A Systematic Review of Drugs for Brugian filariasis Treatment

Abstract

Background

Lymphatic filariasis elimination was launched in Thailand since declaration of World Health

Assembly resolution (WHA 50.29) to eliminate LF as a public-health problem by 2020. We can declare LF elimination in most part of the country except Narathiwat province where transmission has been interrupted and in the process of post-MDA surveillance. Transmission re-assessment will be done to declare elimination for the whole country soon. Updated, standardized guideline will be necessary for provincial public health system on LF surveillance control and prevention after that. Treatment is one issue that needed to be reviewed. Diethylcarbamazine (DEC) is a drug for treatment LF in country, both types of infection. DEC treatment dosage was recently changed for only bancroftian filariasis. So this study will be focused on drugs regimen for brugian filariasis only.

           Objective

To conduct a systemic review of drug treatment studies for brugian filariasis in order to guide national drug policy.

Method

A systemic review of the literature was conducted in scope of related LF post market drugs for brugian filariasis treatment which was published from January 1984-December 2012.

Result

The electronic databases Sciendirect. Pubmed and Google scholar were searched and also for bibliographies of cited literatures. There were 6,001 articles in the origin search. Suitable data was available in 28 papers to identify 1) drugs for brugian filariasis treatment in vitro and vivo 2) drugs for human brugian filariasis and adverse reaction and 3) drugs for brugian affected person.

Conclusion

Filarialcidal drugs (DEC, Ivermectin), some antibiotics (Tetracycline, Doxycycline, Rifampicin,

Azithromycin) and drugs for helminth treatment (Albendazole) are effective for brugian treatment in vitro and vivo. DEC and ivermectin are effective drugs to reduce micrifilaria in brugian indection and more effective when combined with albendazole. Doxycycline is effective for Wolbachia reduction with less side effects but it takes long duration of treatment. Foot care is effective method for brugian affected persons while filarialcidal drugs and oral antibiotics are not necessary.