Effect of a single dose of diethylcarbamazine, albendazole or both on the clearance of Wuchereria bancrofti microfilariae and antigenaemia among microfilaria carriers: A randomized trial.
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2010-03
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Abstract
Background. Lymphatic filariasis is a major vector-borne
parasitic disease. The global programme to eliminate lymphatic
filariasis was launched in 1997 and currently over 570 million
people are covered under it in 48 countries. Mass annual
single-dose drug administration of diethylcarbamazine (DEC),
co-administrated with albendazole for 5–6 years and mass
distribution of diethylcarbamazine-fortified salt are the two
strategies for elimination of filariasis.
Methods. Asymptomatic volunteers residing in Puducherry,
India were screened for microfilaria (mf) by examining nocturnal
thick blood smears. Those testing positive were randomly
assigned to receive a single dose of DEC (6 mg/kg body weight)
or albendazole 400 mg or both. Participants were hospitalized
for 5 days. Membrane filtration count was used to assess microfilaraemia
and ELISA (Og4C3) assay to measure circulating
filarial antigens (CFA). Measurements were done before
treatment and at 1, 2 and 3 years post-treatment. Viability of
the adult worms was assessed by looking for the filarial dance
sign (FDS) using ultrasound examination of the scrotum in
men with hydrocele.
Results. Fifty-four microfilaraemic individuals were studied.
The mf prevalence started decreasing only by day 180 posttreatment
in the DEC group but much earlier in the other two
groups (day 30 in the albendazole and day 90 in the DEC with
albendazole group). The decrease in mf was marginal (17.6%,
26.3% and 27.8%, respectively) by the end of year 1 posttreatment,
but significant (96.7%, 78.6% and 93.3%,
respectively) by the end of year 2 post-treatment (p<0.05).
By the end of year 3, the level decreased to 80% in the DEC,
90% in the albendazole and to 100% in the DEC and
albendazole groups. However, the mf intensity decreased
© The National Medical Journal of India 2010
Vector Control Research Centre, Department of Health Research (ICMR),
Indira Nagar, Puducherry 605006, India
S. L. HOTI, S. P. PANI, P. VANAMAIL, K. ATHISAYA MARY,
L. K. DAS, P. K. DAS
Correspondence to S. L. HOTI; slhoti@yahoo.com
significantly (by 39%; p<0.05) by day 7 post-treatment in
both the DEC and DEC with albendazole groups, but only by
day 30 in the albendazole group. In all the drug groups, the
prevalence as well as intensity of CFA returned to pretreatment
levels by the end of year 3 post-treatment.
Conclusion. Annual single-dose administration of all the 3 drug regimens significantly reduced antigenaemia levels. There were no significant differences in the efficacy and overall pattern of CFA clearance between the 3 drug regimens.
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Hoti S L, Pani S P, Vanamail P, Mary K Athisaya, Das L K, Das P K. Effect of a single dose of diethylcarbamazine, albendazole or both on the clearance of Wuchereria bancrofti microfilariae and antigenaemia among microfilaria carriers: A randomized trial. National Medical Journal of India. 2010 Mar-Apr; 23(2): 72-76.