Volume 75, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Michael E, Bundy DA, Grenfell BT, 1996. Re-assessing the global prevalence and distribution of lymphatic filariasis. Parasitology 112 : 409–428. [Google Scholar]
  2. Ottesen EA, Duke BO, Karam M, Behbehani K, 1997. Strategies and tools for the control/elimination of lymphatic filariasis. Bull World Health Organ 75 : 491–503. [Google Scholar]
  3. Beau de Rochars MV, Milord MD, St Jean Y, Desormeaux AM, Dorvil JJ, Lafontant JG, Addiss DG, Streit TG, 2004. Geographic distribution of lymphatic filariasis in Haiti. Am J Trop Med Hyg 71 : 598–601. [Google Scholar]
  4. Beau de Rochars MV, Kanjilal S, Direny AN, Radday J, Lafontant JG, Mathieu E, Rheingans RD, Haddix AC, Streit TG, Beach MJ, Addiss DG, Lammie PJ, 2005. The Leogane, Haiti demonstration project: decreased microfilaremia and program costs after three years of mass drug administration. Am J Trop Med Hyg 73 : 888–894. [Google Scholar]
  5. Addiss DG, Beach MJ, Streit TG, Lutwick S, LeConte FH, Lafontant JG, Hightower AW, Lammie PJ, 1997. Randomised placebo-controlled comparison of ivermectin and albendazole alone and in combination for Wuchereria bancrofti microfilaraemia in Haitian children. Lancet 350 : 480–484. [Google Scholar]
  6. Kimura E, Mataika JU, 1996. Control of lymphatic filariasis by annual single-dose diethylcarbamazine treatments. Parasitol Today 12 : 240–244. [Google Scholar]
  7. Ramaiah KD, Das PK, Vanamail P, Pani SP, 2003. The impact of six rounds of single-dose mass administration of diethylcarbamazine or ivermectin on the transmission of Wuchereria bancrofti by Culex quinquefasciatus and its implications for lymphatic filariasis elimination programmes. Trop Med Int Health 8 : 1082–1092. [Google Scholar]
  8. Kshirsagar NA, Gogtay NJ, Garg BS, Deshmukh PR, Rajgor DD, Kadam VS, Kirodian BG, Ingole NS, Mehendale AM, Fleckenstein L, Karbwang J, Lazdins-Helds JK, 2004. Safety, tolerability, efficacy and plasma concentrations of diethylcarbamazine and albendazole co-administration in a field study in an area endemic for lymphatic filariasis in India. Trans R Soc Trop Med Hyg 98 : 205–217. [Google Scholar]
  9. Ottesen EA, Vijayasekaran V, Kumaraswami V, Perumal Pillai SV, Sadanandam A, Frederick S, Prabhakar R, Tripathy SP, 1990. A controlled trial of ivermectin and diethylcarbamazine in lymphatic filariasis. N Engl J Med 322 : 1113–1117. [Google Scholar]
  10. Michael E, Malecela-Lazaro MN, Simonsen PE, Pedersen EM, Barker G, Kumar A, Kazura JW, 2004. Mathematical modelling and the control of lymphatic filariasis. Lancet Infect Dis 4 : 223–234. [Google Scholar]
  11. Plaisier AP, Stolk WA, van Oortmarssen GJ, Habbema JD, 2000. Effectiveness of annual ivermectin treatment for Wuchereria bancrofti infection. Parasitol Today 16 : 298–302. [Google Scholar]
  12. Bradley MH, Kumaraswami V, 2004. 2.2 Essential tools—drugs and clinical drug trials. Am J Trop Med Hyg 71 : 7–11. [Google Scholar]
  13. Dreyer G, Pires ML, de Andrade LD, Lopes E, Medeiros Z, Tenorio J, Coutinho A, Noroes J, Figueredo-Silva J, 1994. Tolerance of diethylcarbamazine by microfilaraemic and amicrofilaraemic individuals in an endemic area of bancroftian filariasis, Recife, Brazil. Trans R Soc Trop Med Hyg 88 : 232–236. [Google Scholar]
  14. Mackenzie CDK, Kron MA, 1985. Diethylcarbamazine: A review of its action in onchocerciasis, lymphatic filariasis and inflammation. Trop Dis Bull 82 : R1–R36. [Google Scholar]
  15. El Setouhy M, Ramzy RM, Ahmed ES, Kandil AM, Hussain O, Farid HA, Helmy H, Weil GJ, 2004. A randomized clinical trial comparing single- and multi-dose combination therapy with diethylcarbamazine and albendazole for treatment of bancroftian filariasis. Am J Trop Med Hyg 70 : 191–196. [Google Scholar]
  16. Supali T, Wibowo H, Ruckert P, Fischer K, Ismid IS, Purnomo, Djuardi Y, Fischer P, 2002. High prevalence of Brugia timori infection in the highland of Alor Island, Indonesia. Am J Trop Med Hyg 66 : 560–565. [Google Scholar]
  17. Ramaiah KD, Das PK, Appavoo NC, Ramu K, Augustin DJ, Kumar KN, Chandrakala AV, 2000. A programme to eliminate lymphatic filariasis in Tamil Nadu state, India: Compliance with annual single-dose DEC mass treatment and some related operational aspects. Trop Med Int Health 5 : 842–847. [Google Scholar]
  18. Supali T, Ismid IS, Ruckert P, Fischer P, 2002. Treatment of Brugia timori and Wuchereria bancrofti infections in Indonesia using DEC or a combination of DEC and albendazole: Adverse reactions and short-term effects on microfilariae. Trop Med Int Health 7 : 894–901. [Google Scholar]
  19. Ottesen EA, 1985. Efficacy of diethylcarbamazine in eradicating infection with lymphatic-dwelling filariae in humans. Rev Infect Dis 7 : 341–356. [Google Scholar]
  20. Addiss DG, Eberhard ML, Lammie PJ, McNeeley MB, Lee SH, McNeeley DF, Spencer HC, 1993. Comparative efficacy of clearing-dose and single high-dose ivermectin and diethylcarbamazine against Wuchereria bancrofti microfilaremia. Am J Trop Med Hyg 48 : 178–185. [Google Scholar]
  21. Noroes J, Addiss D, Cedenho A, Figueredo-Silva J, Lima G, Dreyer G, 2003. Pathogenesis of filarial hydrocele: risk associated with intrascrotal nodules caused by death of adult Wuchereria bancrofti. Trans R Soc Trop Med Hyg 97 : 561–566. [Google Scholar]
  22. McLaughlin SI, Radday J, Michel MC, Addiss DG, Beach MJ, Lammie PJ, Lammie J, Rheingans R, Lafontant J, 2003. Frequency, severity, and costs of adverse reactions following mass treatment for lymphatic filariasis using diethylcarbamazine and albendazole in Leogane, Haiti, 2000. Am J Trop Med Hyg 68 : 568–573. [Google Scholar]
  23. Weil GJ, Lammie PJ, Weiss N, 1997. The ICT filariasis test: A rapid-format antigen test for diagnosis of bancroftian filariasis. Parasitol Today 13 : 401–404. [Google Scholar]
  24. Hawking F, 1979. Diethylcarbamazine and new compounds for the treatment of filariasis. Garattini SGA, Hawking F, Kopin IJ, Schnitzer RJ, eds. Advances in Pharmacology and Chemotherapy. New York: Academic Press, 129–194.
  25. Fox LM, Furness BW, Haser JK, Desire D, Brissau JM, Milord MD, Lafontant J, Lammie PJ, Beach MJ, 2005. Tolerance and efficacy of combined diethylcarbamazine and albendazole for treatment of Wuchereria bancrofti and intestinal helminth infections in Haitian children. Am J Trop Med Hyg 73 : 115–121. [Google Scholar]
  26. De Rochars MB, Direny AN, Roberts JM, Addiss DG, Radday J, Beach MJ, Streit TG, Dardith D, Lafontant JG, Lammie PJ, 2004. Community-wide reduction in prevalence and intensity of intestinal helminths as a collateral benefit of lymphatic filariasis elimination programs. Am J Trop Med Hyg 71 : 466–470. [Google Scholar]
  27. Rocha A, Addiss D, Ribeiro ME, Noroes J, Baliza M, Medeiros Z, Dreyer G, 1996. Evaluation of the Og4C3 ELISA in Wuchereria bancrofti infection: Infected persons with undetectable or ultra-low microfilarial densities. Trop Med Int Health 1 : 859–864. [Google Scholar]
  28. Michael E, Malecela-Lazaro MN, Kabali C, Snow LC, Kazura JW, 2006. Mathematical models and lymphatic filariasis control: endpoints and optimal interventions. Trends Parasitol 22 : 226–233. [Google Scholar]
  29. Ottesen EA, 2000. The global programme to eliminate lymphatic filariasis. Trop Med Int Health 5 : 591–594. [Google Scholar]

Data & Media loading...

  • Received : 20 Apr 2006
  • Accepted : 10 Jul 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error