Meyrowitsch D W, Simonsen P E, Makunde W H
Danish Bilharziasis Laboratory, Charlottenlund, Denmark.
Trans R Soc Trop Med Hyg. 1996 Jan-Feb;90(1):69-73. doi: 10.1016/s0035-9203(96)90484-8.
The efficacy of 2 strategies for control of bancroftian filariasis using mass diethylcarbamazine (DEC) chemotherapy was evaluated and compared in 2 endemic communities in Tanzania with pre-treatment microfilarial (mf) prevalences of 28.5% and 17.7%, and mf geometric mean intensities (GMI) of 588 mf/mL and 251 mf/mL, respectively. All individuals in the first community were offered DEC treatment with 6 mg/kg body weight given daily for 12 d (standard treatment). The second community was offered DEC treatment with 2 single doses of 6 mg/kg body weight given with an interval of 6 months (semi-annual single-dose treatment). Among those who were microfilaraemic before treatment, the mf clearance rates were 51.2% and 36.0%, and the mf GMIs were reduced by 98.6% and 92.2% one year after the start of the standard and the semi-annual regimens, respectively. At community level, the standard strategy and the semi-annual strategy reduced the mf prevalences to 15.1% and 11.6% (reductions of 47.0% and 34.5%) and the mf GMIs to 112 mf/mL and 102 mf/mL (reductions of 81.0% and 59.4%, respectively) one year after start of treatment. Both regimens resulted in remarkable improvements in small hydroceles among males presenting this condition before treatment. The lower efficacy of the semi-annual single-dose treatment in relation to the standard treatment in reducing microfilaraemias might be compensated for by continuing semi-annual treatments for a slightly longer period of time. Considering that the semi-annual treatment is easy to administer and more acceptable to the treated individuals, it may in the long run be a more feasible strategy for mass DEC chemotherapy than the standard treatment.
在坦桑尼亚的两个流行社区，对使用乙胺嗪（DEC）进行大规模化疗的两种控制班氏丝虫病策略的疗效进行了评估和比较。这两个社区治疗前的微丝蚴（mf）患病率分别为28.5%和17.7%，mf几何平均强度（GMI）分别为588 mf/mL和251 mf/mL。第一个社区的所有个体接受DEC治疗，每日给予6 mg/kg体重，共12天（标准治疗）。第二个社区接受DEC治疗，分2次单剂量给予6 mg/kg体重，间隔6个月（半年单剂量治疗）。在治疗前有微丝蚴血症的人群中，标准治疗方案和半年方案开始一年后，mf清除率分别为51.2%和36.0%，mf GMI分别降低了98.6%和92.2%。在社区层面，治疗开始一年后，标准策略和半年策略分别将mf患病率降至15.1%和11.6%（降低了47.0%和34.5%），mf GMI降至112 mf/mL和102 mf/mL（分别降低了81.0%和59.4%）。两种方案都使治疗前出现这种情况的男性小鞘膜积液有了显著改善。半年单剂量治疗在降低微丝蚴血症方面相对于标准治疗的较低疗效，可能通过持续半年治疗稍长一段时间来弥补。考虑到半年治疗易于实施且更易被接受治疗的个体接受，从长远来看，它可能是比标准治疗更可行的大规模DEC化疗策略。
