Long-term efficacy of single-dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis.
In a 'blinded' trial (in Sri Lanka, 1996-98) of 47 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of 3 single-dose combination regimens were compared: albendazole 400 mg with ivermectin 200 micrograms/kg, albendazole 400 mg with diethylcarbamazine citrate (DEC) 6 mg/kg or albendazole 600 mg with ivermectin 400 micrograms/kg. Treated subjects were followed-up for 24 months. This represents the first long-term study using combinations of albendazole with DEC or ivermectin in the above doses against bancroftian filariasis. All subjects had pre-treatment microfilaria (mf) counts over 100/mL. All 3 treatments significantly reduced mf counts, with the albendazole-DEC-treated group showing the lowest mf levels at 18 and 24 months post-treatment. Filarial antigen tests suggested that all 3 treatments had significant activity against adult W. bancrofti; albendazole-DEC combination had the greatest activity according to this test, with antigen levels decreasing to 30.5% of pre-treatment antigen levels, 24 months after therapy. All 3 treatments were clinically safe and well tolerated. These results suggest that a single dose of albendazole 400 mg together with DEC 6 mg/kg is a safe and effective combination for suppression of microfilaraemia of bancroftian filariasis that could be considered for use in filariasis control programmes based on mass treatment of endemic populations.
Ismail
M M
MM
Department of Parasitology, Faculty of Medicine, Kynsey Road, Colombo 8, Sri Lanka. mismail@slt.lk
Jayakody
R L
RL
Weil
G J
GJ
Fernando
D
D
De Silva
M S
MS
De Silva
G A
GA
Balasooriya
W K
WK
D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000008:administration & dosage*; D000704:Analysis of Variance; D000962:Antimalarials / Q000008:administration & dosage*; D004049:Diethylcarbamazine / Q000008:administration & dosage*; D004338:Drug Combinations; D004605:Elephantiasis, Filarial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000962:Antimalarials; D004338:Drug Combinations; D007559:Ivermectin; D015766:Albendazole; D004049:Diethylcarbamazine