Impact of two rounds of mass treatment with diethylcarbamazine plus albendazole on Wuchereria bancrofti infection and the sensitivity of immunochromatographic test in Malindi, Kenya

Annual single-dose mass treatment of endemic populations with a combination of either diethylcarbamazine (DEC) or ivermectin plus albendazole is recommended as the mainstay of lymphatic filariasis elimination programmes. We evaluated the impact of two rounds of annual mass drug administration (MDA)...

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Bibliographic Details
Published in:Transactions of the Royal Society of Tropical Medicine and Hygiene 2008-10, Vol.102 (10), p.1017-1024
Main Authors: Njenga, S.M., Wamae, C.N., Njomo, D.W., Mwandawiro, C.S., Molyneux, D.H.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Albendazole
Albendazole - administration & dosage
Animals
Anti-Infective Agents - administration & dosage
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antigens, Bacterial - blood
Antiparasitic agents
Biological and medical sciences
Child
Child, Preschool
Diethylcarbamazine
Diethylcarbamazine - administration & dosage
Diseases caused by nematodes
Drug Therapy, Combination
Elephantiasis, Filarial - diagnosis
Elephantiasis, Filarial - drug therapy
Elephantiasis, Filarial - epidemiology
Female
Filariases
General aspects
Helminthic diseases
Humans
Immunoassay - methods
Infectious diseases
Kenya
Kenya - epidemiology
Lymphatic filariases
Lymphatic filariasis
Male
Mass drug administration
Medical sciences
Microfilariae - isolation & purification
Middle Aged
Parasitic diseases
Pharmacology. Drug treatments
Pilot Projects
Prevalence
Sensitivity and Specificity
Wuchereria bancrofti
Wuchereria bancrofti - isolation & purification
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Summary:Annual single-dose mass treatment of endemic populations with a combination of either diethylcarbamazine (DEC) or ivermectin plus albendazole is recommended as the mainstay of lymphatic filariasis elimination programmes. We evaluated the impact of two rounds of annual mass drug administration (MDA) of DEC and albendazole on bancroftian filariasis in a pilot elimination programme in an endemic area of Kenya. Overall prevalence of microfilaraemia decreased by 65.4%, whereas community microfilarial load decreased by 84% after the two MDAs. The prevalence of parasite antigenaemia determined by immunochromatographic test (ICT) declined significantly by 43.5% after the two MDAs. We also studied the effect of mass treatment on the sensitivity of the ICT. Although the sensitivity of the test before treatment was high (89.9%; κ = 0.909) sensitivity was lower after two MDAs (59.3%; κ = 0.644). The finding raises concern about the reliability of the ICT in long-term monitoring of infection and for establishing programmatic endpoints. The results of the present study indicate a relatively high effectiveness of MDA using a DEC/albendazole combination against Wuchereria bancrofti infection and, therefore, it may be a useful strategy to eliminate lymphatic filariasis in onchocerciasis-free areas.
ISSN:0035-9203
1878-3503
DOI:10.1016/j.trstmh.2008.04.039