doses are based on weight.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Albendazole will not treat a viral infection such as the flu or a common cold.

Albendazole can weaken your immune system. Your blood may need to be tested often. You will need frequent blood tests (every 2 weeks) to check your liver function.

Store at room temperature away from moisture and heat.


albendazole – how long does it take to work and kill all the pinworms

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Deworming in children

World Health Organization 64% of the Indian population less than 14 years are at risk of Soil-Transmitted Helminths (STH) infections.

STH transmission

  • There are three main types of STH that infect people: roundworm (Ascaris lumbricoides), whipworm (Trichuris trichiura) and hookworms (Necator americanus and Ancylostoma duodenale).
  • Adult worms live in human intestines for food and survival where they produce thousands of eggs each day.
  • Infected people who defecate outdoors spread worm eggs in their feces.
  • Subsequently, the eggs contaminate the soil which can spread infection in several ways:
    • Attached to vegetables that are ingested when the vegetables are not carefully cooked, washed or peeled;
    • Ingested from contaminated water sources;
    • Ingested by children who play in soil and then put their hands in their mouths without washing them.

Symptoms of infection

  • Regular treatment of at-risk populations will reduce the intensity of infection and protect infected individuals from morbidity.
  • The greater the amount of worms in an individual (intensity), the more symptoms the infected individual will have.
  • People with light infections usually have no symptoms.
  • Heavier infections can cause a range of symptoms including diarrhea, abdominal pain, and weakness.
  • Loss of appetite.

Harms associated with having worms

Effect of STH on the nutritional status of children

Worms impair the nutritional status of people they infect in multiple ways:

  • Worms feed on host tissues, including blood, which leads to a loss of iron and protein and often contributes to anaemia.
  • Worms can increase the malabsorption of nutrients; roundworm may compete for Vitamin A in the intestine.
  • Some worms can cause a loss of appetite, reducing nutritional intake and physical fitness.
  • Some worms can cause diarrhea and dysentery.

Development and educational consequences of worms in children

Worms have negative effects on the mental and physical development of children. Children with worms are often underweight and have stunted growth. Heavy infections often make children too sick or too tired to concentrate at or even attend school. Long term, children not treated for worms are shown to earn less as adults.

Effect of worms on child mortality

Intestinal worm infections affect child morbidity, not mortality. There is not rigorous evidence that suggests that worms affect child mortality but there is ample evidence that worms fundamentally affect the quality of children’s lives and negatively impact their access to health, education and livelihoods.

Prevention of infection

Infections can be prevented by taking precautions, including:

  • Using sanitary toilets, not defecating outside.
  • Keep the surroundings clean
  • Hand-washing, particularly before eating and after using toilets.
  • Wearing slippers and shoes.
  • Washing fruits and vegetables in safe and clean water.
  • Properly cooking food; Keeping cooked food covered
  • Always drink clean water

Deworming treatment given to children

Albendazole and Mebendazole are the names of the deworming drugs used by the Government of India and is a safe treatment for intestinal worms. The recommended dosage is as follows

  • For children of 2 years and upwards – : 1 tablet Albendazole (400 mg) or 1 tablet Mebendazole (500 mg)
  • For children of age 1 – 2 years – ½ tablet of Albendazole (400 mg) or 1 tablet of Mebendazole (500 mg)

Appropriate administration of tablets to children between the ages of 1 and 3 years is important. The tablet should be broken and crushed between 2 spoons, then safe water added to help administer the drug. The older children should chew the tablet and if required should consume some water.

Side effects of deworming treatment

The deworming treatment has very few side effects. There may be some mild side effects like dizziness, nausea, headache, and vomiting, all likely due to the worms being passed through the child’s body. These side effects disappear after some time. Side effects are usually experienced by children with high infections. If symptoms do not go away within 24 hours, or if they are very severe, the child is probably experiencing something unrelated to the treatment and should be taken to the nearest health facility.

Benefits of treatment

Rigorous studies have shown that deworming has a significant impact on the health, education and livelihoods of treated children. Outcomes of deworming can include:

  • Decreases anaemia and improves nutrition
  • Increases growth and weight gain
  • Improves cognition and mental and physical development
  • Increases resistance to other infections
  • Supports more frequent school attendance
  • Improves children’s ability to learn better and be more active in school
  • Increase hours worked and wages earned in the long-run in adulthood

Deworming also has important spillover effects, meaning that other members of the community who do not receive treatment benefit, as there are fewer worms in the environment. This is especially important for children who are too young to be treated but for whom worms can greatly impair cognitive development.

National Deworming Day 2019

With an aim to intensify efforts towards STH control among children in India, the Ministry of Health & Family Welfare, Government of India (GoI) observes the National Deworming Day (NDD) bi-annually on 10th February and 10th August in all states and UTs followed by mop-up activities. This year the NDD is being conducted on 8th February and mop up day on the 14th February. The biennial round (recommended in selected states based on worm prevalence data) is being conducted on August 8 followed by a mop-up activities on August 16. The Mop-Up Day (MUD) on 14th February 2019 and August 16th 2019 is being organised with the intent of deworming children who missed the dose on February 10th and August 8th respectively. All Government and Government aided schools and anganwadi centers will be the sites for implementation of National Deworming Day across the country.

Currently largest single day public health program in the world, the National Deworming Day this year is set to reach 32.81 crore children and adolescents in 30 states/UTs, in the age group of 1-19 years.

Target audience – All children (both boys and girls) in the age group of 1-19 years.

The NDD is being implemented through the combined efforts of Department of School Education and Literacy under Ministry of Human Resource and Development, Ministry of Women and Child Development and Ministry of Drinking Water and Sanitation.

Source : National Deworming Day – Training toolkit

Generic Name: albendazole (al BEN da zole)
Brand Name: Albenza

Medically reviewed by on Aug 30, 2019 – Written by Cerner Multum

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

What is Albenza?

Albenza is an anthelmintic (an-thel-MIN-tik) or anti-worm medication. It prevents newly hatched insect larvae (worms) from growing or multiplying in your body.

Albenza is used to treat certain infections caused by worms such as pork tapeworm and dog tapeworm.

Albenza may also be used for purposes not listed in this medication guide.

Important Information

Albenza may harm an unborn baby. Use effective birth control while taking Albenza and for at least 3 days after your last dose.

Before taking this medicine

You should not use this medicine if you are allergic to Albenza, or to similar drugs such as mebendazole.

Tell your doctor if you have ever had:

  • eye problems (especially a problem with your retina);

  • liver disease; or

  • bone marrow suppression.

Albenza may harm an unborn baby. Use effective birth control to prevent pregnancy while taking this medicine and for at least 3 days after your last dose. Tell your doctor if you become pregnant.

You may need to have a negative pregnancy test before starting this treatment.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How should I take Albenza?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Take with food.

If you cannot swallow the tablet whole, you may crush or chew it and swallow with a full glass of water.

You may be given other medicines to prevent certain side effects of albendazole, or certain effects that can result when the parasites die within your body.

Albenza doses are based on weight (especially in children and teenagers). Your dose needs may change if you gain or lose weight.

Use Albenza for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Albenza will not treat a viral infection such as the flu or a common cold.

Albenza can increase your risk of bleeding or infection. You will need frequent medical tests.

Your liver function may also need to be checked every 2 weeks.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Albenza?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Albenza side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fever, chills, sore throat, mouth sores, feeling light-headed;

  • a seizure; or

  • increased pressure inside the skull–severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes.

Common side effects may include:

  • headache, neck stiffness, increased sensitivity to light, confusion;

  • fever;

  • nausea, vomiting, stomach pain;

  • abnormal liver function tests;

  • dizziness, spinning sensation; or

  • temporary hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Albenza?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your other medicines, especially:

  • dexamethasone;

  • praziquantel; or

  • cimetidine.

This list is not complete. Other drugs may affect Albenza, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 4.01.

  • Albendazole – how long does it take to work and kill all the pinworms?
  • What are Zentel 400mg used for?
  • Pinworm Infection (Enterobius vermicularis) – how long does albenza take to work?

Medical Disclaimer


Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The adverse reaction profile of ALBENZA differs between hydatid disease and neurocysticercosis. Adverse reactions occurring with a frequency of 1% or greater in either disease are described in Table 2 below.

These symptoms were usually mild and resolved without treatment. Treatment discontinuations were predominantly due to leukopenia (0.7%) or hepatic abnormalities (3.8% in hydatid disease). The following incidence reflects adverse reactions that were reported to be at least possibly or probably related to ALBENZA.

Table 2: Adverse Reaction Incidence 1% or Greater in Hydatid Disease and Neurocysticercosis

Adverse Reaction Hydatid Disease Neurocysticercosis
Abdominal Pain 6 0
Nausea 4 6
Vomiting 4 6
General disorders and administration site conditions
Fever 1 0
Elevated Hepatic Enzymes 16 less than 1
Nervous system disorders
Dizziness 1 less than 1
Headache 1 11
Meningeal Signs 0 1
Raised Intracranial Pressure 0 2
Vertigo 1 less than 1
Skin and subcutaneous tissue disorders
Reversible Alopecia 2 less than 1

The following adverse events were observed at an incidence of less than 1%:

Blood and Lymphatic System Disorders : There have been reports of leukopenia, granulocytopenia, pancytopenia, agranulocytosis, or thrombocytopenia .

Immune System Disorders : Hypersensitivity reactions, including rash and urticaria.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of ALBENZA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Blood and Lymphatic System Disorders : Aplastic anemia, bone marrow suppression, neutropenia.

Eye Disorders : Vision blurred.

Gastrointestinal Disorders : Diarrhea.

General System Disorders : Asthenia.

Hepatobiliary Disorders : Elevations of hepatic enzymes, hepatitis, acute liver failure.

Musculoskeletal and Connective Tissue Disorders : Rhabdomyolysis.

Nervous System Disorders : Somnolence, convulsion.

Renal and Urinary Disorders : Acute renal failure.

Skin and Subcutaneous Tissue Disorders : Erythema multiforme, Stevens-Johnson syndrome.

Read the entire FDA prescribing information for Albenza (Albendazole)

The Effect of Deworming Using Triple-Dose Albendazole on Nutritional Status of Children in Perobatang Village, Southwest Sumba, Indonesia


High prevalence of STH leads to malnutrition, anemia, cognitive impairment, and growth disorders. Triple-dose albendazole 400 mg is a broad-spectrum anthelminthic; however, its effectiveness varies in every region. This study aims to determine the benefits of deworming using triple-dose albendazole on children’s nutritional status in Perobatang Village, Southwest Sumba, Indonesia. This pre-post study was conducted in July 2016 and January 2017. Children aged 1–15 years were asked to collect stool for diagnosis of STH infection (Kato-Katz method), were measured for anthropometry status to obtain the nutritional status, and took albendazole 400 mg for three consecutive days. Data was analyzed with SPSS version 20. Prevalence of STH prior to the treatment was 95.4%: T. trichiura 85.2%, A. lumbricoides 71.6%, and hookworm 18.2%. After treatment, prevalence of STH decreased significantly (McNemar test, ) to 53.4%, (T. trichiura 39.8%, A. lumbricoides 22.7%, and hookworm 1.1%). Before treatment, 33% participants were in normal nutritional status, 47.7% underweight, and 19.3% severely underweight. After treatment, children in normal nutritional status increased to 75%, underweight children decreased to 25%, and there were no severely underweight children. In conclusion, deworming with triple-dose albendazole 400 mg is effective in improving the nutritional status of children in Perobatang Village.

1. Background

Soil transmitted helminths (STH) are worms whose life cycle requires soil for its embryonic maturation process. The most common STH infecting humans are A. lumbricoides, T. trichiura, and hookworm (A. duodenale and N. americanus) .

In Indonesia, especially in areas with poor hygiene, sanitation, and low socioeconomic status, the prevalence of STH is still high. In 2013, the prevalence of STH infection in various districts of Indonesia was more than 20%, one of which is located in Southwest Sumba District (SSD) . Perobatang Village is an underdeveloped area in SSD which has difficulty in obtaining clean water; thus, water is used for drinking and cooking only, rarely for hand washing before eating and after defecating. This condition is worsened by the practice of open defecation, a risk factor for STH infection .

STH could infect people in all ages but more often in children due to poor personal hygiene. A. lumbricoides and T. trichiura affect the process of digestion, absorption, and food metabolism, whereas hookworms cause chronic intestinal blood loss that result in anemia. Therefore, STH could cause physical and cognitive developmental disorders and decrease body immunity, making it susceptible to other diseases . Hence, deworming should be done in areas with high risk of STH.

STH control could resolve anemia and in turn improve children’s nutritional status . According to WHO, if a sampling area shows STH prevalence is more than 50%, mass treatment should be conducted every 6 months and once a year when prevalence is 20–50%, and if the prevalence is less than 20%, selective treatment is carried out using single dose of 400 mg albendazole .

Single-dose albendazole is effective in controlling A. lumbricoides and hookworm but not T. trichiura. For treatment of T. trichiura, triple-dose albendazole gave higher cure rates (56%) than single dose (31%) . However, the cure rates of albendazole vary geographically. Based on that fact, it is necessary to conduct a study to investigate the benefits of triple-dose albendazole in reducing STH prevalence and its effect on improving the nutritional status of children in Perobatang Village, SSD. The village was chosen due to high risk of STH infection and there was no history of previous mass drug administration with albendazole in the village.

2. Methods and Materials

This study used a pre-post study design and was conducted in Perobatang Village, SSD, Indonesia (Figure 1). Data was taken in July 2016 (pretest) and January 2017 (posttest). All children aged 1–15 years who were willing (having parental permissions) to follow the study and did not take anthelmintic in the last six months were included. Severely ill or febrile children were excluded. The dropout criteria were participants who did not collect the fecal samples or did not present during the posttest.

Figure 1 Geographical map of study location. Tambolaka is the capital of SSD, Indonesia, and Perobatang Village is a 2-hour drive from the capital.

2.1. Procedures

All children in the village were included in the study. The data was collected by performing anthropometry assessment and fecal examination. Data retrieval was done twice at pretest and posttest with six-month interval.

On the first day, participants were given explanation regarding the study and asked for informed consent. To obtain the nutritional status, anthropometry measurement was done by measuring height and weight. The participants were asked to remove any hat, caps, and footwear during height measurement to gather exact measurement. Digital scale, prior to calibrated, was used to measure the weight. After the examination was completed, the participants were given explanation on how to collect the fecal samples. Thumb-sized feces were put into 10 cc pot which had been labeled. On the next day, the pot containing feces was returned to the researcher for Kato-Katz method preparations. The samples were examined by light microscope to identify eggs or larvae of the worms. Kato-Katz method was chosen to count the eggs to determine the intensity of infections. The egg counts were later used to determine the intensity of infection (see Supplementary Table in Supplementary Material available online at

Participants were treated with albendazole 400 mg (2–15 years) and 200 mg (1-2 years) for three consecutive days and the administration of the drugs was witnessed by the researchers. Triple-dose albendazole was administered rather than single dose due to its higher cure rate for T. trichiura . To increase the absorption of albendazole, the drugs were taken with milk and milk biscuits.

The data was analyzed using McNemar test in SPSS version 20 to identify the association between the prevalence of STH before and after the treatment and Wilcoxon test for the nutritional status. Deworming is considered to be successful if there is a significant difference in the decrease of the prevalence of STH and the increase of nutritional status before and after deworming. The value of α was 0.05 and confidence interval (CI) was 95%. value of less than 0.05 is considered significant.

Ethical approval was obtained from the ethics committee Faculty of Medicine Universitas Indonesia number 876/UN2.F1/ETIK/2016.

3. Results

3.1. The Prevalence of STH before and after Deworming

From 192 children aged 1–15 years in Perobatang Village, 109 children were registered as participants of this study; however, 88 participants were included in the analysis due to exclusion and dropout criteria.

Based on the WHO chart of weight-for-age and BMI-for-age, the category of children was divided into two: 1–5 years and 6–15 years. A total of 31 children (35.2%) aged 1–5 years and 57 children (64.8%) aged 6–15 years were included in this study. The prevalence of STH prior to deworming shows very high results (95.4%). STH infection was higher (63.6%) in children aged 6–15 years (Table 1).

Table 1 The prevalence of STH prior to deworming based on age and gender.

Table 2 shows that 95.4% out of 88 participants were infected with STH and after deworming, the infection of STH decreased significantly to 53.4% (McNemar test, ).

Deworming Positive STH 95% CI Negative STH 95% CI
Before 84 (95.4%) 91%–99.8% 4 (4.6%) 0.2%–9%
After 47 (53.4%) 43%–63.8% 41 (46.6%) 36.2%–57%

Table 2 The prevalence of STH before and after deworming.

Table 3 shows that the highest STH infection was T. trichiura (85.2%) and the least common was hookworm (18.2%). The prevalence of A. lumbricoides infection was high (71.6%). The intensity of infection was generally light and moderate.

Table 3 The prevalence of STH based on intensity of infection before and after deworming.

The evaluation six months after deworming showed that the prevalence of infection of each worm species decreased significantly (McNemar test; ). The prevalence of T. trichiura reduced to 39.8%, A. lumbricoides to 22.7%, and hookworm to 1.1%. The intensity of infection decreased; there was no heavy and moderate infections except for T. trichiura (3 children were still positive with moderate intensity of infection). Classification of each intensity of infection is provided in Supplementary Table .

3.2. The Nutritional Status before and after Deworming

The data distribution of body weight, height, and IMT of children is not normal (Shapiro-Wilk test ); therefore, the median is used to count the average. The median weight of children before treatment was 16 kg, height was 113 cm, and BMI was 13.6 kg/m2 (Table 4). Six-month evaluation after deworming showed the increase of body weight, height, and BMI. The median weight increased to 18 kg, height to 115 cm, and BMI to 14.4 kg/m2. Data on body weight and height were analyzed by plotting body weight/age (1–5 years) and BMI/age (6–15 years) to the WHO chart.

Table 4 The children anthropometry results before and after deworming.

Prior to the deworming, 29 children (33%) were within normal nutritional status, 42 children (47.7%) were underweight, and 17 children (19.3%) were severely underweight (Table 5). Six months after deworming, the nutritional status improved, 66 children were within normal nutritional status (75%), underweight dropped to 22 children (25%), and there were no more children with severe underweight. Wilcoxon test shows a significant difference of nutritional status before and after deworming ().

Table 5 The children nutritional status before and after deworming.

4. Discussion

Deworming is an effort in eradicating worms with anthelmintic agents. The effects of deworming, such as the release of 20–30 worms after the treatment, attracted the public to participate in the treatment and education. Education is an important aspect to transform participant’s behavior, otherwise reinfection will occur. To prevent reinfection, communities should change their behavior by regularly washing hands before meals and after passing bowels or after contact with soil. However, behavioral changes are difficult to obtain in poor and remote areas especially when the people are low educated. Therefore, WHO recommends performing mass treatment every six months for at least 5 years; consequently, the worms could be controlled without changing the environment and behavior.

4.1. The Prevalence of STH before and after Deworming

This study shows a significant decrease in STH prevalence, thus indicating that deworming using albendazole 400 mg for three days was effective in controlling STH. The prevalence of A. lumbricoides decreased from 71.6% to 22.7%, T. trichiura from 85.2% to 39.8%, and hookworm from 18.2% to 1.1%. Steinmann et al. reported that triple dose of albendazole 400 mg gave higher cure rates compared to single-dose albendazole and single-dose or triple-dose mebendazole. Triple-dose albendazole gave high cure rates for A. lumbricoides (96.8%) and hookworm (92%). In T. trichiura, the cure rate of triple-dose albendazole was 56.2% and triple-dose mebendazole was 70.7%. Keiser and Utzinger stated that the efficacy of albendazole is higher compared to mebendazole, except for T. trichiura.

Aside from decreasing the prevalence, triple dose of albendazole is also able to reduce the intensity of infection which has a role in transmitting the infection through soil contamination. Positive participants will continue to contaminate the environment; thus, if not retreated immediately, the prevalence will increase rapidly. Therefore, the results of this study should be submitted to the local governments to conduct deworming program every six months for a minimum of five consecutive years. In addition, local governments need to improve the environmental condition by providing clean water and latrines, as well as educating people for good hygiene practices, especially the practice of washing hands with soap.

Jia et al. stated that reinfection will occur in 6–12 months after the treatment with albendazole and mebendazole due to failure of behavioral changes, such as defecating indiscriminately and neglecting washing hands at five important times (before eating, after passing stool, before handling babies, after changing diapers, and before preparing food). Appleton et al. reported that within five months there had been a high reinfection of A. lumbricoides by 75%, T. trichiura by 71%, and hookworm by 48%. Reinfection will return to its baseline prevalence level within 12 months if no retreatment is performed and if retreatment was done twice every six months, the reinfection will be less than 8% .

Okoyo et al. stated that despite the occurrence of reinfection, the first three years of deworming reduced the infections with moderate to heavy intensity, as well as the overall prevalence of STH infection. After deworming twice with triple-dose albendazole, the infection with moderate intensity was significantly reduced by 32.7% for STH combination infection, 86.9% for hookworm, 33.9% for A. lumbricoides, and T. trichiura for 58.4%. Tun et al. performed deworming using triple-dose albendazole for seven years in Myanmar and the results showed a decrease of heavy to moderate intensity infection from 18.5% to less than 7%.

4.2. Nutritional Status before and after Deworming

In this study, children who are underweight were 47.7%, normal nutritional status was 33%, and those severely underweight were 19.3%. After deworming, the nutritional status of the children increased; normal was 75%, underweight was 25%, and no severely underweight was found. Wilcoxon test shows a significant difference () between nutritional status of children before and after deworming, which showed that deworming with triple-dose albendazole effectively improved the nutritional status of STH-infected children.

A. lumbricoides absorbs nutrients from the intestine, thus causing malabsorption and reducing the cognitive abilities in children. T. trichiura adheres in the ascending colon and cecum, which lead to a continuous reflex of defecation; this results in rectal prolapse and chronic diarrhea. T. trichiura inflicts a lesion resulting in intestinal bleeding, which may lead to anemia . Hookworms cause chronic intestinal blood loss that result in iron deficiency anemia . Iron deficiency anemia could decrease nutritional intake and gastrointestinal disorders resulting in malnutrition .

Deworming could control worms and thus may avoid malabsorption, malnutrition, and anemia and subsequently increase the nutritional status. Therefore, in areas with high risk factors of STH, sampling should be done to determine the prevalence of STH and followed by mass treatment using broad-spectrum anthelmintic agents.

Beside the intestinal worms, malnutrition of children in Perobatang Village is caused by lack of nutrient intake due to the limited daily diet composed of rice and sweet potatoes with no side dishes. Although they live on the coast and most of the residents work as fishermen, people rarely eat fish because fish are for sale; thus, only unsold fish could be consumed. Swine and buffalo are only eaten at certain events, such as wedding ceremony and funeral approximately twice a year. In addition, it is also necessary to provide education to improve nutrition by adding more side dishes (not all fish should be sold), breeding chickens for consumption (for meat and eggs), and farming and cooking meat properly (well done) to avoid tapeworm.

5. Conclusion

Deworming with triple-dose albendazole effectively improved the nutritional status of children in Perobatang Village. Before deworming, children with good nutritional status were 33%, underweight were 47.7%, and severely underweight were 19.3%. After deworming, the number of participants with good nutritional status increased to 75%, underweight decreased up to 25%, and severely underweight children were not found. Since the prevalence of STH is high, repeated mass treatment for at least five consecutive years to prevent reinfection is needed.

Conflicts of Interest

The authors declare that there are no conflicts of interest regarding the publication of this article.


This study was supported by grants from the Directorate of Research and Public Services, Universitas Indonesia.

Supplementary Materials

Supplementary Table 1. Classification of STH infection intensity.

  1. Supplementary Material

What To Expect After Deworming a Dog

There are many unpleasant things you are forced to deal with as a dog owner, and your favorite fur pup getting worms or intestinal parasites is one of them. You just cringed, didn’t you? No one wants to deal with these creepy crawlers, and it is highly unpleasant to think that your favorite fur friend carries them around inside their body.

Worm infestations are common in dogs, and a natural part of owning dogs, and there are many effective treatments to turn to if (or more likely – when) your fur bestie gets them. Everyone talks about what to do if a dog gets worms, however, but what can you expect once your pooch has received his or her treatment? When is it over?

Recognizing Signs of Worms

One of the easiest ways to see and confirm that your dog has worms is by looking at its stool. It may sound gross, but it is a good idea to overcome that feeling and to have a peek at your pup’s poo every time he or she does a number two. Do this even when you don’t suspect worms, just to make sure that everything looks the way that it should.

Remember, dogs can’t talk, and they can’t tell you if they are feeling queasy or off, but a dog’s stool says a lot about their general health and wellbeing. Also, this habit can help you spot worms right away so that you can start de-worming treatment before the condition advances.

Worms, however, are sneaky, and they don’t always show up in the dog’s stool. Just because you cannot see them, it is not a guarantee for them not being there. Another sign of a dog having worms is unexplained weight loss. When a dog has worms, the worms greedily “steel” nutrition from its host, so that even if your pup appears to be eating normally – he or she is not getting as many nutrients as would normally be the case. If your dog seems to be slimming down for no apparent reason (no change in food, appetite or activity level), then it could be worth booking a trip to the vet to see what the reason is.

Other signs are vomiting, lethargy, scooting across the floor (when your dog is rubbing its behind on the floor or on carpets), appetite changes, a dull and dry coat, the typical pot-belly or – and especially when dealing with heartworms – coughing. When suspecting that your pup may have worms, it is important to visit a vet to establish what type of worm you are dealing with. If you can – bring a stool sample in for analysis. This is mainly because it can be dangerous to experiment with dewormers unless you know what you are trying to treat.

The Deworming Process

When it comes to your dog’s health, the first step should always be a visit to the vet’s office. They can help you establish what type of worm your pup has, or if the symptoms are caused by something else, and they can recommend a suitable treatment. Some of the most effective worm medications require a prescription, which is yet another good reason for why contacting your trusted veterinarian is a must.

Most dewormers are given orally and will usually be flavored chew treats to make administration easy and stress-free. Just feed it to your pup the way you would any other treat, but double check so that they ate it all, without leaving any pieces or crumbs behind. Not taking the full dosage or forgetting a daily dosage could make the treatment ineffective and giving a bigger dosage than advised can put your pup in danger.

Depending on the medication used, you might have to repeat the treatment over the course of a few days, or it could be enough with only one pill, but this is something your veterinarian will explain to you once having prescribed the medication.

What Dewormer to Use?

Leave the decision for which wormer to use to your veterinarian, rather than to start experimenting on your own. Substance examples are ivermectin, fenbendazole, and milbemycin, where some are given as chews, others injected and some – like selamectin – are topical treatments that are applied directly onto the skin. Which one you should use depends on what types of worms your dog is infested with.

After Deworming – What to Expect?

Once you get to the stage of post-treatment, there are a few things to expect. It is normal for the dog to seem unusually tired and drowsy after receiving worm medication, and in most cases, there is no need to worry. You should let your pups rest as much as they seem to need and avoid any challenging activities for a day or two. Regular walks are okay, but only if your dog seems up for it.

You might also notice a lack of appetite and gastronomical upset, which is also to be considered normal. If it persists for several days, however, or if you notice other signs that you find concerning – do not hesitate to contact your veterinarian. It is always better to be safe than sorry. You can also try dog food to prevent gas in combination with seeing your vet.

Some worm medications dissolve the worms altogether, which means there won’t be any sign of dead ones in your pup’s stool. Others only kill them, and they might then be visible in stool and vomit. Keep a close eye on it to make sure that what is coming out are dead worms, because if they are still alive and crawling, it is possible that your pooch needs another round of medication. One treatment is not always enough, so don’t be discouraged if it does not seem to have worked the first time, and just head back to your vet for round number two.

It cannot be stretched enough how important it is to consult a veterinarian when in doubt and when unsure of how to proceed, or when having questions or concerns regarding your pup’s post-treatment symptoms and behaviors. Expect some side effects after deworming your dog and use common sense for what should be considered normal, and what shouldn’t. Keep the vet’s phone number on the fridge, in your phone or anywhere where you can easily access it, and call if anything seems off.

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Cat Deworming

It is fairly common for a cat to become infected with internal parasites at some point in its lifetime. Most of these worms live in the intestines and feed on the digesting food that is found in the gut or attach to the gut wall and feed on the animal’s blood.

Internal parasites in cats can be acquired in many different ways:

  1. The fetus can be infected by larvae passing through the placenta of the mother;
  2. kittens can be infected by larvae transferred in the mother’s milk;
  3. By ingesting parasite eggs from the environment, for example, other animals’ feces, catching and eating small rodents and birds, or by ingesting fleas while grooming. Some parasites, like hookworms, can penetrate a cat’s skin.

Because these worms come in all shapes and sizes, a fecal analysis may be recommended by your veterinarian in order to determine the exact nature of the intestinal parasite affecting your pet.

What are some internal cat parasites?

Roundworms, whipworms, and hookworms are the most common intestinal parasites of cats. Cats that hunt or are exposed to fleas are also likely to become infected with tapeworms.

What are worm infestation symptoms in cats?

Many cats with a low burden of parasites have little or no clinical signs. Evidence of some types of intestinal worm infections, such as tapeworms, can sometimes be seen in the stool or on the fur around the anus. In these cases usually, small segments of the tapeworms can be seen. However, the majority of intestinal parasite eggs and larvae cannot be seen with the naked eye. Infection of internal parasites can result in poor body condition, weight loss, vomiting, diarrhea and in more severe cases anemia, liver disease, kidney disease, or neurological disorders.

Do worm affect humans?

Some of the worms can be passed on to people. This is referred to as zoonosis. The risk of infection is higher in children due to the amount of time spent outdoors where animals defecate. Young children are also more likely to put their dirty hands in their mouths after playing in the dirt, grass or sand that might be contaminated. Pregnant women and immunocompromised individuals are also at greater risk. When zoonotic roundworms and hookworms infect humans, the parasites rarely mature in the intestine; rather, the larval worms migrate in the host’s tissues (larva migrants).

People become infected with roundworms by accidentally ingesting eggs or larvae that are shed in the feces of infected animals. People can become infected with hookworms through direct skin contact with hookworm larvae in soil contaminated with the feces of infected animals.

When roundworm eggs are accidentally ingested, they hatch, and infective-stage larvae migrate through the human liver, lungs, and other organs and tissues where they produce damage and induce allergic responses. Infection may leave children with permanent visual or neurologic damage. Infection with hookworms causes a cutaneous larva migrants syndrome, which is characterized by progressive, intensely itchy, lesions in the skin.

What is the deworming schedule?

Kittens and their dams are the most susceptible to intestinal parasite infection and thus they are likely to harbour the most worms and produce the most infective-stage larvae. Therefore, they require a more intensive deworming schedule compared to an adult cat. The recommended deworming schedule for kittens is to begin deworming at 6 weeks of age and repeat deworming at 8, 10 and 12 weeks of age. Nursing dams should also be treated concurrently. Kittens should then be dewormed every month until 6 months of age. For adult cats, it is recommended that cats receive monthly dewormers in combination with their flea and heartworm prevention during the summer months, as well as have an annual fecal examination. For all outdoor cats, it is also recommended that they are dewormed 1-2 times a year for tapeworms.

Any deworming medication side effects?

Deworming products are quite safe and rarely have side effects when used at the correct dose. The most common side effects include vomiting, diarrhea, excessive salivation, and hair loss at the site of application if a topical product is used. If you notice any unusual behaviours in your cat after administering a dewormer, please contact your veterinarian.

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