Bancroftian filariasis: effect of repeated treatment with diethylcarbamazine and albendazole on microfilaraemia, antigenaemia and antifilarial antibodies.
Diethylcarbamazine/albendazole (DEC/ALB) therapy is widely used in mass drug administration (MDA) programmes aimed at eliminating lymphatic filariasis. We studied the effects of repeated annual treatments with DEC/ALB on Wuchereria bancrofti microfilaraemia, filarial antigenaemia and IgG4 antibodies to Bm14 antigen. Fifty-seven subjects with asymptomatic microfilaraemia were treated with one or seven daily doses of DEC/ALB at time zero. All subjects were re-treated with single-dose DEC/ALB 12, 24 and 36 months later. The two treatment groups had comparable pre-treatment microfilaria counts. Multidose treatment cleared microfilaraemia more effectively than single-dose treatment. Filarial antigen levels decreased equally in both treatment groups. Total antigen clearance was observed in 29.6%, 52.0%, 63.6% and 79.5% of subjects at 12, 24, 36 and 48 months. These clearance rates are much higher than those observed in prior treatment trials with DEC or ivermectin. Antibody levels increased 4 weeks after treatment and then slowly decreased in most subjects. Antibody tests turned negative in 20%, 35%, 39.4% and 52.5% of treated subjects at 12, 24, 36 and 48 months post treatment. These results show that the studied parameters decline at different rates and to differing degrees following DEC/ALB treatment. These findings have important implications regarding strategies for monitoring the effects of MDA in populations.
Helmy
Hanan
H
Research and Training Center on Vectors of Diseases, Faculty of Science Building, Ain Shams University, Abbassia Square, Cairo 11566, Egypt.
Weil
Gary J
GJ
Ellethy
Abou Sree T
AS
Ahmed
Ehab S
ES
Setouhy
Maged El
ME
Ramzy
Reda M R
RM
D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000008:administration & dosage*; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage*; D000909:Antibodies, Helminth / Q000097:blood; D000947:Antigens, Helminth / Q000097:blood; D004049:Diethylcarbamazine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004605:Elephantiasis, Filarial / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005369:Filaricides / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008842:Microfilariae / Q000302:isolation & purification; D016896:Treatment Outcome
D000871:Anthelmintics; D000909:Antibodies, Helminth; D000947:Antigens, Helminth; D005369:Filaricides; D007074:Immunoglobulin G; D015766:Albendazole; D004049:Diethylcarbamazine