Background Lymphatic filariasis and intestinal helminth infections are important disorders in tropical areas. Periodic treatment with albendazole is now used in many school-based intestinal helminth-control programmes. However, few such programmes exist for lymphatic filariasis, despite evidence that single-dose treatment with ivermectin can greatly reduce the concentration of Wuchereria bancrofti microfilariae in the blood for months to years. We aimed to assess the potential for school-based control of lymphatic filariasis by investigating the efficacy and tolerability of combined ivermectin and albendazole in Haitian schoolchildren.Methods In January, 1996, we collected 83220 L capillary blood samples for inclusion in a randomised controlled study from children aged 511 years, and examined them by microscopy for W bancrofti microfilariae. Infected children were randomly assigned treatment with placebo (n=29), a single 200400 g/kg dose of ivermectin (mean, 273 g/kg, n=28), 400 mg albendazole (n=29), or a combination of 200400 g/kg ivermectin and 400 mg albendazole (n=24). Children with high concentrations of microfilariae in the blood were admitted to hospital and adverse reactions were monitored for 35 days, otherwise children were examined at school or during a visit to their home. 4 months after treatment, we examined blood samples again for microfilariae.Findings 113 microfilaraemic children were enrolled (mean age 78 years). 4 months after treatment, the proportion of children who remained positive for microfilariae was significantly lower in the ivermectin plus albendazole group (four [17]), but there were no significant changes in the other three groups (20 [69] placebo, 22 [76] albendazole alone, 17 [61] ivermectin alone remained positive; p=0004). Geometric mean microfilarial concentration decreased from 93 to 53 per 20 L blood among children who received placebo; from 155 to 15 per 20 L blood among those who received ivermectin only (p=0032); from 141 to 51 per 20 L blood among those who received albendazole alone; and from 137 to 03 per 20 L blood among those who received both ivermectin and albendazole (p=00001). Systemic adverse reactions did not differ significantly between the four groups.Interpretation For children with W bancrofti microfilaraemia, combined treatment with ivermectin and albendazole was more effective than treatment with ivermectin only, with no measurable increase in severity of adverse reactions.

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   |wiki=    Wicri/Sante
   |area=    LymphedemaV1
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   |étape=   Exploration
   |type=    RBID
   |clé=     ISTEX:026E3AFD1EE32197E2F9F5C76857FC499C2E45BD
   |texte=   Randomised placebo-controlled comparison of ivermectin and albendazole alone and in combination for Wuchereria bancrofti microfilaraemia in Haitian children
}}