SELECTIVE DIETHYLCARBAMAZINE CHEMOTHERAPY FOR CONTROL OF BANCROFTIAN FILARIASIS IN 2 COMMUNITIES OF TANZANIA - COMPARED EFFICACY OF A STANDARD-DOSE TREATMENT AND 2 SEMIANNUAL SINGLE-DOSE TREATMENTS
Pe. Simonsen et al., SELECTIVE DIETHYLCARBAMAZINE CHEMOTHERAPY FOR CONTROL OF BANCROFTIAN FILARIASIS IN 2 COMMUNITIES OF TANZANIA - COMPARED EFFICACY OF A STANDARD-DOSE TREATMENT AND 2 SEMIANNUAL SINGLE-DOSE TREATMENTS, The American journal of tropical medicine and hygiene, 53(3), 1995, pp. 267-272
Citations number
24
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
The efficacy of two strategies for control of Bancroftian filariasis u
sing selective rather than community-wide diethylcarbamazine (DEC) che
motherapy was evaluated and compared in two endemic communities of nor
theastern Tanzania, with pretreatment microfilariae (mf) prevalences o
f 22% and 38%, and geometric mean intensities (GMIs) of 668 mf/ml and
735 mf/ml of blood. All mf-positive cases in the first community were
offered treatment with 6 mg of DEC/kg of body weight a day for 12 days
(group 1), and those in the second community were offered treatment w
ith two doses of 6 mg of DEC/kg of body weight at an interval of six m
onths (group 2). The effect of treatment was followed both among those
treated and at the community level. In treated individuals, there was
a rapid decrease in the mf load that was significantly greater among
those receiving the 12-day standard dose. One year after the start of
treatment, the mf clearance rates were 59% and 39% and the GMIs were r
educed by 99% and 97% among treated individuals in groups 1 and 2, res
pectively. However, at the community level, the mf prevalences were 16
.3% and 27.9% (reduced by 27% and 26%) and the GMIs were 129 mf/ml and
224 mf/ml (reduced by 81% and 70%) one year after the start of treatm
ent with the two regimens, respectively, suggesting that transmission
continued at a significant level in the villages after treatment. The
limitations of selective chemotherapy are discussed, and it is argued
that strategies based on mass DEC chemotherapy would be more effective
in reducing the microfilarial load in the community and thereby in re
ducing transmission.