title: Duplex Doppler sonographic assessment of the effects of diethylcarbamazine and albendazole therapy on adult filarial worms and adjacent host tissues in Bancroftian filariasis.
abstract: We used duplex Doppler sonography to assess effects of diethylcarbamazine and albendazole therapy (DEC/ALB) on adult Wuchereria bancrofti in vivo. The study was performed in clinically normal Egyptian adults with blood microfilaria counts > 80/mL. Motile adult worms were observed before treatment in dilated scrotal lymphatic vessels in 28 of 36 men (78%) and over the proximal extremities in 5 of 22 women (23%). Most worm nests were inactivated in the months following treatment (90% at 12 months). Circulating filarial antigen levels (a marker for living adult worms) also fell dramatically following treatment. Some men had intrascrotal calcifications and/or non-palpable hydroceles detectable by ultrasound before they were treated. New hydroceles and intrascrotal calcifications appeared after treatment in many cases. However, most of these were transient and of no clinical significance. Prevelance rates for hydrocele and intrascrotal calcifications 24 months after treatment were essentially the same as those prior to treatment. These results show that DEC/ALB is highly active against adult W. bancrofti. They also suggest that host responses to dying adult worms are important in the pathogenesis of filarial hydroceles.
authors.affiliation: Department of Radiology, Department of Community, Environmental, and Occupational Medicine, and Research and Training Center on Vectors of Diseases, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Omar
authors.initials: O
authors.lastname: Hussein
authors.forename: Maged
authors.initials: M
authors.lastname: El Setouhy
authors.forename: Ehab S
authors.initials: ES
authors.lastname: Ahmed
authors.forename: Amr M
authors.initials: AM
authors.lastname: Kandil
authors.forename: Reda M R
authors.initials: RM
authors.lastname: Ramzy
authors.forename: Hanan
authors.initials: H
authors.lastname: Helmy
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Weil
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D004049:Diethylcarbamazine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004605:Elephantiasis, Filarial / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology; D005260:Female; D005369:Filaricides / Q000627:therapeutic use*; D006801:Humans; D008208:Lymphatic System / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012611:Scrotum / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014958:Wuchereria bancrofti / Q000187:drug effects*
chemical_list: D005369:Filaricides; D015766:Albendazole; D004049:Diethylcarbamazine