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Adherence to Hygiene Protocols and Doxycycline Therapy in Ameliorating Lymphatic Filariasis Morbidity in an Endemic Area Post-Interruption of Disease Transmission in Ghana.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2024 Oct 01; Vol. 111 (4_Suppl), pp. 66-82. Date of Electronic Publication: 2024 Oct 01 (Print Publication: 2024). - Publication Year :
- 2024
-
Abstract
- Filarial lymphedema (LE) remains a significant global problem despite the progress made toward elimination of lymphatic filariasis (LF). In Ghana, the main approach to LF is preventive chemotherapy, but this has minimal impact on individuals who have already developed LE. In 2018-2020, a 24-month randomized, double-blind, placebo-controlled trial was conducted to evaluate the efficacy of stringent hygiene measures using the Essential Package of Care with or without additional administration of doxycycline (DOX) to improve filarial leg LE. This study enrolled 356 participants with LE stages 1-3 from two districts in the Upper East Region of Ghana. In addition to regular training on appropriate care for their affected legs, participants were randomized to receive 6 weeks of either 200 mg/day DOX (n = 117), 100 mg/day DOX (n = 120), or matching placebo (n = 119). Participants were seen every 2 months, with clinical measurements done at 6, 12, 18, and 24 months to assess the status of affected legs. There was a trend toward later appearance of acute attacks after DOX, but surprisingly, DOX showed no effect on LE stage progression. In all groups, leg LE improvement was more common (DOX 200 mg: n = 23 [20%]; DOX 100 mg: n = 23 [19.5%]; placebo: n = 32 [27.4%]) than LE worsening (DOX 200 mg: n = 2 [1.7%]; DOX 100 mg: n = 3 [2.5%]; placebo: n = 2 [1.7%]). Overall, these data show a strong benefit from adherence to a strict hygiene protocol, with some added potential benefit for DOX in preventing acute attacks.
- Subjects :
- Humans
Ghana epidemiology
Male
Female
Adult
Middle Aged
Double-Blind Method
Hygiene
Endemic Diseases prevention & control
Young Adult
Filaricides therapeutic use
Filaricides administration & dosage
Patient Compliance
Adolescent
Doxycycline therapeutic use
Doxycycline administration & dosage
Elephantiasis, Filarial drug therapy
Elephantiasis, Filarial prevention & control
Elephantiasis, Filarial epidemiology
Elephantiasis, Filarial transmission
Subjects
Details
- Language :
- English
- ISSN :
- 1476-1645
- Volume :
- 111
- Issue :
- 4_Suppl
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 39362213
- Full Text :
- https://doi.org/10.4269/ajtmh.24-0313