Could a mango-flavoured pill end intestinal worms?

A new tablet being developed to cure intestinal worms has shown promising results in trials and could help eradicate the parasitic infection, which affects about 1.5 billion people globally, researchers say.

The mango-flavoured pill is a combination of two existing anti-parasitic drugs that, used together, appear more effective in getting rid of worms.

These worms are caught through contact with food or water that has been infected by soil contaminated with worm eggs and infections cause severe gastrointestinal symptoms, malnutrition and anaemia.

Researchers say the pill could help overcome any future drug resistance problems and better manage the disease on a large scale.

The parasites, also known as soil-transmitted helminths (STHs), include whipworm and hookworm and are endemic in many developing countries where hygiene levels are poor.

Many of those affected are children and there is no preventative treatment other than better sanitation.

According a study, called “ALIVE”, published in the Lancet, this new pill could help countries most affected reach goals set by the World Health Organization to eliminate the diseases.

It would be taken as a fixed-dose of of either one single pill or three tablets over consecutive days.

Researchers from eight European and African institutions say it would be a simple way to cure large numbers of people in mass treatment programmes.

“It is easy to administer, as it is one single pill,” says project leader Prof Jose Muñoz.

“Also, we hope that combining two drugs with different mechanisms of action will reduce the risk of the parasites becoming drug-resistant,” Prof Muñoz says.

Once a person is infected, the parasites root themselves in people’s digestive tracts.

While the drug albendazole is good at treating some species of STH, it appears to be becoming less effective in tackling some others.

During a clinical trial involving 1,001 children aged between 5-18 in Ethiopia, Kenya and Mozambique, it was found to be more effective on more types of infection when combined with the drug ivermectin.

However, researchers said the results were not conclusive on how well it treated threadworm.

Prof. Hany Elsheikha, an expert in parasitology at the University of Nottingham said the pill could be a “significant improvement over other treatments” and could be used against multiple parasites.

“There are some challenges with existing medications…so this could be a major, major addition.”

However, he said that while the study was “promising”, it had “some gaps”.

“We don’t know if the results would be the same for adults, mature people, younger kids, people in other parts of the world.”

The results of the trial have been submitted to regulators in Europe and Africa, with decisions expected in early 2025.

Participants are now being recruited to take part in a further trial on 20,000 people in Kenya and Ghana.

Dr Stella Kepha, a researcher at Kenya Medical Research Institute who worked on the study said the pill had ” great potential for improving the health of affected communities” but that there was still “work to do” to widely roll out the treatment.