Ultrasonographic assessment of the adulticidal efficacy of repeat high‐dose ivermectin in bancroftian filariasis

Abstract

SummarySince diethylcarbamazine, the drug recommended for treatment of lymphatic filariasis, seems only partially effective against the adult worm, intense interest persists in identifying a macrofilaricidal drug for this infection. To evaluate directly in vivo the macrofilaricidal activity of repeat high-dose ivermectin, I 5 men who had living adult Wuchereria bancrofti detected in the scrota1 area by ultrasound were treated with 400 pg/kg of ivermectin at 2-week intervals for 6 months (total dose, 4.8 mg/kg). Serial ultrasound examinations were performed before, during, and for 6 months after treatment. Profound suppression of microfilaraemia followed the first dose of ivermectin, but movements characteristic of the adult worm on ultrasound remained unchanged both in location and pattern. Even when given in total doses of 4.8 mg/kg, ivermectin appears to have no observable activity against adult W . bancrofti, although its ability to suppress microfilaraemia makes it potentially useful for the control of lymphatic filariasis.

Impact of seven rounds of mass administration of diethylcarbamazine and ivermectin on prevalence of chronic lymphatic filariasis in south India

“…Hence mass treatment of the endemic population using the drugs with best macrofilaricidal properties may exert maximum impact on hydrocele incidence and prevalence. It is well-known that DEC kills a considerable proportion of adult worm population (Ottesen 1984) and such action is poor with ivermectin (Dreyer et al 1996). Higher and significant reduction in hydrocele prevalence in DEC arm, observed in the present study, may be due to the adulticidal action of the drug.…”

Circulating filarial antigen in the hydrocele fluid from individuals living in a bancroftian filariasis area - Recife, Brazil: detected by the monoclonal antibody Og4C3-assay

“…The use of the hydrocele fluid became a tool of value in diagnosing individuals with W. bancrofti infection due to the straight-forward procedure to obtain fluid in ambulatory punctions or in the hydrocelectomies (Acton & Rao 1933, Malhotra et al 1985, Ramaprasad & Harinath 1989, Singh et al 1993. Recently, the availability of monoclonal antibodies Og4C3 ultrasound for a year (Dreyer et al 1996b) had a significant reduction in the CFA levels, when compared to the pre-treatment period, but they did not become negative (Rocha, data not published).…”

Microfilariae recurrence in graded murrah buffalo treated with repeated doses of ivermectin

“…It is confirmed in loaosis patients with ultrasonography that, the adult worms are not killed even at total doses of 4,800 lg/kg bodyweight over a period of 6 months (Dreyer et al 1996).…”