title: Efficacy of co-administered diethylcarbamazine and albendazole against adult Wuchereria bancrofti.
abstract: Although diethylcarbamazine (DEC) and albendazole are recommended to interrupt transmission of Wuchereria bancrofti, little is known about the macrofilaricidal effect of this drug combination. Forty-seven men with W. bancrofti infection were randomly assigned to receive a single dose of either DEC alone (6 mg/kg) (n=25) or a combination of DEC (6 mg/kg) and albendazole (400 mg) (n=22). Physical examinations for scrotal nodules (resulting from worm death) and ultrasound examinations (to detect living adult worms) were performed before treatment and 7, 14, 30, 45, 60, 90, 180, 270 and 360 days after treatment. Blood was examined for microfilariae before and 30 days and 360 days after treatment. Seven days post treatment, intrascrotal nodules were detected at the site of 21 (46.7%) adult worm nests in men who received DEC alone compared with 2 (6.1%) sites in men who received DEC and albendazole (P=0.002). One year after treatment, 10 (22.2%) original adult worm nests remained detectable by ultrasound among men who received DEC alone compared with 18/32 (56.3%) nests among men who received both drugs (P=0.016). Microfilaraemia prevalence and density decreased to a similar extent in both groups. Addition of albendazole appeared to decrease the macrofilaricidal effect of DEC against W. bancrofti, with no detectable enhancement in microfilarial suppression.
authors.affiliation: NEPAF, Hospital das Clínicas, Universidade Federal de Pernambuco, Av Prof Moraes Rego s/n, Cidade Universitária, CEP 50740-900, Recife PE, Brazil. dreyer-g@uol.com.br
authors.forename: Gerusa
authors.initials: G
authors.lastname: Dreyer
authors.forename: David
authors.initials: D
authors.lastname: Addiss
authors.forename: John
authors.initials: J
authors.lastname: Williamson
authors.forename: Joaquim
authors.initials: J
authors.lastname: Norões
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000008:administration & dosage*; D000818:Animals; D004049:Diethylcarbamazine / Q000008:administration & dosage*; D004338:Drug Combinations; D005368:Filariasis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005369:Filaricides / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005832:Genital Diseases, Male / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008842:Microfilariae / Q000302:isolation & purification; D008875:Middle Aged; D012611:Scrotum / Q000000981:diagnostic imaging / Q000469:parasitology; D016896:Treatment Outcome; D014463:Ultrasonography; D014958:Wuchereria bancrofti / Q000302:isolation & purification*
chemical_list: D004338:Drug Combinations; D005369:Filaricides; D015766:Albendazole; D004049:Diethylcarbamazine