Combination Therapy Improves Treatment of Whipworm in Children

17.07.2025

A new clinical trial led by Swiss TPH and partners on Pemba Island, Tanzania, has shown that combining moxidectin with albendazole is far more effective than current standard treatment for whipworm infections in school-aged children. Published in The Lancet Infectious Diseases, the results strengthen the evidence base for expanding current treatment options and are expected to inform future guide-lines for soil-transmitted helminth control.

The trial is the first to demonstrate the efficacy of moxidectin–albendazole in school-aged children, who are the most affected group by whipworm and the primary target for preventive chemotherapy. (Photo: AdobeStock)

High burden of parasitic worm infections

The whipworm Trichuris trichiura is one of the most persistent soil-transmitted helminths, affecting over 270 million people globally, with children in low-income settings most at risk. While large-scale deworming efforts rely primarily on benzimidazoles such as albendazole, these monotherapies have long shown poor efficacy against T. trichiura, limiting progress toward elimination.

To address this gap, researchers from Swiss TPH and the Public Health Laboratory Ivo de Carneri on Pemba Island, Tanzania, conducted a phase III randomised, double-blind trial among 224 children aged 6–11, testing the efficacy and safety of the combination therapy moxidectin–albendazole.

High cure rate of moxidectin–albendazole

The results are clear: moxidectin–albendazole achieved cure rates of 69%, compared to just 16% with albendazole alone, and reduced egg counts by 99% versus 64%, demonstrating clear superiority across both light and moderate infections. The study, conducted on Pemba Island, Tanzania, was published on 14 July 2025 in the peer-reviewed journal The Lancet Infectious Diseases.

“This is a significant milestone,” said Annina Schnoz, co-first author of the study and PhD candidate at Swiss TPH. “Our results confirm that moxidectin–albendazole is not only safe and well tolerated in young children, but also highly effective.”

Focus on school-aged children

The trial is the first to demonstrate the efficacy of this combination in school-aged children — the group most affected by whipworm and the primary target for preventive chemotherapy. Until now, moxidectin’s use had been limited to individuals aged 12 and older, following its approval for treating onchocerciasis.

“Moxidectin–albendazole can be administered as a single dose, which makes it a compelling option for integration into mass drug administration programmes,” added Viviane Sprecher, co-first author and PhD candidate at Swiss TPH.

Informing policy

The authors hope that their findings will inform future World Health Organization (WHO) guidelines for soil-transmitted helminth control and help expand the limited treatment toolbox, supporting more effective and pragmatic approaches to deworming in endemic regions.

“This study adds a powerful new option to the limited range of treatments available,” said Jennifer Keiser, Principal Investigator and Head of the Helminth Drug Development unit at Swiss TPH. “Ultimately, we need pragmatic, integrated strategies that combine better drugs with effective delivery systems and broader public health measures.”

Expertise in parasitic worm infections

Swiss TPH is a global leader in parasitic worm research, combining laboratory science, clinical trials, and field implementation. As a WHO Collaborating Centre, we work across the full R&D pipeline to develop and validate new treatments, inform global guidelines, and strengthen control programmes in endemic settings.