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SYMPTOMS REPORTED AFTER MASS DRUG ADMINISTRATION FOR LYMPHATIC FILARIASIS IN LEOGANE, HAITI

Mass drug administration (MDA) for lymphatic filariasis (LF) can cause adverse reactions from microfilarial and adult worm death. Symptoms after the fifth annual MDA in Leogane, Haiti, were studied to determine whether they resulted from parasite death. Persons reporting post-MDA systemic symptoms at 5 of 148 drug distribution posts and men reporting scrotal pain at any post were interviewed. Participants were tested with immunochromatographic tests (ICTs), and men with scrotal symptoms were examined. At the five posts, 3,781 persons took anti-filarial medication. Of these, 314 (8%) returned with symptoms; the most common were headache (36%) and gastrointestinal complaints (28%). Of the 294 (94%) who consented to ICT testing, 47 (16%) were positive. Of 69 men with scrotal symptoms who consented to ICT testing, 18 (26.1%) were positive. After Leogane’s fifth MDA, most symptomatic persons had undetectable levels of filarial antigen by ICT. Free symptomatic treatment may motivate some people to report symptoms and seek care.

Received April 20, 2006. Accepted for publication July 10, 2006.

Acknowledgments: We thank the residents of Leogane Commune for participation; Denise Dor, Casseus Carlide, Elsie Boulin, Elaus Venus, and Carole Lafleur for work in administering the survey; John Williamson for reviewing the manuscript; and Dr. Thomas Streit for his valuable support for LF elimination in Haiti.

Financial support: Funding for this project was provided by the Emerging Infectious Disease Program at the Centers for Disease Control and Prevention.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

^* Address correspondence to Natasha S. Hochberg, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-22, Atlanta, GA 30341. E-mail: natasha_hochberg{at}post.harvard.edu

Authors’ addresses: Natasha Hochberg, Epidemic Intelligence Service Officer, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-22, Atlanta, GA 30341, Telephone: 770-488-7741, Fax: 770-488-7761, E-mail: natasha_hochberg{at}post.harvard.edu. Marie C. Michel, Abdel N. Direny, and Madsen Beau de Rochars, Filariasis Program, Hôpital Sainte Croix, Leogane, Haiti, Telephone: 509-555-5246, Fax: 509-235-1845, E-mails: mmichel{at}nd.edu, adireny{at}nd.edu, mbeauder{at}nd.edu. Patrick J. Lammie, Els Mathieu, and David G. Addiss, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-13, Atlanta, GA 30341, Telephone 770-488-4054, 770-488-3603, and 770-488-7770, Fax: 770-488-7761, E-mails: pjl1{at}cdc.gov, emm7{at}cdc.gov, and dga1{at}cdc.gov.

Reprint requests: Natasha Hochberg, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-22, Atlanta, GA 30341.