Volume 92, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Implementation of mass drug administration (MDA) with ivermectin plus albendazole (ALB) for lymphatic filariasis (LF) has been delayed in central Africa because of the risk of serious adverse events in subjects with high microfilaremia. We conducted a community trial to assess the impact of semiannual MDA with ALB (400 mg) alone on LF and soil-transmitted helminth (STH) infections in the Republic of Congo. Evaluation at 12 months showed that ALB MDA had not significantly reduced antigenemia or microfilaria (mf) rates in the community (from 17.3% to 16.6% and from 5.3% to 4.2%, respectively). However, the geometric mean mf count in mf-positive subjects was reduced from 202.2 to 80.9 mf/mL (60% reduction, = 0.01). The effect of ALB was impressive in 38 subjects who were mf-positive at baseline and retested at 12 months: 37% had total mf clearance, and individual mf densities were reduced by 73.0%. MDA also dramatically reduced the hookworm infection rate in the community from 6.5% to 0.6% (91% reduction), with less impressive effects on and . These preliminary results suggest that semiannual community MDA with ALB is a promising strategy for controlling LF and STH in areas with coendemic loiasis.


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  1. World Health Organization, 2012. Provisional strategy for interrupting lymphatic filariasis transmission in loiasis-endemic countries. Proceedings of the Meeting on Lymphatic Filariasis, Malaria and Integrated Vector Management; Accra, Ghana, March 5–9, 2012. [Google Scholar]
  2. Ottesen EA, Hooper PJ, Bradley M, Biswas G, , 2008. The global programme to eliminate lymphatic filariasis: health impact after 8 years. PLoS Negl Trop Dis 2: e317.[Crossref] [Google Scholar]
  3. Carme B, Ebikili B, Mbitsi A, Copin N, , 1991. Essai thérapeutique de l'ivermectine au cours de la loase à moyenne et forte microfilarémie. Ann Soc Belg Med Trop 71: 4750. [Google Scholar]
  4. Gardon J, Gardon-Wendel N, Demanga-Ngangue Kamgno J, Chippaux JP, Boussinesq M, , 1997. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet 350: 1822.[Crossref] [Google Scholar]
  5. Boussinesq M, Gardon J, Gardon-Wendel N, Chippaux J-P, , 2003. Clinical picture, epidemiology and outcome of Loa-associated serious adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon. Filaria J 2 (Suppl 1): S4.[Crossref] [Google Scholar]
  6. Addiss D, Global Alliance to Eliminate Lymphatic Filariasis; , 2010. The 6th Meeting of the Global Alliance to Eliminate Lymphatic Filariasis: a half-time review of lymphatic filariasis elimination and its integration with the control of other neglected tropical diseases. Parasit Vectors 3: 100.[Crossref] [Google Scholar]
  7. Bockarie MJ, Deb RM, , 2010. Elimination of lymphatic filariasis: do we have the drugs to complete the job? Curr Opin Infect Dis 23: 617620.[Crossref] [Google Scholar]
  8. Klion AD, Massougbodji A, Horton J, Ekoue S, Lanmasso T, Ahouissou NL, Nutman TB, , 1993. Albendazole in human loiasis: results of a double-blind, placebo-controlled trial. J Infect Dis 168: 202206.[Crossref] [Google Scholar]
  9. Ismail MM, Jayakody RL, Weil GJ, Fernando D, De Silva MS, De Silva GA, Balasooriya WK, , 2001. Long-term efficacy of single-dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis. Trans R Soc Trop Med Hyg 95: 332335.[Crossref] [Google Scholar]
  10. Makunde WH, Kamugisha LM, Massaga JJ, Makunde RW, Savael ZX, Akida J, Salum FM, Taylor MJ, , 2003. Treatment of co-infection with bancroftian filariasis and onchocerciasis: a safety and efficacy study of albendazole with ivermectin compared to treatment of single infection with bancroftian filariasis. Filaria J 2: 15.[Crossref] [Google Scholar]
  11. Wamae CN, Njenga SM, Ngugi BM, Mbui J, Njaanake HK, , 2011. Evaluation of effectiveness of diethylcarbamazine/albendazole combination in reduction of Wuchereria bancrofti infection using multiple infection parameters. Acta Trop 120 (Suppl 1): S33S38.[Crossref] [Google Scholar]
  12. Ottesen EA, Duke BO, Karam M, Behbehani K, , 1997. Strategies and tools for the control/elimination of lymphatic filariasis. Bull World Health Organ 75: 491503. [Google Scholar]
  13. Ottesen EA, , 2006. Lymphatic filariasis: treatment, control and elimination. Adv Parasitol 61: 395441.[Crossref] [Google Scholar]
  14. Stolk WA, ten Bosch QA, de Vlas SJ, Fischer PU, Weil GJ, Goldman AS, , 2013. Modeling the impact and costs of semiannual mass drug administration for accelerated elimination of lymphatic filariasis. PLoS Negl Trop Dis 7: e1984.[Crossref] [Google Scholar]
  15. Panicker KN, Krishnamoorthy K, Sabesan S, Prathiba J, Abidha, 1991. Comparison of effects of mass annual and biannual single dose therapy with diethylcarbamazine for the control of Malayan filariasis. Southeast Asian J Trop Med Public Health 22: 402411. [Google Scholar]
  16. Cartel JL, Spiegel A, Nguyen Ngnoc L, Cardines R, Plichart R, Martin PM, Roux JF, , 1991. Single versus repeated doses of ivermectin and diethylcarbamazine for the treatment of Wuchereria bancrofti var. pacifica microfilaremia. Results at 12 months of a double-blind study. Trop Med Parasitol 42: 335338. [Google Scholar]
  17. Cartel JL, Spiegel A, Nguyen Ngnoc L, Cardines R, Plichart R, Martin PM, Roux JF, Moulia-Pelat JP, , 1992. Compared efficacy of repeated annual and semi-annual doses of ivermectin and diethylcarbamazine for prevention of Wuchereria bancrofti filariasis in French Polynesia. Final evaluation. Trop Med Parasitol 43: 9194. [Google Scholar]
  18. Dembele B, Coulibaly YI, Dolo H, Konate S, Coulibaly SY, Sanogo D, Soumaoro L, Coulibaly ME, Doumbia SS, Diallo AA, Traore SF, Diaman Keita A, Fay MP, Nutman TB, Klion AD, , 2010. Use of high-dose, twice-yearly albendazole and ivermectin to suppress Wuchereria bancrofti microfilarial levels. Clin Infect Dis 51: 12291235.[Crossref] [Google Scholar]
  19. Kazura JW, , 2010. Higher-dose, more frequent treatment of Wuchereria bancrofti . Clin Infect Dis 51: 12361237.[Crossref] [Google Scholar]
  20. Chesnais CB, Missamou F, Pion SDS, Bopda J, Louya F, Majewski AC, Weil GJ, Boussinesq M, , 2013. Semi-quantitative scoring of an immunochromatographic test for circulating filarial antigen. Am J Trop Med Hyg 89: 916918.[Crossref] [Google Scholar]
  21. World Health Organization, 1998. Guidelines for the Evaluation of Soil-Transmitted Helminthiases and Schistosomiasis at Community Level. Geneva: World Health Organization. [Google Scholar]
  22. Critchley J, Addiss D, Ejere H, Gamble C, Garner P, Gelband H, , 2005. Albendazole for the control and elimination of lymphatic filariasis: systematic review. Trop Med Int Health 10: 818825.[Crossref] [Google Scholar]
  23. Dunyo SK, Nkrumah FK, Simonsen PE, , 2000. Single-dose treatment of Wuchereria bancrofti infections with ivermectin and albendazole alone or in combination: evaluation of the potential for control at 12 months after treatment. Trans R Soc Trop Med Hyg 94: 437443.[Crossref] [Google Scholar]
  24. Ismail MM, Jayakody RL, Weil GJ, Nirmalan N, Jayasinghe K, Abeyewickrema W, Sheriff MR, Rajaratnam HN, Amarasekera N, De Silva D, , 1998. Efficacy of single dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis. Trans R Soc Trop Med Hyg 92: 9497.[Crossref] [Google Scholar]
  25. World Health Organization, 2006. Preventive Chemotherapy in Human Helminthiasis: Coordinated Use of Anthelminthic Drugs in Control Interventions: A Manual for Health Professionals and Programme Managers. Available at: http://books.google.com/books?hl=en&lr=&id=5qJvG5Eek1cC&oi=fnd&pg=PR4&dq=Preventive+chemotherapy+in+human+helminthiasis+(WHO)&ots=IdgsIVxekL&sig=6dmMeAu2tsjZB_cTbgZSsbbCpxU. Accessed January 16, 2015. [Google Scholar]
  26. Anderson R, Truscott J, Hollingsworth TD, , 2014. The coverage and frequency of mass drug administration required to eliminate persistent transmission of soil-transmitted helminths. Philos Trans R Soc Lond B Biol Sci 369: 20130435. [Google Scholar]
  27. Truscott JE, Hollingsworth TDI, Brooker SJ, Anderson RM, , 2014. Can chemotherapy alone eliminate the transmission of soil transmitted helminths? Parasit Vectors 7: 18.[Crossref] [Google Scholar]
  28. Beach MJ, Streit TG, Addiss DG, Prospere R, Roberts JM, Lammie PJ, , 1999. Assessment of combined ivermectin and albendazole for treatment of intestinal helminth and Wuchereria bancrofti infections in Haitian schoolchildren. Am J Trop Med Hyg 60: 479486. [Google Scholar]
  29. Ismail MM, Jayakody RL, , 1999. Efficacy of albendazole and its combinations with ivermectin or diethylcarbamazine (DEC) in the treatment of Trichuris trichiura infections in Sri Lanka. Ann Trop Med Parasitol 93: 501504.[Crossref] [Google Scholar]
  30. Knopp S, Mohammed KA, Speich B, Hattendorf J, Khamis IS, Khamis AN, Stothard JR, Rollinson D, Marti H, Utzinger J, , 2010. Albendazole and mebendazole administered alone or in combination with ivermectin against Trichuris trichiura: a randomized controlled trial. Clin Infect Dis 51: 14201428.[Crossref] [Google Scholar]
  31. Belizario VY, Amarillo ME, De Leon WU, De Los Reyes AE, Bugayong MG, Macatangay B, , 2003. A comparison of the efficacy of single doses of albendazole, ivermectin, and diethylcarbamazine alone or in combinations against Ascaris and Trichuris spp. Bull World Health Organ 81: 3542. [Google Scholar]
  32. World Health Organization, 2013. Sustaining the Drive to Overcome the Global Impact of Neglected Tropical Diseases: Second WHO Report on Neglected Tropical Diseases: Summary. Geneva: World Health Organization. [Google Scholar]
  33. Chu BK, Gass K, Batcho W, 'Ake M, Dorkenoo AM, Adjinacou E, Mafi' Addiss DG, , 2014. Pilot assessment of soil-transmitted helminthiasis in the context of transmission assessment surveys for lymphatic filariasis in Benin and Tonga. PLoS Negl Trop Dis 8: e2708.[Crossref] [Google Scholar]
  34. Albonico M, Engels D, Savioli L, , 2004. Monitoring drug efficacy and early detection of drug resistance in human soil-transmitted nematodes: a pressing public health agenda for helminth control. Int J Parasitol 34: 12051210.[Crossref] [Google Scholar]
  35. Vercruysse J, Albonico M, Behnke JM, Kotze AC, Prichard RK, McCarthy JS, Montresor A, Levecke B, , 2011. Is anthelmintic resistance a concern for the control of human soil-transmitted helminths? Int J Parasitol Drugs Drug Resist 14: 1427.[Crossref] [Google Scholar]
  36. Vercruysse J, Behnke JM, Albonico M, Ame SM, Angebault C, Bethony JM, Engels D, Guillard B, Nguyen TV, Kang G, Kattula D, Kotze AC, McCarthy JS, Mekonnen Z, Montresor A, Periago MV, Sumo L, Tchuenté LA, Dang TC, Zeynudin A, Levecke B, , 2011. Assessment of the anthelmintic efficacy of albendazole in school children in seven countries where soil-transmitted helminths are endemic. PLoS Negl Trop Dis 5: e948.[Crossref] [Google Scholar]
  37. Diawara A, Schwenkenbecher JM, Kaplan RM, Prichard RK, , 2013. Molecular and biological diagnostic tests for monitoring benzimidazole resistance in human soil-transmitted helminths. Am J Trop Med Hyg 88: 10521061.[Crossref] [Google Scholar]

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  • Received : 20 Oct 2014
  • Accepted : 09 Dec 2014
  • Published online : 06 May 2015

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