Children and adolescents infected with Wuchereria bancrofti in Greater Recife, Brazil: a randomized, year-long clinical trial of single treatments with diethylcarbamazine or diethylcarbamazine-albendazole.
In filariasis-endemic areas beyond sub-Saharan Africa, the World Health Organization's recommended strategy for interrupting transmission of the causative parasites is annual, single-dose, mass treatment with a combination of diethylcarbamazine (DEC; given at 6 mg/kg) and albendazole (ALB; given at 400 mg) for 4-6 years (the minimum estimated life-span of the adult parasites). In an open, hospital-based, randomized and controlled trial, with a blinded evaluation of outcome, 82 children and adolescents from Recife, all with Wuchereria bancrofti microfilaraemias, were given either DEC alone (6 mg/kg) or the same dose of DEC combined with ALB (at 400 mg/patient). Every 90 days for 1 year after the single treatment, each patient was checked for microfilaraemia by the filtration of up to 5 ml of venous blood collected at night. One year post-treatment, 16 (39%) of the 41 patients given DEC alone and 20 (49%) of the 41 given DEC-ALB were found microfilaraemic (relative risk=0.8, with a 95% confidence interval of 0.49-1.31) and the corresponding geometric mean levels of microfilaraemia were 2.0% and 1.8% of the levels recorded immediately pre-treatment, respectively (P>0.05). In terms of the prevalences and intensities of microfilaraemia, therefore, the addition of ALB to the DEC appeared to offer no significant benefit.
Rizzo
J A
JA
Centro de Pesquisas em Alergia e Imunologia Clínica, Ambulatório de Alergia, Hospital das Clínicas, Universidade Federal de Pernambuco, Avenida Moraes Rego s/n, Cidade Universitária, CEP 50740-900, Recife, PE, Brazil.
Belo
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C
Lins
R
R
Dreyer
G
G
D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000009:adverse effects / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004049:Diethylcarbamazine / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D005260:Female; D005369:Filaricides / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D015995:Prevalence; D016896:Treatment Outcome; D014958:Wuchereria bancrofti
D000871:Anthelmintics; D005369:Filaricides; D015766:Albendazole; D004049:Diethylcarbamazine