Assessment of the efficacy of diethylcarbamazine on adult Wuchereria bancrofti in vivo

✍ Scribed by Joaquim Norões; Gerusa Dreyer; Abiel Santos; Veronica G. Mendes; Zulma Medeiros; David Addiss

• Publisher: Elsevier Science
• Year: 1997
• Tongue: English
• Weight: 581 KB
• Volume: 91
• Category: Article
• ISSN: 0035-9203
• DOI: 10.1016/s0035-9203(97)90405-3

✦ Synopsis

To assess directly the effect of various doses of diethylcarbamazine (DEC) on adult Wchereria bancrofti, 3 1 infected men were randomly assigned to receive an initial single DEC dose of 1 mg/kg (n=7), 6 mg/kg (n= lo), or 12 mg/kg (n= 14). Beginning 7 d later, the dosage of DEC and duration of treatment were progressively increased for 7-l 0 weeks. Physical examinations were performed to detect scrotal nodules and the scrotal area was examined by ultrasound (7.5 MHz transducer) to monitor the 'filaria dance sign' (FDS), the characteristic pattern of adult worm movement. Of 53 adult worm 'nests' that were detected by ultrasound, 22 (415%) were DEC-sensitive (FDS became non-detectable and a nodule became palpable at the site); 20 (37.7%) were not sensitive (FDS remained unchanged and detectable and no nodule developed), and 11 (208%) showed mixed responses (FDS remained detectable but a palpable nodule developed). All but one sensitive or mixed response occurred within 1 week after the initial single dose. Of 39 'nests' in men who initially received a single 6 or 12 mg/kg dose of DEC, 20 (5 1.3%) had sensitive responses compared to 2 (14.3%) of 14 'nests' in men who received a single 1 mg/kg dose pO.04). Above 6 mg/kg, the macrofilaricidal effect of DEC did not increase with dose; a significant proportion of adult W bancrofn' were not susceptible to DEC during the study period.