Background We aimed to find out whether symptomless infection with Tri
churis trichiura is associated with impairment of growth and to assess
the effect of a multiple-doses regimen of anthelmintic drugs on the g
rowth of children. Methods In a community based trial, 622 Mexican chi
ldren were randomly allocated one of three treatment regimens: 3 days
of albendazole 400 mg daily (high efficacy); one dose of albendazole 4
00 mg (moderate efficacy); one dose of pyrantel (pyrantel embonate) 11
mg/kg (low efficacy). Growth was monitored for 12 months. Analyses we
re by intention to treat. Findings 113 (18%) children were lost to fol
low-up-34 from the pyrantel group, 45 from the albendazole 400 mg grou
p, and 34 from the albendazole 1200 mg group. Among the 127 children w
ith heavy pretreatment infections, albendazole 1200 mg was better than
pyrantel in terms of an increase in arm circumference (mean 0.26 cm,
p=0.044), Among the 381 children with low pretreatment levels of infec
tion, changes in weight (mean difference between groups -0.33 kg, p=0.
036), arm circumference (-0.18 cm, p=0.0095), and thickness of triceps
skinfold (-0.41 mm, p=0.0031) were less in children on albendazole 12
00 mg than in those on pyrantel. Interpretation Symptomless trichurias
is impairs growth and albendazole or pyrantel may affect growth, indep
endently of a therapeutic action on parasites. Possible toxic effects
of high-dose albendazole require further investigation.