title: The impact of two semiannual treatments with albendazole alone on lymphatic filariasis and soil-transmitted helminth infections: a community-based study in the Republic of Congo.
abstract: Implementation of mass drug administration (MDA) with ivermectin plus albendazole (ALB) for lymphatic filariasis (LF) has been delayed in central Africa because of the risk of serious adverse events in subjects with high Loa loa microfilaremia. We conducted a community trial to assess the impact of semiannual MDA with ALB (400 mg) alone on LF and soil-transmitted helminth (STH) infections in the Republic of Congo. Evaluation at 12 months showed that ALB MDA had not significantly reduced Wuchereria bancrofti antigenemia or microfilaria (mf) rates in the community (from 17.3% to 16.6% and from 5.3% to 4.2%, respectively). However, the geometric mean mf count in mf-positive subjects was reduced from 202.2 to 80.9 mf/mL (60% reduction, P = 0.01). The effect of ALB was impressive in 38 subjects who were mf-positive at baseline and retested at 12 months: 37% had total mf clearance, and individual mf densities were reduced by 73.0%. MDA also dramatically reduced the hookworm infection rate in the community from 6.5% to 0.6% (91% reduction), with less impressive effects on Ascaris and Trichuris. These preliminary results suggest that semiannual community MDA with ALB is a promising strategy for controlling LF and STH in areas with coendemic loiasis.
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri sebastien.pion@ird.fr.
authors.forename: Sébastien D S
authors.initials: SD
authors.lastname: Pion
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Cédric B
authors.initials: CB
authors.lastname: Chesnais
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Jean
authors.initials: J
authors.lastname: Bopda
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Louya
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Peter U
authors.initials: PU
authors.lastname: Fischer
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Majewski
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Weil
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Michel
authors.initials: M
authors.lastname: Boussinesq
authors.affiliation: Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: François
authors.initials: F
authors.lastname: Missamou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D000947:Antigens, Helminth / Q000276:immunology; D001196:Ascariasis / Q000188:drug therapy / Q000453:epidemiology; D017164:Ascaris lumbricoides / Q000187:drug effects / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003223:Congo / Q000453:epidemiology; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006373:Helminthiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D006725:Hookworm Infections / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012987:Soil / Q000469:parasitology; D014257:Trichuriasis / Q000188:drug therapy / Q000453:epidemiology; D014258:Trichuris / Q000187:drug effects / Q000302:isolation & purification; D014958:Wuchereria bancrofti / Q000187:drug effects / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D000947:Antigens, Helminth; D012987:Soil; D015766:Albendazole