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This randomized, placebo-controlled trial investigated the tolerance, efficacy, and nutritional benefit of combining chemotherapeutic treatment of intestinal helminths and lymphatic filariasis. Children were infected with Ascaris (30.7%), Trichuris (53.4%), and hookworm (9.7%) with 69.9% having more than one of these parasites. A total of 15.8% of the children had Wuchereria bancrofti microfilariae. Children were randomly assigned treatment with placebo, albendazole (ALB), diethylcarbamazine (DEC), or combined therapy. The combination of DEC/ALB reduced microfilarial density compared with placebo, ALB, or DEC (P 
0.03). Albendazole and DEC/ALB reduced the prevalence of Ascaris, Trichuris, and hookworm more than placebo or DEC (P 0.03). Among Trichuris-infected children, those receiving ALB and DEC/ALB demonstrated greater gains in weight compared with placebo (P 0.05). Albendazole and DEC/ALB were equally efficacious in treating intestinal helminths and for children with W. bancrofti microfilaremia, DEC/ALB was more effective than DEC, with no increase in severity of adverse reactions.
Received August 18, 2004. Accepted for publication February 2, 2005.
Acknowledgments: We thank Amanda Freeman and Thomas Streit for their contributions to the study, as well as the children of Leogane who participated in this study, their parents, and the headmasters and staff of the participating schools.
Financial support: This study was supported by the Emerging Infections Program of the Centers for Disease Control and Prevention and by an Institutional Strengthening Grant from the World Health Organization to the Hôpital Sainte Croix.
Disclaimer: Use of trade names is for identification only and does not imply endorsement by the Public Health Service or by the U.S. Department of Health and Human Services.
* Address correspondence to Dr. Michael J. Beach, Division of Parasitic Diseases, Centers for Disease Control and Prevention, 4770 Bu-ford Highway, Mailstop F-22, Atlanta, GA 30341-3724, E-mail: mbeach{at}cdc.gov
Authors’ addresses: LeAnne M. Fox, Center for International Health and Development, Boston University School of Public Health, 85 East Concord Street, Boston, MA 02118, Telephone: 617-414-1209, Fax: 617-414-1261, E-mail: lfox{at}bu.edu. Bruce W. Furness, STD Control Program, Washington, DC, 20005, Telephone: 202-727-9066, Fax: 202-727-3345, E-mail: bff0{at}cdc.gov. Jennifer K. Haser, Oregon Health and Science University, Portland, OR 97239, Telephone: 503-494-8428, Fax: 503-494-8120, E-mail: haserj{at}ohsu.edu. Dardith Desire, Jean-Marc Brissau, Marie-Denise Milord, and Jack Lafontant, Filariasis Program, Hôpital Sainte Croix, Leogane, Haiti, Telephone: 509-557-6424, Fax: 509-235-1845, E-mails: jbrissau{at}nd.edu, mmilord{at}nd.edu, and gastro{at}hopital-stecroix.org. Patrick J. Lammie and Michael J. Beach, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-22, Atlanta, GA 30341-3724, Telephone: 770-488-4054 and 770-488-7760, Fax: 770-488-4108 and 770-488-7761, E-mails: pjl1{at}cdc.gov and mbeach{at}cdc.gov.
Reprint requests: Michael J. Beach, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-22, Atlanta, GA 30341-3724.
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