EFFICACY OF SINGLE-DOSE COMBINATIONS OF ALBENDAZOLE, IVERMECTIN AND DIETHYLCARBAMAZINE FOR THE TREATMENT OF BANCROFTIAN FILARIASIS

In a 'blind' trial on 50 male asymptomatic microfilaraemic subjects wi th Wuchereria bancrofti infection, the safety, tolerability and filari cidal efficacy of a single dose of albendazole (alb) 600 mg alone or i n combination with ivermectin liver) 400 mu g/kg or diethylcarbamazine citrate (DEC) 6 mg/kg was compared with a single dose of the combinat ion DEC 6 mg/kg and iver 400 mu g/kg over a period of 15 months after treatment. All but one subject, with 67 microfilariae (mf)/mL, had pre -treatment counts >100 mf/mL. All 4 treatments significantly reduced m f counts, but alb/iver was the most effective regimen for clearing mf from night blood: 9 of 13 subjects (69%) were amicrofilaraemic by memb rane filtration 15 months after treatment compared to one of 12 (8%), 3 of 11 (27%), and 3 of 10 (30%) in the groups treated with alb, alb/D EC, and DEC/iver, respectively. Filarial antigen tests suggested that all 4 treatments had significant activity against adult W. bancrofti; alb/DEC had the greatest activity according to this test, with antigen levels decreasing by 77% 15 months after therapy. All 4 regimens were well tolerated and clinically safe, although mild, self-limited syste mic reactions were observed in all treatment groups. These results sug gest that alb/iver is a safe and effective single dose regimen for sup pression of microfilaraemia in bancroftian filariasis that could be co nsidered for control programmes. Additional benefits of this combinati on are its potent, broad spectrum activity against intestinal helminth s and potential relative safety in areas of Africa where DEC cannot be used for filariasis control because of co-endemicity with onchocercia sis or loiasis.