The effect of salt medicated with diethylcarbamazine in bancroftian filariasis.

The paper describes a trial conducted in Tanzania of the effect on bancroftian microfilaraemia of common salt medicated with diethylcarbamazine at a 0.1% (w/w) concentration, when given to a closed population of 600-700 with a known salt intake.After good observer agreement in microfilarial counting had been demonstrated, quantitative blood surveys were performed monthly on known carriers. Paired pretreatment microfilarial counts from the same patients at an interval of 4 months suggested a natural fluctuation in microfilarial densities and emphasized the need for parallel concurrent controls during treatment.During the trial the mean microfilarial densities fell steadily, being reduced by 73% at 3 months and 90% after 6 months. Tolerance to the drug-salt mixture was extremely good.Problems of planning, salt preparation and assessment of results are discussed and the importance of correct experimental design in future trials is stressed. The authors suggest that a trial of salt containing 0.2% (w/w) diethylcarbamazine may achieve optimum results. They point out that, while the use of diethylcarbamazine-medicated salt may prove useful in reducing transmission in closed communities or in endemic areas with no alternative source of salt, its extension to national populations as a sole means of bancroftian filariasis control would be of problematical value.