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2017 ; 11
(10
): e0005631
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Lymphatic pathology in asymptomatic and symptomatic children with Wuchereria
bancrofti infection in children from Odisha, India and its reversal with DEC and
albendazole treatment
#MMPMID29059186
Kar SK
; Dwibedi B
; Das BK
; Agrawala BK
; Ramachandran CP
; Horton J
PLoS Negl Trop Dis
2017[Oct]; 11
(10
): e0005631
PMID29059186
show ga
BACKGROUND: Once interruption of transmission of lymphatic filariasis is
achieved, morbidity prevention and management becomes more important. A study in
Brugia malayi filariasis from India has shown sub-clinical lymphatic pathology
with potential reversibility. We studied a Wuchereria bancrofti infected
population, the major contributor to LF globally. METHODS: Children aged 5-18
years from Odisha, India were screened for W. bancrofti infection and disease.
102 infected children, 50 with filarial disease and 52 without symptoms were
investigated by lymphoscintigraphy and then randomized to receive a supervised
single oral dose of DEC and albendazole which was repeated either annually or
semi-annually. The lymphatic pathology was evaluated six monthly for two years.
FINDINGS: Baseline lymphoscintigraphy showed abnormality in lower limb lymphatics
in 80% of symptomatic (40/50) and 63·5% (33/52) of asymptomatic children.
Progressive improvement in baseline pathology was seen in 70·8, 87·3, 98·6, and
98·6% of cases at 6, 12, 18, and 24 months follow up, while in 4·2, 22·5, 47·9
and 64·8%, pathology reverted to normal. This was independent of age (p = 0·27),
symptomatic status (p = 0·57) and semi-annual/bi-annual dosing (p = 0·46). Six of
eleven cases showed clinical reduction in lymphedema of legs. INTERPRETATION: A
significant proportion of a young W. bancrofti infected population exhibited
lymphatic pathology which was reversible with annual dosage of DEC and
albendazole. This provides evidence for morbidity prevention & treatment of early
lymphedema. It can also be used as a tool to improve community compliance during
mass drug administration. TRIAL REGISTRATION: ClinicalTrials.gov No
CTRI/2013/10/004121.
|Administration, Oral
[MESH]
|Adolescent
[MESH]
|Albendazole/administration & dosage/*therapeutic use
[MESH]
|Animals
[MESH]
|Asymptomatic Infections
[MESH]
|Child
[MESH]
|Child, Preschool
[MESH]
|Diethylcarbamazine/administration & dosage/*therapeutic use
[MESH]