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Tolerance to diethylcarbamazine-medicated salt in individuals infected with Onchocerca volvulus
D W Meyrowitsch1, P E Simonsen, P Magnussen
1Danish Bilharziasis Laboratory, Jaegersborg Alle 1 D, 2920 Charlottenlund, Denmark. fildan@inet.uni2.dk
Abstract:
The tolerance of Onchocerca volvulus-infected individuals to diethylcarbamazine (DEC)-medicated salt (0.33% w/w) was assessed in 1996 in Tanzania in a double-blind placebo-controlled hospital-based trial involving 4 groups, each of 10 adult males. Groups I and II had O. volvulus microfilariae (mf) only, group III had both O. volvulus and Wuchereria bancrofti mf, and group IV had W. bancrofti mf only. Groups I, III and IV received DEC-medicated salt, whereas group II was a control to group I and received normal cooking salt. Medication was given for 10 days. The most pronounced adverse reactions in groups I and III were mild-to-moderate itching and rash, beginning after 3-4 days and lasting for the remaining medication period. The reactions did not interfere with normal daily activities. By 20 days after the end of medication, adverse reactions had disappeared in all individuals. The low daily dose of DEC had no significant effect on the O. volvulus pre-medication mf geometric mean intensities (GMIs). In contrast, the medication significantly reduced the pre-medication W. bancrofti mf GMIs. The prospects for using DEC-medicated salt for control of bancroftian filariasis in areas where incidental infections with O. volvulus occur are discussed.
Insights
Diethylcarbamazine (DEC)-medicated salt effectively reduced Wuchereria bancrofti microfilariae but caused mild side effects in Onchocerca volvulus-infected individuals. This suggests potential for controlling bancroftian filariasis in co-infected areas.
Area of Science:
- Tropical Medicine
- Parasitology
- Public Health
Background:
- Filariasis, including Onchocerca volvulus and Wuchereria bancrofti infections, poses a significant global health burden.
- Diethylcarbamazine (DEC) is a key drug for lymphatic filariasis control, but its use in areas with co-infections needs careful evaluation.
- Assessing the safety and efficacy of DEC-medicated salt in mixed infection scenarios is crucial for public health strategies.
Purpose of the Study:
- To evaluate the tolerance and adverse reactions to DEC-medicated salt in individuals infected with Onchocerca volvulus, Wuchereria bancrofti, or both.
- To determine the impact of DEC-medicated salt on microfilarial loads of O. volvulus and W. bancrofti.
- To explore the feasibility of using DEC-medicated salt for bancroftian filariasis control in regions with incidental O. volvulus infections.
Main Methods:
- A double-blind, placebo-controlled hospital-based trial was conducted in Tanzania in 1996.
- Four groups of 10 adult males each were enrolled, with varying microfilarial infections (O. volvulus only, W. bancrofti only, or mixed).
- Participants received either DEC-medicated salt (0.33% w/w) or normal salt for 10 days, with adverse reactions and microfilarial geometric mean intensities (GMIs) monitored.
Main Results:
- Mild-to-moderate itching and rash were the most common adverse reactions in groups receiving DEC-medicated salt, resolving within 20 days post-treatment.
- DEC-medicated salt did not significantly affect Onchocerca volvulus microfilarial geometric mean intensities (GMIs).
- A significant reduction in Wuchereria bancrofti microfilarial GMIs was observed in individuals treated with DEC-medicated salt.
Conclusions:
- DEC-medicated salt is generally well-tolerated, with manageable side effects, in individuals with O. volvulus infections.
- DEC-medicated salt demonstrates efficacy in reducing W. bancrofti microfilarial loads.
- The findings support the potential use of DEC-medicated salt for controlling bancroftian filariasis, even in areas where O. volvulus infections may co-exist.