Low dosage diethylcarbamazine administered by villagers for the control of timorian filariasis

Partònò, F; Purnomo, Purnomo; Soewarta, A.; Oemijati, S

doi:10.1016/0035-9203(84)90124-x

Cited by 20 publications

(4 citation statements)

References 2 publications

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“…2000). Only very few drug studies, especially with low dosage of DEC, were performed in B. timori endemic areas (Partono et al . 1981, 1984).…”

Section: Discussionmentioning

confidence: 99%

“…In the treated B. timori infected individuals, the percentage of fever as well as the number of adverse reactions was higher than in W. bancrofti patients. Adenolymphangitis observed in patients treated with both regimens showed that DEC has prominent macrofilaricidal activity that induces local inflammatory responses around dying parasites (Partono et al . 1984).…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Brugia timori and Wuchereria bancrofti infections in Indonesia using DEC or a combination of DEC and albendazole: adverse reactions and short‐term effects on microfilariae

Supali

Ismid

Fischer

2002

Tropical Med Int Health

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SummaryFilariasis caused by Brugia timori and Wuchereria bancrofti is an important public health problem on Alor island, East Nusa Tenggara, Indonesia. To implement a control programme, adverse reactions and short-term effects on the microfilaria (mf) density were studied following a divided dose of diethylcarbamazine (DEC, 6 mg/kg body weight -100 mg on day 1 and the rest on day 3) or a single dose of DEC (6 mg/kg body weight on day 3) and albendazole (Alb, 400 mg). In order to define the most appropriate regimen, 30 persons infected with B. timori were treated in the hospital and results were compared with those obtained from the treatment of 27 persons infected with W. bancrofti. Adverse reactions consisted of systemic reactions such as fever, headache, myalgia, itching and local reactions such as adenolymphangitis. Fever experienced by a number of patients in both treatment groups generally occurred 12-24 h after drug administration and lasted up to 2 days. Adenolymphangitis tended to occur later and was resolved within 4 days. The number of W. bancrofti patients suffering from adverse reactions was lower and the reactions were milder than those of the B. timori patients. There was no difference in adverse reactions between DEC alone and DEC-Alb treatment for either infection. The geometric mean mf count decreased on day 7 in the B. timori infected patients from 234 mf/ml in the DEC group and from 257 mf/ml in the DEC-Alb group to 7 and 8 mf/ml, respectively. The mf densities of the W. bancrofti infected patients decreased on day 7 from 214 mf/ml in the DEC group and from 559 mf/ml in the DEC-Alb group to 15 and 14 mf/ml, respectively. Our data indicate that the microfilaricidal effect of the drugs is achieved more rapidly for B. timori, which is associated with more adverse reactions than W. bancrofti. In addition, 111 B. timori infected persons were treated in the community with DEC-Alb in one selected village. The adverse reactions and the reduction of mf density was similar to the findings of the hospital-based study. In this group, there was a strong correlation of mf density with the frequency and severity of adverse reactions. The addition of Alb resulted in no additional adverse reactions compared with DEC treatment alone and can also be used for the treatment of B. timori infection. In Indonesia, where the prevalence of intestinal helminths is high, the use of a combination of DEC and Alb to control lymphatic filariasis may also have impact on the control of intestinal helminths.keywords Brugia timori, Wuchereria bancrofti, diethylcarbamazine, albendazole correspondence Dr Taniawati Supali,

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“…2000). Only very few drug studies, especially with low dosage of DEC, were performed in B. timori endemic areas (Partono et al . 1981, 1984).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of Brugia timori and Wuchereria bancrofti infections in Indonesia using DEC or a combination of DEC and albendazole: adverse reactions and short‐term effects on microfilariae

Supali

Ismid

Fischer

2002

Tropical Med Int Health

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“…It would be unfortunate if DEC were discarded for such reasons. In lymphatic filariasis, spreading the therapeutic regimen over weekly low-dose treatments has proved successful at both avoiding sideeffects and eradicating infection (Partono et al 1984;Partono, Maizels & Purnomo, 1989). Although the evidence we have presented argues against the use of steroids to alleviate adverse reactions, it may be that a further understanding of the mode of action of DEC will define accompanying medication and provide acceptable treatment with a drug which is both microfilaricidal and macrofilaricidal for the lymphatic parasites.…”

Section: Discussionmentioning

confidence: 99%

“…However, the side-effects are clearly related to (a) the parasite load (Wilson, 1950;Partono et al 1981;Francis, Awadzi & Ottesen, 1985), with uninfected individuals showing no symptoms at all; and (6) the drug dose. Low-dose therapy avoids the side reactions (Partono et al 1984).…”

Section: Immunological Side-effects Of Dec Administrationmentioning

confidence: 99%

Diethylcarbamazine (DEC): immunopharmacological interactions of an anti-filarial drug

Maizels¹,

Denham

1992

Parasitology

134

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Anti-parasitic drugs may achieve their therapeutic effect either by direct activity against the pathogenic organism, or by altering host factors which lead to parasite killing. In this review, we discuss the evidence for an indirect mode of action for one major anti-filarial drug, diethylcarbamazine (DEC). The interpretation most consistent with existing data is that DEC alters arachidonic acid metabolism in microfilariae and in host endothelial cells. These changes may result in vasoconstriction and amplified endothelial adhesion leading to immobilization of microfilarial parasites, enhanced adherence and cytotoxic activity by host platelets and granulocytes. These events would represent activation of the innate, non-specific immune system, independent of the adaptive, antigen-specific, immune response. This model explains the paradox between rapid clearance in vivo and the lack of an in vitro effect, as well as the efficacy of DEC in non-immune animals. It may also account for the inconsistencies in the effects of DEC against different filariae in different host species. In addition, we discuss the significant side-effects often associated with treatment of heavily infected patients, and the longer-term changes in T-cell reactivity and the host-parasite relationship which follow successful treatment with DEC.

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Epidemiology of Lymphatic Filariasis

2007

Ciba Foundation Symposium 127 ‐ Filariasis

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Low dosage diethylcarbamazine administered by villagers for the control of timorian filariasis

Cited by 20 publications

References 2 publications

Treatment of Brugia timori and Wuchereria bancrofti infections in Indonesia using DEC or a combination of DEC and albendazole: adverse reactions and short‐term effects on microfilariae

Treatment of Brugia timori and Wuchereria bancrofti infections in Indonesia using DEC or a combination of DEC and albendazole: adverse reactions and short‐term effects on microfilariae

Diethylcarbamazine (DEC): immunopharmacological interactions of an anti-filarial drug

Epidemiology of Lymphatic Filariasis

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