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The influence of the mass administration of diethylcarbamazine, alone or with albendazole, on the prevalence of filarial antigenaemia.
- Source :
-
Annals of tropical medicine and parasitology [Ann Trop Med Parasitol] 2002 Sep; Vol. 96 (6), pp. 595-602. - Publication Year :
- 2002
-
Abstract
- The current Indian campaign for the elimination of lymphatic filariasis is largely based on mass drug administration (MDA). As part of this campaign, villagers in the Tirukoilur and Mugaiyur 'blocks' (i.e. revenue units) of Villupuram district, in Tamil Nadu, India, were treated with diethylcarbamazine (DEC), either alone (Mugaiyur) or with albendazole (Tirukoilur), in March 2001. The efficacy of treatment, in each of the two treatment arms, was evaluated by determining the percentages of the subjects who were carrying antigen from adult Wuchereria bancrofti before, 6 months and 12 months after the MDA. In a cross-sectional survey at each time-point, commercial, immunochromatographic tests were used to check 1000-1200, randomly selected, young residents (aged 2-25 years) of 18 index villages for the antigen; at least 300 villagers aged 2-9 years and at least 170 aged 10-25 years from each treatment arm were screened in each survey. Before the MDA, 12.7% of the subjects aged 2-9 years and 23.6% of those aged 10-25 years were found to be positive for the filarial antigen. Although only about 50% of villagers aged 2-9 years were successfully treated, MDA (with DEC alone or DEC plus albendazole) led to a significant (28.7%) reduction in the prevalence of antigenaemia in this age-group 6 months later (P<0.05). Although, the prevalences of antigenaemia among those aged 2-9 years were higher 12 months post-treatment than 6 months post-treatment, they were still lower (by 16%-23%) than those observed pre-treatment. The addition of albendazole to the DEC treatment appeared to offer no additional benefit in terms of the prevalence of antigenaemia in children aged <10 years; in fact, the use of DEC alone produced a slightly greater reduction in the prevalence of antigenaemia than the use of both DEC and albendazole. In the block given MDA based on both DEC and albendazole, the prevalences of antigenaemia among the villagers aged 10-25 years were 19.4% and 16.6% lower 6 and 12 months post-treatment, respectively, than observed pre-treatment. Curiously, in the block given DEC alone, the prevalences in this age-group were higher at both post-treatment follow-ups (by 17.4% at 6 months and 35.1% at 12 months) than observed pre-treatment. In concurrent experimental studies, high drug compliance (90%) among young children (aged 2-5 years) led to a pronounced (62.6%) reduction in the prevalence of antigenaemia after one MDA. In follow-up studies of those found antigen-positive, 40% of those aged 2-9 years but only 23% of those aged 10-25 years cleared their antigenaemias after three (annual) MDA. To maximize the benefits of MDA, greater efforts should be made to increase treatment coverage among young children.
- Subjects :
- Adolescent
Adult
Animals
Antigens, Helminth blood
Child
Child, Preschool
Cross-Sectional Studies
Drug Therapy, Combination
Female
Filariasis epidemiology
Follow-Up Studies
Humans
India epidemiology
Male
Patient Compliance
Prevalence
Treatment Outcome
Albendazole therapeutic use
Diethylcarbamazine therapeutic use
Filariasis drug therapy
Filaricides therapeutic use
Wuchereria bancrofti immunology
Subjects
Details
- Language :
- English
- ISSN :
- 0003-4983
- Volume :
- 96
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Annals of tropical medicine and parasitology
- Publication Type :
- Academic Journal
- Accession number :
- 12396322
- Full Text :
- https://doi.org/10.1179/000349802125001726