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J. A . Rizzo, C. Belo, R. Lins and G. Dreyer

CHILDREN AND ADOLESCENTS INFECTED WITH WUCHERERIA BANCROFTI IN GREATER RECIFE, BRAZIL: A RANDOMIZED,YEAR-LONG CLINICAL TRIAL OF SINGLE TREATMENTS WITH DIETHYLCARBAMAZINE OR DIETHYLCARBAMAZINE–ALBENDAZOLE

Annals of Tropical Medicine & Parasitology, Vol. 101, No. 5, 1–11 (2007)

ABSTRACT

In filariasis-endemic areas beyond sub-Saharan Africa, the World Health Organization’s recommended strategy for interrupting transmission of the causative parasites is annual, single-dose, mass treatment with a combination of diethylcarbamazine (DEC; given at 6 mg/kg) and albendazole (ALB; given at 400 mg) for 4–6 years (the minimum estimated life-span of the adult parasites). In an open, hospital-based, randomized and controlled trial, with a blinded evaluation of outcome, 82 children and adolescents from Recife, all with Wuchereria bancrofti microfilaraemias, were given either DEC alone (6 mg/kg) or the same dose of DEC combined with ALB (at 400 mg/patient). Every 90 days for 1 year after the single treatment, each patient was checked for microfilaraemia by the filtration of up to 5 ml of venous blood collected at night. One year post-treatment, 16 (39%) of the 41 patients given DEC alone and 20 (49%) of the 41 given DEC–ALB were found microfilaraemic (relative risk50.8, with a 95% confidence interval of 0.49–1.31) and the corresponding geometric mean levels of microfilaraemia were 2.0% and 1.8% of the levels recorded immediately pre-treatment, respectively (P.0.05). In terms of the prevalences and intensities of microfilaraemia, therefore, the addition of ALB to the DEC appeared to offer no
significant benefit.