Combination ivermectin plus diethylcarbamazine, a new effective tool for control of lymphatic filariasis.
In 1993, a three arm double-blind controlled trial was implemented in French Polynesia, to compare the tolerance and efficacy of single doses of the combination ivermectin (IVR) 400 micrograms.kg-1 plus diethylcarbamazine (DEC) 6mg.kg-1 vs IVR 400 micrograms.kg-1 or DEC 6 mg.kg-1 alone, for treatment of Wuchereria bancrofti carriers. Of the 57 treated male patients in whom microfilaremia (mf) densities ranged from 22 to 4,709 mf/ml, three groups of 19 were randomly selected, and allocated to one of the three treatments. Twelve months after treatment 37%, 16% and 16% of patients were mf negative in groups DEC, IVR and IVR plus DEC respectively. Mf percent return to pretreatment level was significantly lower in the group IVR + DEC (1.9%) than for DEC 6 (14.7%) or IVR 400 (11.6%). Antigenemia percent return to pretreatment level was lower in the groups IVR + DEC or DEC 6 than for IVR 400. The combination IVR + DEC proved to be the most effective on macrofilariae and microfilariae (antigenemia and mf negative patients). The combination will be a very powerful tool for control of lymphatic filariasis. An annual filariasis day could be the most cost-effective strategy for administration of the drugs.
Moulia-Pelat
J P
JP
Institut Territorial de Recherches Médicales Louis Malardé, Papeete, Tahiti.
Glaziou
P
P
Weil
G J
GJ
Nguyen
L N
LN
Gaxotte
P
P
Nicolas
L
L
D000818:Animals; D002353:Carrier State / Q000188:drug therapy*; D004049:Diethylcarbamazine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005368:Filariasis / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D007559:Ivermectin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D013997:Time Factors; D014958:Wuchereria bancrofti / Q000302:isolation & purification
D007559:Ivermectin; D004049:Diethylcarbamazine