title: Macrofilaricidal Activity in Wuchereria bancrofti after 2 Weeks Treatment with a Combination of Rifampicin plus Doxycycline.
abstract: Infection with the filarial nematode Wuchereria bancrofti can lead to lymphedema, hydrocele, and elephantiasis. Since adult worms cause pathology in lymphatic filariasis (LF), it is imperative to discover macrofilaricidal drugs for the treatment of the infection. Endosymbiotic Wolbachia in filariae have emerged as a new target for antibiotics which can lead to macrofilaricidal effects. In Ghana, a pilot study was carried out with 39 LF-infected men; 12 were treated with 200 mg doxycycline/day for 4 weeks, 16 were treated with a combination of 200 mg doxycycline/day + 10 mg/kg/day rifampicin for 2 weeks, and 11 patients received placebo. Patients were monitored for Wolbachia and microfilaria loads, antigenaemia, and filarial dance sign (FDS). Both 4-week doxycycline and the 2-week combination treatment reduced Wolbachia load significantly. At 18 months posttreatment, four-week doxycycline resulted in 100% adult worm loss, and the 2-week combination treatment resulted in a 50% adult worm loss. In conclusion, this pilot study with a combination of 2-week doxycycline and rifampicin demonstrates moderate macrofilaricidal activity against W. bancrofti.
authors.affiliation: Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, UPO, PMB, Kumasi, Ghana.
authors.forename: Alexander Yaw
authors.initials: AY
authors.lastname: Debrah
authors.forename: Sabine
authors.initials: S
authors.lastname: Mand
authors.forename: Yeboah
authors.initials: Y
authors.lastname: Marfo-Debrekyei
authors.forename: Linda
authors.initials: L
authors.lastname: Batsa
authors.forename: Anna
authors.initials: A
authors.lastname: Albers
authors.forename: Sabine
authors.initials: S
authors.lastname: Specht
authors.forename: Ute
authors.initials: U
authors.lastname: Klarmann
authors.forename: Kenneth
authors.initials: K
authors.lastname: Pfarr
authors.forename: Ohene
authors.initials: O
authors.lastname: Adjei
authors.forename: Achim
authors.initials: A
authors.lastname: Hoerauf