Albendazole metabolites excretion in human saliva as a biomarker to assess treatment compliance in mass drug administration (MDA) anthelmintic programs

Abstract

Soil-transmitted-helminth (STH) infections continue to be a persistent global public health problem. Control strategies for STH have been based on the use of mass drug administration (MDA). Coverage and compliance assessment is critical to understanding the true efectiveness of albendazole (ABZ) in those MDA programs.The aims of this work were to characterize the pattern of albendazole and metabolites excretion in human saliva, and to develop a saliva-based biomarker (HPLC drug/ metabolite detection) useful to accurately estimate the coverage/compliance in MDA campaigns.The study subjects were 12 healthy volunteers treated with a single oral dose of ABZ (400 mg). Saliva and blood (dried blood spot, DBS) samples were taken previously and between 2 and 72 h post-treatment. The samples were analyzed by HPLC with UV detection, C18 reversed-phase column. ABZ sulphoxide was the main analyte recovered up to 72 h p.t. in blood and saliva. The concentration profles measured in the blood (DBS samples) were higher (P< 0.05) than those in saliva, however, this ABZmetabolite was recovered longer in saliva.The in vivo measurement of drugs/metabolites in saliva samples from ABZ-treated volunteers ofers strong scientifc evidence to support the use of saliva as a valid biological sample for assessing compliance in MDA programs.