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Mass administration of albendazole effective in reducing lymphatic filariasis
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A revised strategy of biannual mass administration of albendazole recommended by WHO for the elimination of lymphatic filariasis in loiasis-prevalent areas, has proven effective according to research published in Lancet Infectious Diseases.
“The strategy for elimination of lymphatic filariasis caused by Wuchereria bancrofti in Africa is annual mass drug administration of ivermectin plus albendazole for 5 to 7 years, supported, when possible, by vector control,” Sébastien D. S. Pion, PhD, from the French Research Institute for Development at the Université de Montpellier, France, and colleagues wrote.
“However, ivermectin can cause serious adverse events in people with Loa loa microfilaria densities greater than 30,000 per milliliter of blood. The risk of serious adverse events induced by ivermectin precludes the launch of standard lymphatic filariasis elimination programs in areas where loiasis is endemic — for example, in forest and forest-savannah transition zones in central Africa.”
To examine this drug administration tactic for the elimination of lymphatic filariasis and soil-transmitted helminth infections, researchers conducted a 3-year community trial in a village within the Republic of the Congo. A 400-mg dose of albendazole was administered to inhabitants at least 2 years old every 6 months. To determine W. bancrofti infection status, rapid card immunochromatographic tests were used to identify antigenemia.
If an individual had antigenemia, night blood smears were administered to detect microfilaremia. Additionally, these people were also tested for soil-transmitted helminth infections with the Kato-Katz method. Participants were given assessment surveys at 12, 24 and 36 months to determine the change in infection rates.
In every round of albendazole mass administration, therapeutic coverage exceeded 80%. In the years studied (2012-2015), the incidence of W. bancrofti antigenemia declined from 17.3% to 4.7%, and microfilaremia rates fell from 5.3% to 0.3%. After the first year of the study was completed, hookworm infections were undetectable. Ascaris lumbricoides eggs that were expelled in feces decreased from 9844.6 to 724.4, as did Trichuris trichiura eggs (1107.4 to 366.0).
“Although our trial had another objective, it is one of the few studies done that provides data for the effect of community-wide mass administration of albendazole over a period of years on soil-transmitted helminths,” Pion and colleagues wrote. “Because therapeutic coverage was high, this study provides information on the maximum effect that can be practically achieved with biannual mass administration of albendazole in this time frame.” — by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
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