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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A Randomized Trial of Doxycycline for <italic>Mansonella perstans</italic> Infection</title><author><name sortKey="Coulibaly, Yaya I" sort="Coulibaly, Yaya I" uniqKey="Coulibaly Y" first="Yaya I." last="Coulibaly">Yaya I. Coulibaly</name></author><author><name sortKey="Dembele, Benoit" sort="Dembele, Benoit" uniqKey="Dembele B" first="Benoit" last="Dembele">Benoit Dembele</name></author><author><name sortKey="Diallo, Abdallah A" sort="Diallo, Abdallah A" uniqKey="Diallo A" first="Abdallah A." last="Diallo">Abdallah A. Diallo</name></author><author><name sortKey="Lipner, Ettie M" sort="Lipner, Ettie M" uniqKey="Lipner E" first="Ettie M." last="Lipner">Ettie M. Lipner</name></author><author><name sortKey="Doumbia, Salif S" sort="Doumbia, Salif S" uniqKey="Doumbia S" first="Salif S." last="Doumbia">Salif S. Doumbia</name></author><author><name sortKey="Coulibaly, Siaka Y" sort="Coulibaly, Siaka Y" uniqKey="Coulibaly S" first="Siaka Y." last="Coulibaly">Siaka Y. Coulibaly</name></author><author><name sortKey="Konate, Siaka" sort="Konate, Siaka" uniqKey="Konate S" first="Siaka" last="Konate">Siaka Konate</name></author><author><name sortKey="Diallo, Dapa A" sort="Diallo, Dapa A" uniqKey="Diallo D" first="Dapa A." last="Diallo">Dapa A. Diallo</name></author><author><name sortKey="Yalcouye, Daniel" sort="Yalcouye, Daniel" uniqKey="Yalcouye D" first="Daniel" last="Yalcouye">Daniel Yalcouye</name></author><author><name sortKey="Kubofcik, Joseph" sort="Kubofcik, Joseph" uniqKey="Kubofcik J" first="Joseph" last="Kubofcik">Joseph Kubofcik</name></author><author><name sortKey="Doumbo, Ogobara K" sort="Doumbo, Ogobara K" uniqKey="Doumbo O" first="Ogobara K." last="Doumbo">Ogobara K. Doumbo</name></author><author><name sortKey="Traore, Abdel K" sort="Traore, Abdel K" uniqKey="Traore A" first="Abdel K." last="Traore">Abdel K. Traore</name></author><author><name sortKey="Keita, Adama D" sort="Keita, Adama D" uniqKey="Keita A" first="Adama D." last="Keita">Adama D. Keita</name></author><author><name sortKey="Fay, Michael P" sort="Fay, Michael P" uniqKey="Fay M" first="Michael P." last="Fay">Michael P. Fay</name></author><author><name sortKey="Traore, Sekou F" sort="Traore, Sekou F" uniqKey="Traore S" first="Sekou F." last="Traore">Sekou F. Traore</name></author><author><name sortKey="Nutman, Thomas B" sort="Nutman, Thomas B" uniqKey="Nutman T" first="Thomas B." last="Nutman">Thomas B. Nutman</name></author><author><name sortKey="Klion, Amy D" sort="Klion, Amy D" uniqKey="Klion A" first="Amy D." last="Klion">Amy D. Klion</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19812401</idno><idno type="pmc">3410935</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410935</idno><idno type="RBID">PMC:3410935</idno><idno type="doi">10.1056/NEJMoa0900863</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">003287</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003287</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Randomized Trial of Doxycycline for <italic>Mansonella perstans</italic> Infection</title><author><name sortKey="Coulibaly, Yaya I" sort="Coulibaly, Yaya I" uniqKey="Coulibaly Y" first="Yaya I." last="Coulibaly">Yaya I. Coulibaly</name></author><author><name sortKey="Dembele, Benoit" sort="Dembele, Benoit" uniqKey="Dembele B" first="Benoit" last="Dembele">Benoit Dembele</name></author><author><name sortKey="Diallo, Abdallah A" sort="Diallo, Abdallah A" uniqKey="Diallo A" first="Abdallah A." last="Diallo">Abdallah A. Diallo</name></author><author><name sortKey="Lipner, Ettie M" sort="Lipner, Ettie M" uniqKey="Lipner E" first="Ettie M." last="Lipner">Ettie M. Lipner</name></author><author><name sortKey="Doumbia, Salif S" sort="Doumbia, Salif S" uniqKey="Doumbia S" first="Salif S." last="Doumbia">Salif S. Doumbia</name></author><author><name sortKey="Coulibaly, Siaka Y" sort="Coulibaly, Siaka Y" uniqKey="Coulibaly S" first="Siaka Y." last="Coulibaly">Siaka Y. Coulibaly</name></author><author><name sortKey="Konate, Siaka" sort="Konate, Siaka" uniqKey="Konate S" first="Siaka" last="Konate">Siaka Konate</name></author><author><name sortKey="Diallo, Dapa A" sort="Diallo, Dapa A" uniqKey="Diallo D" first="Dapa A." last="Diallo">Dapa A. Diallo</name></author><author><name sortKey="Yalcouye, Daniel" sort="Yalcouye, Daniel" uniqKey="Yalcouye D" first="Daniel" last="Yalcouye">Daniel Yalcouye</name></author><author><name sortKey="Kubofcik, Joseph" sort="Kubofcik, Joseph" uniqKey="Kubofcik J" first="Joseph" last="Kubofcik">Joseph Kubofcik</name></author><author><name sortKey="Doumbo, Ogobara K" sort="Doumbo, Ogobara K" uniqKey="Doumbo O" first="Ogobara K." last="Doumbo">Ogobara K. Doumbo</name></author><author><name sortKey="Traore, Abdel K" sort="Traore, Abdel K" uniqKey="Traore A" first="Abdel K." last="Traore">Abdel K. Traore</name></author><author><name sortKey="Keita, Adama D" sort="Keita, Adama D" uniqKey="Keita A" first="Adama D." last="Keita">Adama D. Keita</name></author><author><name sortKey="Fay, Michael P" sort="Fay, Michael P" uniqKey="Fay M" first="Michael P." last="Fay">Michael P. Fay</name></author><author><name sortKey="Traore, Sekou F" sort="Traore, Sekou F" uniqKey="Traore S" first="Sekou F." last="Traore">Sekou F. Traore</name></author><author><name sortKey="Nutman, Thomas B" sort="Nutman, Thomas B" uniqKey="Nutman T" first="Thomas B." last="Nutman">Thomas B. Nutman</name></author><author><name sortKey="Klion, Amy D" sort="Klion, Amy D" uniqKey="Klion A" first="Amy D." last="Klion">Amy D. Klion</name></author></analytic><series><title level="j">The New England journal of medicine</title><idno type="ISSN">0028-4793</idno><idno type="eISSN">1533-4406</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1"><italic>Mansonella perstans</italic> infection is common in areas of Africa where <italic>Wuchereria bancrofti</italic>, a causative agent of lymphatic filariasis, is endemic. <italic>M. perstans</italic> is refractory to standard antifilarial therapies. The recent discovery of bacterial endosymbionts (e.g., wolbachia) in most filarial species, including <italic>M. perstans</italic>, provides new therapeutic options for reducing microfilaremia.</p></sec><sec id="S2"><title>Methods</title><p id="P2">In an open-label, randomized trial, we recruited subjects with <italic>M. perstans</italic> microfilaremia, with or without concomitant <italic>W. bancrofti</italic> infection, from four villages in Mali and randomly assigned them to receive doxycycline, at a dose of 200 mg daily for 6 weeks (106 subjects), or no treatment (110). At 6 months, subjects who were co-infected with <italic>W. bancrofti</italic> underwent a second random assignment, to treatment with a single dose of albendazole (400 mg) and ivermectin (150 μg per kilogram of body weight) or no treatment. Subjects were monitored daily during the first 6-week study period for adverse events. <italic>M. perstans</italic> and <italic>W. bancrofti</italic> microfilarial levels were assessed at 6, 12, and 36 months.</p></sec><sec id="S3"><title>Results</title><p id="P3">At 12 months, 67 of 69 subjects who had received treatment with doxycycline only (97%) had no detectable <italic>M. perstans</italic> microfilariae per 60 μl of blood, as compared with 10 of 63 subjects who had received no treatment (16%) (relative risk, 6.18; 95% confidence interval, 3.63 to 11.89; P<0.001). At 36 months, <italic>M. perstans</italic> microfilaremia remained suppressed in 48 of 64 subjects who had received treatment with doxycycline only (75%), a finding that was consistent with a macrofilaricidal effect of doxycycline. Vomiting was more frequent in the doxycycline-treated group than in the untreated group (17% vs. 4%).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">These results are consistent with previous findings that <italic>M. perstans</italic> harbors the intracellular endosymbiont, wolbachia, and suggest that doxycycline is an effective therapy for <italic>M. perstans</italic> infection.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0255562</journal-id><journal-id journal-id-type="pubmed-jr-id">5985</journal-id><journal-id journal-id-type="nlm-ta">N Engl J Med</journal-id><journal-id journal-id-type="iso-abbrev">N. Engl. J. Med.</journal-id><journal-title-group><journal-title>The New England journal of medicine</journal-title></journal-title-group><issn pub-type="ppub">0028-4793</issn><issn pub-type="epub">1533-4406</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19812401</article-id><article-id pub-id-type="pmc">3410935</article-id><article-id pub-id-type="doi">10.1056/NEJMoa0900863</article-id><article-id pub-id-type="manuscript">NIHMS390886</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>A Randomized Trial of Doxycycline for <italic>Mansonella perstans</italic> Infection</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Coulibaly</surname><given-names>Yaya I.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Dembele</surname><given-names>Benoit</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Diallo</surname><given-names>Abdallah A.</given-names></name><degrees>D.E.A.</degrees></contrib><contrib contrib-type="author"><name><surname>Lipner</surname><given-names>Ettie M.</given-names></name><degrees>M.P.H.</degrees></contrib><contrib contrib-type="author"><name><surname>Doumbia</surname><given-names>Salif S.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Coulibaly</surname><given-names>Siaka Y.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Konate</surname><given-names>Siaka</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Diallo</surname><given-names>Dapa A.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Yalcouye</surname><given-names>Daniel</given-names></name><degrees>Pharm.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Kubofcik</surname><given-names>Joseph</given-names></name><degrees>B.S.</degrees></contrib><contrib contrib-type="author"><name><surname>Doumbo</surname><given-names>Ogobara K.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Traore</surname><given-names>Abdel K.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Keita</surname><given-names>Adama D.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Fay</surname><given-names>Michael P.</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Traore</surname><given-names>Sekou F.</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Nutman</surname><given-names>Thomas B.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Klion</surname><given-names>Amy D.</given-names></name><degrees>M.D.</degrees></contrib><aff id="A1">Faculty of Medicine, Pharmacy and Odontostomatology, University of Bamako (Y.I.C., B.D., A.A.D., S.S.D., S.Y.C., S.K., D.A.D., D.Y., O.K.D., S.F.T.); the Center for Disease Control (A.K.T.); and the Department of Radiology, Hospital at Point G (A.D. Keita) — all in Bamako, Mali; and the Biostatistics and Research Branch (E.M.L., M.P.F.) and Laboratory of Parasitic Diseases (J.K., T.B.N., A.D. Klion), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD</aff></contrib-group><author-notes><corresp id="FN1">Address reprint requests to Dr. Klion at the Laboratory of Parasitic Diseases, National Institutes of Health, Bldg. 50, Rm. 6351, Bethesda, MD 20892, or at <email>aklion@nih.gov</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>19</day><month>7</month><year>2012</year></pub-date><pub-date pub-type="ppub"><day>8</day><month>10</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>02</day><month>8</month><year>2012</year></pub-date><volume>361</volume><issue>15</issue><fpage>1448</fpage><lpage>1458</lpage><permissions><copyright-statement>Copyright © 2009 Massachusetts Medical Society. All rights reserved.</copyright-statement><copyright-year>2009</copyright-year></permissions><abstract><sec id="S1"><title>Background</title><p id="P1"><italic>Mansonella perstans</italic> infection is common in areas of Africa where <italic>Wuchereria bancrofti</italic>, a causative agent of lymphatic filariasis, is endemic. <italic>M. perstans</italic> is refractory to standard antifilarial therapies. The recent discovery of bacterial endosymbionts (e.g., wolbachia) in most filarial species, including <italic>M. perstans</italic>, provides new therapeutic options for reducing microfilaremia.</p></sec><sec id="S2"><title>Methods</title><p id="P2">In an open-label, randomized trial, we recruited subjects with <italic>M. perstans</italic> microfilaremia, with or without concomitant <italic>W. bancrofti</italic> infection, from four villages in Mali and randomly assigned them to receive doxycycline, at a dose of 200 mg daily for 6 weeks (106 subjects), or no treatment (110). At 6 months, subjects who were co-infected with <italic>W. bancrofti</italic> underwent a second random assignment, to treatment with a single dose of albendazole (400 mg) and ivermectin (150 μg per kilogram of body weight) or no treatment. Subjects were monitored daily during the first 6-week study period for adverse events. <italic>M. perstans</italic> and <italic>W. bancrofti</italic> microfilarial levels were assessed at 6, 12, and 36 months.</p></sec><sec id="S3"><title>Results</title><p id="P3">At 12 months, 67 of 69 subjects who had received treatment with doxycycline only (97%) had no detectable <italic>M. perstans</italic> microfilariae per 60 μl of blood, as compared with 10 of 63 subjects who had received no treatment (16%) (relative risk, 6.18; 95% confidence interval, 3.63 to 11.89; P<0.001). At 36 months, <italic>M. perstans</italic> microfilaremia remained suppressed in 48 of 64 subjects who had received treatment with doxycycline only (75%), a finding that was consistent with a macrofilaricidal effect of doxycycline. Vomiting was more frequent in the doxycycline-treated group than in the untreated group (17% vs. 4%).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">These results are consistent with previous findings that <italic>M. perstans</italic> harbors the intracellular endosymbiont, wolbachia, and suggest that doxycycline is an effective therapy for <italic>M. perstans</italic> infection.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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