1921
Volume 71, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Because of the life-threatening, post-treatment reactions that have occurred in patients with loiasis treated with ivermectin, evaluation of a short-course albendazole regimen was undertaken in a -endemic region of Cameroon. In a placebo-controlled, double-blinded, crossover study, 99 subjects with microfilaremia (100–3,3837/mL) were assigned to receive albendazole (400 mg; n = 48) or placebo (n = 51) for three days and were followed for 180 days; at day 180, the groups were crossed over and followed for an additional six months. In those initially receiving albendazole (ALB/PLAC), microfilarial levels decreased significantly by day 90 ( < 0.043), but returned to baseline by day 180. In those receiving albendazole at day 180 (PLAC/ALB), microfilarial levels also decreased following albendazole ( = 0.005). Blood eosinophil and antifilarial IgG levels did not change significantly for either group, although antifilarial IgG4 levels did in the ALB/PLAC group at day 180. Most subjects continued to have elevations in microfilaremia, suggesting that more intensive regimens of albendazole will be necessary to reduce microfilaremia to levels safe enough to allow for ivermectin use.

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2004-08-01
2017-11-25
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References

  1. Awathi S, Bundy DA, Savioli L, 2003. Helminthic infections. BMJ 327 : 431–433.
  2. Carme B, Boulesteix J, Boutes H, Puruehnce MF, 1991. Five cases of encephalitis during treatment of loiasis with diethylcarbamazine. Am J Trop Med Hyg 44 : 684–690.
  3. Fain A, 1978. Les problèmes actuels de la loase. Bull World Health Organ 56 : 155–167.
  4. Ottesen EA, Campbell WC, 1994. Ivermectin in human medicine. J Antimicrob Chemother 34 : 195–203.
  5. Goa KL, McTavish D, Clissold SP, 1991. Ivermectin: a review of its antifilarial activity, pharmacokinetic properties and clinical efficacy in onchocerciasis. Drugs 42 : 640–658.
  6. Burnham GM, 1993. Adverse reactions to ivermectin treatment for onchocerciasis: results of a placebo-controlled, double-blind trial in Malawi. Trans R Soc Trop Med Hyg 87 : 313–317.
  7. Diallo S, Aziz MA, Lariviere M, Diallo JS, Diopmar I, Ndir O, Badiane S, Py D, Schulzkey H, Gaxotte P, Victorius A, 1986. A double blind comparison of the efficacy and safety of ivermectin and diethylcarbamazine in a placebo controlled study of Senegalese patients with onchocerciasis. Trans R Soc Trop Med Hyg 80 : 927–937.
  8. Duke BOL, Zea-Flores G, Castro J, Cupp EW, Munoz B, 1991. Comparison of the effects of a single dose and of four six-monthly doses of ivermectin on adult Onchocerca volvulus. Am J Trop Med Hyg 45 : 132–137.
  9. Arborio M, Schill H, Neveux Y, Nedelec G, Chevalier B, Teysson R, Buissonn Y, 1995. Nephropathie et filariose à Loa loa traitée par ivermictine. Med Trop (Mars) 55 (Suppl 3): 43.
  10. Ducorps M, Gardon-Wendel N, Ranque S, Ndong W, Boussinesq M, Gardon J, Schneider D, Chippaux JP, 1995. Secondary effects of the treatment of hypermicrofilaremic loiaisis using ivervectin. Bull Soc Pathol Exot 88 : 105–112.
  11. 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 : 18–22.
  12. Boussinesq M, Gardon J, Gardon-Wendel N, Kamgno P, Chippaux JP, 1998. Three probable cases of Loa loa encephalopathy following ivermectin treatment for onchocerciasis. Am J Trop Med Hyg 58 : 461–469.
  13. Cline BL, Little MD, Bartholomew RK, Halsey NA, 1984. Larvicidal activity of albendazole against Necator americanus in human volunteers. Am J Trop Med Hyg 33 : 387–394.
  14. Pene P, Mojon M, Garin JP, Coulaud JP, Rossignol JF, 1982. Albendazole: a new broad spectrum anthelmintic. A double blind multicenter clinical trial. Am J Trop Med Hyg 31 : 263–266.
  15. Klion AD, Horton J, Nutman TB, 1999. Albendazole therapy for loiasis refractory to diethylcarbamazine treatment. Clin Infect Dis 29 : 680–682.
  16. 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 : 202–206.
  17. Kamgno J, Boussinesq M, 2002. Effect of a single dose (600 mg) of albendazole on Loa loa microfilaraemia. Parasite 9 : 59–63.
  18. Hussain R, Hamilton RG, Kumaraswami V, Adkinson NF Jr, Ottesen EA, 1981. IgE responses in human filariasis: quantitation of filaria-specific IgE. J Immunol 127 : 1623–1629.
  19. Lal RB, Ottesen EA, 1988. Enhanced diagnostic specificity in human filariasis by IgG4 assessment. J Infect Dis 158 : 1034–1037.
  20. Lange H, Aggers R, Bircger J, 1986. Increased systemic availability of albendazole when taken with a fatty meal. Eur J Clin Pharmacol 30 : 705–708.
  21. Twum-Danso NA, Meredith SE, 2003. Variation in incidence of serious adverse events after onchocerciasis treatment with ivermectin in areas of Cameroon co-endemic for loiasis. Trop Med Int Health 8 : 820–831.
  22. Tsague-Dongmo L, Kamgno J, Pion SD, Moyou-Somo R, Boussinesq M, 2002. Effects of a 3-day regimen of albendazole (800 mg daily) on Loa loa microfilaraemia. Ann Trop Med Parasitol 96 : 707–715.
  23. Horton J, 2002. Albendazole: a broad spectrum anthelminthic for treatment of individuals and populations. Curr Opin Infect Dis 15 : 599–608.
  24. Kwan-Lim GE, Forsyth KP, Maizels RM, 1990. Filarial-specific IgG4 response correlates with active Wuchereria bancrofti infection. J Immunol 145 : 4298–4305.
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  • Received : 30 Nov 2003
  • Accepted : 05 Feb 2004

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