Long-term efficacy of single-dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis

In a 'blinded' trial (in Sri Lanka, 1996-98) of 47 male asymptomatic microf ilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerab ility and filaricidal efficacy of 3 single-dose combination regimens were c ompared: albendazole 400 mg with ivermectin 200 mug/kg, albendazole 400 mg with diethylcarbamazine citrate (DEC) 6 mg/kg or albendazole 600 mg with iv ermectin 400 mug/kg. Treated subjects were followed-up for 24 months. This represents the first long-term study using combinations of albendazole with DEC or ivermectin in the above doses against bancroftian filariasis. All s ubjects had pretreatment microfilaria (mf) counts over 100/mL. All 3 treatm ents significantly reduced mf counts, with the albendazole-DEC-treated grou p showing the lowest mf levels at 18 and 24 months post-treatment. Filarial antigen tests suggested that all 3 treatments had significant activity aga inst adult If: bancrofti; albendazole-DEC combination had the greatest acti vity according to this test, with antigen levels decreasing to 30.5% of pre -treatment antigen levels, 24 months after therapy. All 3 treatments were c linically safe and well tolerated. These results suggest that a single dose of albendazole 400 mg together with DEC 6 mg/kg is a safe and effective co mbination for suppression of microfilaraemia of bancroftian filariasis that could be considered for use in filariasis control programmes based on mass treatment of endemic populations.