Decrease in Mansonella perstans microfilaraemia after albendazole treatment

Duong, Thanh Haï; Kombila, Maryvonne; Ferrer, Alain; Nguiri, Christophe; Richard-Lenoble, D

doi:10.1016/s0035-9203(98)91093-8

Cited by 16 publications

(7 citation statements)

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“…7,14,15 The lack of efficacy of a single dose of albendazole–ivermectin in reducing M. perstans microfilaremia was confirmed in the present study. Although some studies have described a reduction in levels of M. perstans microfilariae after antifilarial treatment, 16,17 complete clearance of microfilariae appears to be uncommon, even with prolonged drug treatment. In an open-label, nonrandomized study that compared the effects of seven different drug regimens, the most effective treatment (diethylcarbamazine at a dose of 200 mg twice daily for 21 days plus mebendazole at a dose of 100 to 200 mg daily for 21 days) effected clearance of M. perstans microfilaremia in only 10 of 27 patients (37%) by 30 days after treatment.…”

Section: Discussionmentioning

confidence: 98%

A Randomized Trial of Doxycycline forMansonella perstansInfection

et al. 2009

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Background Mansonella perstans infection is common in areas of Africa where Wuchereria bancrofti, a causative agent of lymphatic filariasis, is endemic. M. perstans is refractory to standard antifilarial therapies. The recent discovery of bacterial endosymbionts (e.g., wolbachia) in most filarial species, including M. perstans, provides new therapeutic options for reducing microfilaremia. Methods In an open-label, randomized trial, we recruited subjects with M. perstans microfilaremia, with or without concomitant W. bancrofti 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 W. bancrofti 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. M. perstans and W. bancrofti microfilarial levels were assessed at 6, 12, and 36 months. Results At 12 months, 67 of 69 subjects who had received treatment with doxycycline only (97%) had no detectable M. perstans 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, M. perstans 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%). Conclusions These results are consistent with previous findings that M. perstans harbors the intracellular endosymbiont, wolbachia, and suggest that doxycycline is an effective therapy for M. perstans infection.

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Section: Discussionmentioning

confidence: 98%

A Randomized Trial of Doxycycline forMansonella perstansInfection

et al. 2009

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“…Although some activity of ivermectin 11,12 and albendazole 13,14 against M. perstans has been described, the effects appear to be partial and gradual, with no specific posttreatment reactions having been reported. Closely observing post-treatment reactions in lymphatic filariasis in an area endemic for Mansonella is therefore of some scientific interest.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Post-Treatment Reactions to Ivermectin/Albendazole for Wuchereria Bancrofti in a Region Co-Endemic for Mansonella Perstans

Keiser

Coulibaly²,

Keita³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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Post-treatment reactions to single-dose ivermectin (200 g/kg) and albendazole (400 mg) were studied in a filarial endemic region of Mali. The prevalence of Wuchereria bancrofti in this region was 48.3% (69 of 143), and coinfection with Mansonella perstans was common (30 of 40, 75%). Microfilarial levels of M. perstans correlated positively with age (P ‫ס‬ 0.006) and with W. bancrofti microfilarial levels (P ‫ס‬ 0.006). Forty individuals (28 infected and 12 uninfected) were treated, with mild post-treatment reactions occurring in 35.7% (7 of 28) of the W. bancrofti-infected subjects. Reaction severity correlated with pretreatment W. bancrofti microfilarial levels (P ‫ס‬ 0.001). There were no significant differences in the prevalence or severity of post-treatment reactions in those who were co-infected with M. perstans. It is concluded that co-infection with M. perstans does not significantly alter the post-treatment reaction profile to single-dose ivermectin/albendazole in W. bancrofti infection in this community, and that acute post-treatment reactions should not limit patient compliance in community-based programs to eliminate lymphatic filariasis.

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“…11,12 That is why we prescribed to our patient albendazole in the posology of 400 mg twice daily for 3 weeks, with effectiveness after 2 weeks of treatment.…”

Section: Case Reportmentioning

confidence: 99%