Diethylcarbamazine treatment of bancroftian and malayan filariasis with emphasis on side effects

A total of 1015 filarial carriers were hospitalized and treated with DEC either in a long course with light doses (6, 7, 8, 9 or 10 mg kg-1 b.w. divided into three doses daily for seven days) or in a short course with heavy doses (15 mg kg-1 b.w. once daily for one, two or three days). The efficacy of the long course (85%) was much higher than that of the short course (59%); but the reaction rate following the heavy dose (87%) was higher than that following the light dose (72%). For Brugia malayi infections the overall efficacy was 92% and the reaction rate 82%, for mixed infections the respective rates were 85% and 77%, and for Wuchereria bancrofti infections 82% and 69%. The cure rates decreased from 93% in carriers with one to 10 microfilariae in 60 microns blood to 63% in those with over 100 Mff in 60 microns blood. Febrile reactions developed in 92% of carriers with mixed infections, in 91% of those with B. malayi, and in 84% of those with W. bancrofti. Overall, 63% of those treated were free of microfilariae on the last day of treatment, and 92% were free 48 months after treatment.