Albendazole: a broad spectrum anthelminthic for treatment of individuals and populations.

It is over 25 years ago since the original animal research was conducted into albendazole. This review highlights some important steps in fundamental research and the management of helminth disease that have occurred in the past year, appearing in the published literature. In recent years there have been several published studies on lymphatic filariasis and on the impact of albendazole treatment on growth and nutrition. Recent work consolidates some of these data and supplies substantive evidence of benefit especially in the area of hookworm anaemia. Why treatment of helminths actually produces these effects has not been understood, but investigations have begun to highlight the underlying mechanisms that relate to immunity. During the last year several reviews of diagnosis and management of helminth diseases have been published which provide much needed guidance on the effective use of albendazole, and its place in treatment overall. In common with many other parasitic diseases, the validity of using single agents is being challenged, and combination therapy is being investigated at the experimental level and in clinical practice to improve therapeutic responses and to reduce the risk of resistance to the limited range of drugs currently available. Albendazole has changed from being a drug for individuals with worms to one to treat communities and provide benefit in public health terms. In systemic parasitic disease, however, albendazole remains a treatment for individuals. Nearly 20 years of research and of clinical use has refined the tool, but new investigations suggest that much additional study is required before we fully understand helminth parasites and the benefits of treating them.