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FREQUENCY, SEVERITY, AND COSTS OF ADVERSE REACTIONS FOLLOWING MASS TREATMENT FOR LYMPHATIC FILARIASIS USING DIETHYLCARBAMAZINE AND ALBENDAZOLE IN LEOGANE, HAITI, 2000

In October 2000, 71,187 persons were treated for lymphatic filariasis using albendazole and diethylcar-bamazine (DEC) or DEC alone in Leogane, Haiti. We documented the frequency of adverse reactions, severity and cost of treatment. Adverse reactions were classified as minor, moderate, or severe. Overall, 24% (17,421) of the treated persons reported one or more adverse reactions. There were 15,916 (91%) minor and 1502 (9%) moderate adverse reaction reports. Men outnumbered women 2:1 in reporting moderate problems. Three patients, representing roughly one in 25,000 persons treated, were hospitalized with severe adverse reactions judged to be treatment-associated by physician review. The cost per person treated for adverse reactions was more than twice the cost per person treated for lymphatic filariasis ($1.60 versus $0.71). Severe adverse reactions to lymphatic filariasis treatment using DEC with or without albendazole are uncommon. Minor and moderate reactions are more commonly reported and their management represents a challenge to lymphatic filariasis elimination programs.

Received October 3, 2002. Accepted for publication February 3, 2003.

Acknowledgments: We thank the physicians and nursing staff of Hôpital Sainte Croix in Leogane for their efforts in conducting adverse reaction management and surveillance. We also thank Dr. Thomas Streit (Notre Dame University, Notre Dame, IN), Dr. Marcel Parnell, Dr. Marie Denise Milord, Joyanna Wendt, and the community health workers of Leogane for their hard work in support of the filariasis elimination program.

Financial support: Major funding for the filariasis program at Hôpital Sainte Croix was provided by the Emerging Infections Program at the Centers for Disease Control and Prevention. Additional infrastructure support was provided by a grant from the Bill & Melinda Gates Foundation to Notre Dame University.

Authors’ addresses: Steven I. McLaughlin, National Immunization Program, Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-05, Atlanta, GA 30333, Telephone: 404-639-8252/1970, Fax: 404-639-8573, E-mail: swm4{at}cdc.gov. Jeanne Radday, David G. Addiss, Michael J. Beach, and Patrick J. Lammie, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341. Marie Carmel Michel and Jack Lafontant, Hopital Sainte Croix, Leogane, Haiti. John Lammie, Department of Family and Preventative Medicine, University of South Carolina School of Medicine, 6 Richland Medical Park, Columbia, SC 29203. Richard Rheingans, Department of International Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322.

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