High Efficacy of Triclabendazole/Ivermectin Combination Compared to Triclabendazole Monotherapy for Treating Human Fascioliasis in Upper Egypt: A Prospective Study
Abstract
1. Introduction
2. Methods
2.1. Patient Recruitment and Diagnosis
2.2. Treatment Regimens and Follow-Up
2.3. Statistical Analysis
3. Results
3.1. Characteristics of the Study Population
3.2. Clinical, Laboratory, and Radiological Data of the Participants
3.3. Evaluation of Treatment Response
3.4. Factors Associated with Treatment Response
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
TCBZ | Triclabendazole |
IVM | Ivermectin |
NTDs | Neglected tropical diseases |
WHO | World Health Organization |
HFL | Hepatic focal lesion |
References
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Items | Total n = 136 (n, %) | TCBZ (n = 65) (n, %) | TCBZ + IVM (n = 71) (n, %) | p-Value |
---|---|---|---|---|
Gender: | ||||
Females | 77 (56.6) | 33 (44) | 44 (62) | 0.188 |
Males | 59 (43.4) | 32 (27) | 27 (38) | |
Age (years) (mean ± SD) | 33.6 ± 17.3 | 31.6 ± 18.2 | 35.5 ± 16.4 | 0.195 |
Residence: | ||||
Rural | 100 (73.5) | 46 (54) | 54 (76.1) | 0.485 |
Urban | 36 (26.5) | 19 (17) | 17 (23.9) | |
Chronic fascioliasis | 17 (12.5) | 9 (13.8) | 8 (11.3) | 0.650 |
Fasciola antibody levels (mean) | 890.6 ± 390.3 | 960 ± 396 | 827 ± 376.7 | 0.047 * |
Items | Before TCBZ (n = 65) (n, %) | After TCBZ (n = 65) (n, %) | p-Value | Before TCBZ + IVM (n = 71) (n, %) | After TCBZ + IVM (n = 71) (n, %) | p-Value |
Fever | 44 (67.7) | 5 (7.7) | 0.000 * | 32 (45.1) | 0 | <0.001 * |
Abdominal pain | 63 (96.9) | 8 (12.3) | 0.000 * | 71 (100) | 3 (4.2) | <0.001 * |
Ascites | 7 (10.8) | 0 | 0.016 * | 4 (5.6) | 0 | 0.125 |
HFL | 25 (38.5) | 8 (12.3) | 0.000 * | 41 (57.7) | 6 (8.5) | <0.001 * |
Presence of ova in stool | 6 (9.2) | 1 (1.5) | 0.063 | 4 (5.6) | 1 (1.4) | 0.250 |
ALT (IU/L) (median) | 35 (28) | 30 (12) | 0.000 * | 31 (20) | 25 (12) | <0.001 * |
AST (IU/L) (median) | 32 (28.5) | 26 (12) | 0.000 * | 28 (19) | 22 (11) | <0.001 * |
WBCs cells/μL (median) | 10,500 (8830) | 8600 (3355) | 0.000 * | 10,500 (6140) | 7430 (3020) | <0.001 * |
Eosinophilic count (median) cells/μL | 3576 (5717) | 970 (1854.5) | 0.000 * | 3250 (6500) | 400 (400) | <0.001 * |
Eosinophilic percent (median) | 36 (29) | 13 (17.8) | 0.000 * | 30 (37.5) | 6 (6) | <0.001 * |
Items | TCBZ (n = 65) (n, %) | TCBZ + IVM (n = 71) (n, %) | p-Value |
Clinical response | 56 (86.2) | 68 (95.8) | 0.048 * |
Eosinophilic response | 21 (32.3) | 50 (70.4) | <0.001 * |
Radiological response | 18 (27.7) | 35 (49.3) | 0.036 * |
Complete response | 17 (26.2) | 40 (53.3) | <0.001 * |
Variables | p-Value | OR | CI Upper Level | CI Lower Level |
Age | 0.234 | 0.985 | 0.961 | 1.010 |
Gender | 0.841 | 0.915 | 0.382 | 2.189 |
Residence | 0.899 | 0.938 | 0.351 | 2.509 |
Duration of symptoms | 0.297 | 0.992 | 0.976 | 1.007 |
HFL at baseline | 0.330 | 0.648 | 0.271 | 1.552 |
High eosinophil counts at baseline | 0.009 * | 1.000 | 1.000 | 1.000 |
Treatment type | 0.168 | 1.860 | 0.770 | 4.494 |
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Hassan, W.A.; Ramadan, H.K.-A.; Gaber, M.; Alkhalil, S.S.; Ahmad, A.A. High Efficacy of Triclabendazole/Ivermectin Combination Compared to Triclabendazole Monotherapy for Treating Human Fascioliasis in Upper Egypt: A Prospective Study. Trop. Med. Infect. Dis. 2025, 10, 221. https://doi.org/10.3390/tropicalmed10080221
Hassan WA, Ramadan HK-A, Gaber M, Alkhalil SS, Ahmad AA. High Efficacy of Triclabendazole/Ivermectin Combination Compared to Triclabendazole Monotherapy for Treating Human Fascioliasis in Upper Egypt: A Prospective Study. Tropical Medicine and Infectious Disease. 2025; 10(8):221. https://doi.org/10.3390/tropicalmed10080221
Chicago/Turabian StyleHassan, Waleed Attia, Haidi Karam-Allah Ramadan, Mona Gaber, Samia S. Alkhalil, and Alzahraa Abdelraouf Ahmad. 2025. "High Efficacy of Triclabendazole/Ivermectin Combination Compared to Triclabendazole Monotherapy for Treating Human Fascioliasis in Upper Egypt: A Prospective Study" Tropical Medicine and Infectious Disease 10, no. 8: 221. https://doi.org/10.3390/tropicalmed10080221
APA StyleHassan, W. A., Ramadan, H. K.-A., Gaber, M., Alkhalil, S. S., & Ahmad, A. A. (2025). High Efficacy of Triclabendazole/Ivermectin Combination Compared to Triclabendazole Monotherapy for Treating Human Fascioliasis in Upper Egypt: A Prospective Study. Tropical Medicine and Infectious Disease, 10(8), 221. https://doi.org/10.3390/tropicalmed10080221