A longitudinal analysis of the effect of mass drug administration on acute inflammatory episodes and disease progression in lymphedema patients in Leogane, Haiti.
We conducted a longitudinal analysis of 117 lymphedema patients in a filariasis-endemic area of Haiti during 1995-2008. No difference in lymphedema progression between those who received or did not receive mass drug administration (MDA) was found on measures of foot (P = 0.24), ankle (P = 0.87), or leg (P = 0.46) circumference; leg volume displacement (P = 0.09), lymphedema stage (P = 0.93), or frequency of adenolymphangitis (ADL) episodes (P = 0.57). Rates of ADL per year were greater after initiation of MDA among both groups (P < 0.01). Nevertheless, patients who received MDA reported improvement in four areas of lymphedema-related quality of life (P ≤ 0.01). Decreases in foot and ankle circumference and ADL episodes were observed during the 1995-1998 lymphedema management study (P ≤ 0.01). This study represents the first longitudinal, quantitative, leg-specific analysis examining the clinical effect of diethylcarbamazine on lymphedema progression and ADL episodes.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Decatur, Georgia; Children Without Worms, Task Force for Global Health, Decatur, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana; and Lymphatic Filariasis Program, Hôpital Sainte Croix, Léogane, Haiti.
Brittany A
BA
Eddy
Anna J
AJ
Blackstock
John M
JM
Williamson
David G
DG
Addiss
Thomas G
TG
Streit
Valery M
VM
Beau de Rochars
Leanne M
LM
Fox
D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D004049:Diethylcarbamazine / Q000008:administration & dosage / Q000627:therapeutic use*; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D000871:Anthelmintics; D007559:Ivermectin; D015766:Albendazole; D004049:Diethylcarbamazine