Mayfield Helen J, Muttucumaru Ramona, Sartorius Benn, Sheridan Sarah, Ward Selina, Martin Beatris Mario, Hedtke Shannon M, Thomsen Robert, Viali Satupaitea, Fatupaito Glen, Lau Colleen L, Graves Patricia M
University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia; School of Public Health, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.
University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia; School of Public Health, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia; National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
Int J Infect Dis. 2025 Mar;152:107809. doi: 10.1016/j.ijid.2025.107809. Epub 2025 Jan 30.
Contrasting evidence is emerging on the long-term effectiveness of triple-drug therapy for elimination of lymphatic filariasis (LF) in the Pacific region. We evaluated the effectiveness of ivermectin, diethylcarbamazine and albendazole (IDA) for sustained clearance of microfilariae (Mf) in Samoa.
We enrolled two cohorts of Mf-positive participants. Cohort A were Mf-positive participants from 2018, who received directly observed triple-drug therapy in 2019 and were retested and retreated in 2023 and 2024. Cohort B were Mf-positive and treated in 2023 and retested in 2024. Participants were tested for LF antigen and Mf.
In Cohort A, eight of the 14 participants from 2018/2019 were recruited in 2023; six were Mf-positive. In 2024, six participants were retested, and two were Mf-positive. Cohort B included eight participants, and two remained Mf-positive in 2024. Mf prevalence in 2023 for Cohort A (71.4%, 95% CI 29.0%-96.3%) was significantly higher than among their household members (12.0%, 95% CI 2.5%-31.2%).
One or two doses of directly observed IDA was not sufficient for sustained clearance of Wuchereria bancrofti Mf in Samoa. The high Mf prevalence in treated individuals compared to household members suggests recrudescence rather than reinfection.
关于三药联合疗法在太平洋地区消除淋巴丝虫病（LF）的长期有效性，出现了相互矛盾的证据。我们评估了伊维菌素、乙胺嗪和阿苯达唑（IDA）在萨摩亚持续清除微丝蚴（Mf）的有效性。
我们招募了两组Mf阳性参与者。A组是2018年的Mf阳性参与者，他们在2019年接受了直接观察下的三药联合治疗，并在2023年和2024年再次接受检测和治疗。B组是2023年Mf阳性并接受治疗，2024年再次接受检测。对参与者进行了LF抗原和Mf检测。
在A组中，2018/2019年的14名参与者中有8名在2023年被招募；6名Mf阳性。2024年，6名参与者再次接受检测，2名Mf阳性。B组包括8名参与者，2024年有2名仍为Mf阳性。A组2023年的Mf患病率（71.4%，95%CI 29.0%-96.3%）显著高于其家庭成员（12.0%，95%CI 2.5%-31.2%）。
在萨摩亚，一或两剂直接观察下的IDA不足以持续清除班氏吴策线虫微丝蚴。与家庭成员相比，接受治疗个体的高Mf患病率表明是复发而非再感染。
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