Study shows benefit of semiannual albendazole to control lymphatic filariasis
Semiannual doses of albendazole decreased the average time it took to clear circulating filarial antigenemia in patients with lymphatic filariasis compared with a single or no dose, study findings showed.
The results, which were published in Clinical Infectious Diseases, “demonstrate a clear dose-response relationship for the effect of” albendazole (ALB) on clearance of circulating filarial antigenemia (CFA) and microfilaremia, the researchers wrote.
“The analyses presented here provide important information regarding the added value of semiannual ALB treatment vs. annual mass drug administration (MDA) or no treatment on lymphatic filariasis (LF) infection parameters,” Cédric B. Chesnais, MD, PhD, of the French National Research Institute for Sustainable Development, and colleagues wrote. “Our results show that good adherence leads to faster clearance of LF infection in individuals.”
Chesnais and colleagues examined trial data to determine the relationship between individual adherence to ALB MDA and CFA clearance in patients with LF, a mosquito-borne infection primarily caused by Wuchereria bancrofti. Participants were given one dose of ALB every 6 months and tested for LF at baseline and annually. CFA-positive individuals were included for analysis.
Of the 2,658 subjects in the trials, 394 were eligible for CFA analysis and 129 were eligible for microfilaremia analysis. The average clearance time for CFA was briefer in participants who took two doses of ALB per year (3.9 years) than individuals who took one or no doses (4.4 and 5.3 years; P < .001).
Chesnais and colleagues noted that WHO has provisionally recommended semiannual MDA with ALB to control LF in areas where it is co-endemic with another filarial infection, loiasis, but said the recommendation was “based on thin evidence.”
“We believe that we have demonstrated through these new analyses that participation rates in MDA programs must be maintained at high levels to accelerate the elimination of LF in individuals and communities,” the authors concluded. “Evidence from this study could be used in social mobilization programs to illustrate the importance of achieving and sustaining high rates of MDA adherence in LF elimination programs.”