CLINICAL CHARACTERISTICS OF POST-TREATMENT REACTIONS TO IVERMECTIN/ALBENDAZOLE FOR WUCHERERIA BANCROFTI IN A REGION CO-ENDEMIC FOR MANSONELLA PERSTANS

PAUL B. KEISER Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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YAYA I. COULIBALY Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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FALAYE KEITA Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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DIAKARIDIA TRAORE Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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ABDALLAH DIALLO Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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DAPA A. DIALLO Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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ROSHANAK T. SEMNANI Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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OGOBARA K. DOUMBO Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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SEKOU F. TRAORE Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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AMY D. KLION Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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THOMAS B. NUTMAN Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Departments of Epidemiology and Parasitic Diseases, University of Mali School of Medicine, Pharmacy, and Dentistry, Bamako, Mali

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Post-treatment reactions to single-dose ivermectin (200 μg/kg) and albendazole (400 mg) were studied in a filarial endemic region of Mali. The prevalence of Wuchereria bancrofti in this region was 48.3% (69 of 143), and coinfection with Mansonella perstans was common (30 of 40, 75%). Microfilarial levels of M. perstans correlated positively with age (P = 0.006) and with W. bancrofti microfilarial levels (P = 0.006). Forty individuals (28 infected and 12 uninfected) were treated, with mild post-treatment reactions occurring in 35.7% (7 of 28) of the W. bancrofti-infected subjects. Reaction severity correlated with pretreatment W. bancrofti microfilarial levels (P = 0.001). There were no significant differences in the prevalence or severity of post-treatment reactions in those who were co-infected with M. perstans. It is concluded that co-infection with M. perstans does not significantly alter the post-treatment reaction profile to single-dose ivermectin/albendazole in W. bancrofti infection in this community, and that acute post-treatment reactions should not limit patient compliance in community-based programs to eliminate lymphatic filariasis.

Author Notes

Reprint requests: Thomas B. Nutman, Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Building 4, Room B1-03, Bethesda, MD, 20892-0425, Telephone: 301-496-5398, Fax: 301-496-5398, E-mail: tnutman@niaid.nih.gov.
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