Treatment of co-infection with bancroftian filariasis and onchocerciasis: a safety and efficacy study of albendazole with ivermectin compared to treatment of single infection with bancroftian filariasisReport as inadecuate




Treatment of co-infection with bancroftian filariasis and onchocerciasis: a safety and efficacy study of albendazole with ivermectin compared to treatment of single infection with bancroftian filariasis - Download this document for free, or read online. Document in PDF available to download.

Filaria Journal

, 2:15

First Online: 06 November 2003Received: 20 December 2002Accepted: 06 November 2003

Abstract

BackgroundIn order to use a combination of ivermectin and albendazole for the elimination of lymphatic filariasis, it is important to assess the potential risk of increased adverse events in individuals infected with both lymphatic filariasis and onchocerciasis. We compared the safety and efficacy of albendazole 400 mg in combination with ivermectin 150 micrograms-kg, for the treatment of co-infections of Wuchereria bancrofti and Onchocerca volvulus with single infection of W. bancrofti.

MethodsThe safety study on co-infections was a crossover, double blind design, while for the single infection of bancroftian filariasis an open design comparing two treatments was used. For co-infection, one group was allocated a single dose of ivermectin 150 micrograms-kg plus albendazole 400 mg Group A. The other group received placebo Group B. Five days later the treatment regime was reversed, with the Group A receiving placebo and Group B receiving treatment. For the single bancroftian filariasis infection, one group received a single dose of albendazole 400 mg plus ivermectin 150 μg-kg Group C while the other group received a single dose of albendazole 400 mg alone Group D. Blood and skin specimens were collected on admission day, day 0, and on days 2, 3, and 7 to assess drug safety and efficacy. Thereafter, blood and skin specimens were collected during the 12 months follow up for the assessment of drug efficacy. Study individuals were clinically monitored every six hours during the first 48 hours following treatment, and routine clinical examinations were performed during the hospitalisation period and follow-up.

ResultsIn individuals co-infected with bancroftian filariasis and onchocerciasis, treatment with ivermectin and albendazole was safe and tolerable. Physiological indices showed no differences between groups with co-infection W. bancrofti and O. volvulus or single infection W. bancrofti. The frequency of adverse events in co-infected individuals was 63% 5-8, Group A, albendazole + ivermectin and 57% 4-7, Group B, placebo and of mild or moderate intensity. In single W. bancrofti infection the frequency of adverse events was 50% 6-12, Group C, albendazole + ivermectin and 38% 5-13, Group D, albendazole and of a similar intensity to those experienced with co-infection. There were no differences in adverse events between treatment groups. There was no significant difference in the reduction of microfilaraemia following treatment with albendazole and ivermectin in groups with single or co-infection.

ConclusionOur findings suggest that ivermectin plus albendazole is a safe and tolerable treatment for co-infection of bancroftian filariasis and onchocerciasis.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2883-2-15 contains supplementary material, which is available to authorized users.

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Author: William H Makunde - Leo M Kamugisha - Julius J Massaga - Rachel W Makunde - Zakana X Savael - Juma Akida - Fred M Sal

Source: https://link.springer.com/



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