Serveur d'exploration sur le lymphœdème

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Randomised community-based trial of annual single-dose diethylcarbamazine with or without ivermectin against Wuchereria bancrofti infection in human beings and mosquitoes.

Identifieur interne : 004F39 ( PubMed/Curation ); précédent : 004F38; suivant : 004F40

Randomised community-based trial of annual single-dose diethylcarbamazine with or without ivermectin against Wuchereria bancrofti infection in human beings and mosquitoes.

Auteurs : M J Bockarie [Papouasie-Nouvelle-Guinée] ; N D Alexander ; P. Hyun ; Z. Dimber ; F. Bockarie ; E. Ibam ; M P Alpers ; J W Kazura

Source :

RBID : pubmed:9449870

Descripteurs français

English descriptors

Abstract

WHO has targeted lymphatic filariasis for elimination. Studies of vector-parasite relations of Wuchereria bancrofti suggest that a reduction in the microfilarial reservoir by mass chemotherapy may interrupt transmission and thereby eliminate infection. However, no field data exist on the impact of chemotherapy alone on vector efficiency and transmission intensity of W bancrofti. We compared the impact of an annual community-wide single-dose treatment with diethylcarbamazine alone or with ivermectin on rate and intensity of microfilaraemia, and transmission intensity in an area of Papua New Guinea endemic for intense W bancrofti transmission.

DOI: 10.1016/S0140-6736(97)07081-5
PubMed: 9449870

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pubmed:9449870

Le document en format XML

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<term>Anopheles (parasitology)</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Diethylcarbamazine (administration & dosage)</term>
<term>Diethylcarbamazine (therapeutic use)</term>
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<term>Drug Therapy, Combination</term>
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<term>Filaricides (therapeutic use)</term>
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<term>Insect Vectors (parasitology)</term>
<term>Ivermectin (administration & dosage)</term>
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<term>Diéthylcarbamazine (administration et posologie)</term>
<term>Diéthylcarbamazine (usage thérapeutique)</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
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<term>Humains</term>
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<term>Elephantiasis, Filarial</term>
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<term>Elephantiasis, Filarial</term>
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<term>Wuchereria bancrofti</term>
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<term>Wuchereria bancrofti</term>
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<term>Anopheles</term>
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<term>Diethylcarbamazine</term>
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<term>Ivermectin</term>
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<term>Filariose lymphatique</term>
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<term>Adulte</term>
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<term>Calendrier d'administration des médicaments</term>
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<div type="abstract" xml:lang="en">WHO has targeted lymphatic filariasis for elimination. Studies of vector-parasite relations of Wuchereria bancrofti suggest that a reduction in the microfilarial reservoir by mass chemotherapy may interrupt transmission and thereby eliminate infection. However, no field data exist on the impact of chemotherapy alone on vector efficiency and transmission intensity of W bancrofti. We compared the impact of an annual community-wide single-dose treatment with diethylcarbamazine alone or with ivermectin on rate and intensity of microfilaraemia, and transmission intensity in an area of Papua New Guinea endemic for intense W bancrofti transmission.</div>
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<Month>02</Month>
<Day>18</Day>
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<Year>1998</Year>
<Month>02</Month>
<Day>18</Day>
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<Year>2015</Year>
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<Day>16</Day>
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<Issue>9097</Issue>
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<ArticleTitle>Randomised community-based trial of annual single-dose diethylcarbamazine with or without ivermectin against Wuchereria bancrofti infection in human beings and mosquitoes.</ArticleTitle>
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<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">WHO has targeted lymphatic filariasis for elimination. Studies of vector-parasite relations of Wuchereria bancrofti suggest that a reduction in the microfilarial reservoir by mass chemotherapy may interrupt transmission and thereby eliminate infection. However, no field data exist on the impact of chemotherapy alone on vector efficiency and transmission intensity of W bancrofti. We compared the impact of an annual community-wide single-dose treatment with diethylcarbamazine alone or with ivermectin on rate and intensity of microfilaraemia, and transmission intensity in an area of Papua New Guinea endemic for intense W bancrofti transmission.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We carried out clinical and parasitological surveys in 14 communities in matched pairs. People aged 5 years or older in seven communities received randomly assigned diethylcarbamazine 6 mg/kg and people in the other seven communities received diethylcarbamazine 6 mg/kg plus ivermectin 400 micrograms/kg. We made physical examinations for hydroceles and leg oedema and investigated microfilarial densities by membrane filtration before and after treatment. We selected five communities for monthly entomological surveys between September, 1993, and September, 1995. Mosquitoes were collected in these communities by the all-night landing catch method and were individually dissected to identify rates of infection and infectiveness.</AbstractText>
<AbstractText Label="FINDINGS" NlmCategory="RESULTS">2219 (87.6%) of 2534 eligible people received treatment. Microfilarial rate and density had decreased 1 year after treatment in all 14 communities; this decrease was significantly higher in communities given combined therapy than in those given diethylcarbamazine alone (mean decreases 57.5% and 30.6%, respectively; p = 0.0013). Greater decreases were also seen in community-specific microfilarial intensity with combined therapy (mean reductions 91.1% and 69.8%, respectively; p = 0.0047). The rate of leg oedema was not altered, but the frequency of advanced hydroceles decreased by 47% with combined therapy and 56% with diethylcarbamazine alone. 26,641 Anopheles punctulatus mosquitoes were caught during 499 person-nights of landing catches. Exposure to infective third-stage larvae decreased in all monitored five communities. Annual transmission potential decreased by between 75.7% and 98.8% in combined-therapy communities and between 75.6% and 79.4% in communities given diethylcarbamazine alone. Transmission was almost interrupted in two communities treated with combined therapy.</AbstractText>
<AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">Annual single-dose community-wide treatment with diethylcarbamazine alone or with ivermectin is effective for the control of lymphatic filariasis in highly endemic areas, but combination therapy brings about greater decreases in rates and intensity of microfilaraemia.</AbstractText>
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<LastName>Bockarie</LastName>
<ForeName>M J</ForeName>
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<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<DescriptorName UI="D007303" MajorTopicYN="N">Insect Vectors</DescriptorName>
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<DescriptorName UI="D014958" MajorTopicYN="Y">Wuchereria bancrofti</DescriptorName>
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