{
  "abstract": "BackgroundThe primary approach to controlling soil-transmitted helminths (STH) is preventive chemotherapy using single-dose benzimidazoles. However, single-dose regimens frequently result in suboptimal clearance against species like Trichuris trichiura and hookworm. This systematic review and meta-analysis evaluated the comparative efficacy of repeated-dose versus standard single-dose albendazole or mebendazole regimens in paediatric populations.\n\nMethodsRegistered prospectively on PROSPERO (CRD420261491616), a comprehensive search of PubMed, Embase, Cochrane Library, and Google Scholar was conducted from database inception up to September 1, 2026, restricted to English-language publications. The search identified clinical trials comparing repeated-dose against single-dose albendazole or mebendazole in paediatric STH infections. Primary outcomes were cure rate (CR) and egg reduction rate (ERR). Random-effects models synthesized pooled odds ratios (OR) and mean differences (MD). Risk of bias was assessed using the Cochrane RoB 2 tool.\n\nResultsFive randomized clinical trials (N = 1,718 participants) met the inclusion criteria. Overall, repeated dosing demonstrated significant superiority in cure rate (pooled OR = 4.47, 95% CI: 1.58-12.67; I{superscript 2} = 92%) and egg reduction rate (pooled MD = 0.17, 95% CI: 0.01-0.32; I{superscript 2} = 87%).\n\nDiscussionRepeated-dose benzimidazole regimens offer superior overall therapeutic efficacy compared to standard single-dose administration in children. However, this therapeutic advantage is drug-specific: multi-dose albendazole consistently enhances parasite clearance across trial settings, whereas multi-dose mebendazole exhibits variable performance and lacks conclusive superiority over single dosing.\n\nConclusionTransitioning to targeted, multi-dose albendazole protocols--rather than mebendazole--may serve as an effective public health intervention to eliminate residual parasite reservoirs in high-transmission endemic regions.\n\nAuthor summaryWhile current WHO guidelines recommend single-dose preventive chemotherapy for soil-transmitted helminths, standard regimens often fail to achieve optimal clearance for Trichuris trichiura and hookworms. Our meta-analysis of randomized clinical trials (N = 1,718 children) demonstrates that repeated-dose regimens significantly improve cure rates (pooled OR = 4.47; post-sensitivity OR = 2.60) and egg reduction rates (pooled MD = 0.17; post-sensitivity MD = 0.08), driven specifically by albendazole (cure rate OR = 3.10, I-squared = 7%; egg reduction rate pooled MD = 0.07, 95% CI: 0.03-0.11, I-squared = 0%, Z = 3.29, P = 0.001) rather than mebendazole. This work provides key empirical evidence that shifting public health policy from single-dose mass drug administration to targeted, multi-dose albendazole in high-transmission hotspots can effectively eliminate persistent parasite reservoirs and prevent therapeutic failure.",
  "abstract_shown": true,
  "affiliations": [
    "Government Medical College Badaun"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "N. Singh"
    },
    {
      "name": "P. Sahu"
    },
    {
      "affs": [
        0
      ],
      "name": "V. Singh"
    },
    {
      "name": "P. P. Bharti"
    },
    {
      "name": "A. M. Siddiqui"
    },
    {
      "name": "A. Kumar"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cs2q7hk9jye6x.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.09.26365109",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365109v1.full",
  "id": "cs2q7hk9jye6x",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365109v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "pediatrics"
    ],
    [
      "openalex",
      "2405|Parasites and Host Interactions"
    ]
  ],
  "openalex": "W7221567252",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365109v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cs2q7hk9jye6x.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:43Z",
      "native_id": "10.64898/2026.10.09.26365109",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365109v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:pediatrics",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Efficacy of Repeated-Dose Albendazole/ Mebendazole Regimens for Soil-Transmitted Helminth Infections in Paediatric Population: A Systematic Review and Meta-Analysis",
  "title_text": "Efficacy of Repeated-Dose Albendazole/ Mebendazole Regimens for Soil-Transmitted Helminth Infections in Paediatric Population: A Systematic Review and Meta-Analysis",
  "type": "preprint",
  "updated_at": "2026-10-30T12:20:43Z",
  "url": "https://research.draconitic.com/paper/cs2q7hk9jye6x",
  "venue": "medRxiv",
  "versions": []
}