scholarly journals Systematic Review: Comparison of triple drug therapy versus double drug therapy for Lymphatic Filariasis

2021 ◽  
Vol 5 (1) ◽  
pp. 34-45
Author(s):  
I Gusti Agung Ari Kusuma Yana
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Combination Therapy ◽  
Lymphatic Filariasis ◽  
Disease Transmission ◽  
Parasitic Infection ◽  
Wuchereria Bancrofti ◽  
Geographical Variations ◽  
Online Databases ◽  
Vector Identity

Background: Lymphatic filariasis is a parasitic infection caused by nematodes such as filaria Wuchereria bancrofti, Brugia malayi, and Brugia timori. These parasites can be transmitted through mosquito bites such as several species of mosquitoes, particularly Anopheles, Aedes, Culex, and Mansonia with geographical variations in the dominant vector identity. The main strategy used consists of community-wide mass drug administration (MDA) for the entire population at risk to stop disease transmission and prevent infectious morbidity. WHO recommends the use of annual medication in combination with the triple drug ivermectin therapy. Objective: To compare DEC and albendazole (IDA) versus the two drugs albendazole and diethycarbamazine or albendazole and ivermectin therapy. Methods: The literature search was carried out independently by the researcher using the Sciencedirect, Pubmed, and Cochrane online databases without limiting the type of study or the year of publication. The keywords used in this study were combined with the Boolean operator, namely "AND" namely ((((Lymphatic filariasis) AND (albendazole)) AND (diethylcarbamazine)) AND (ivermectin)) AND (compare). Results: Where triple drug therapy was significantly better in reducing and clearing microfilariae and worm nests in patients with lymphatic filariasis compared to two drug therapy alone. However, side effects occur more frequently in the combination of three therapies. The average side effects were low, such as headaches, joint pain, fatigue, and nausea. Conclusion: although it has relatively low side effects that occur in three drug combinations rather than two drug combination therapy, triple therapy combination therapy is more effective than two drug therapy in treating lymphatic filariasis disease.

Should Monotherapy for Epilepsy Be Reconsidered?

US Neurology ◽  
2009 ◽  
Vol 05 (01) ◽  
pp. 59 ◽  
Author(s):  
Edward Faught ◽  
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Combination Therapy ◽  
Antiepileptic Drug ◽  
Seizure Control ◽  
Unanswered Question ◽  
Complete Control ◽  
Standard Practice ◽  
Pharmacodynamic Interactions ◽  
Antiepileptic Drug Therapy

The critical goal of antiepileptic drug therapy is complete seizure control without side effects. For about half of patients, this goal is achievable with the first drug tried. Standard practice has been to switch to a second monotherapy drug if the first fails. It is time to re-think this strategy because relatively few patients achieve complete control with the second and subsequent monotherapy trials, some patients achieve complete control without intolerable side effects with combination therapy, and the new generations of drugs are easier to use in combination because they are more free of pharmacokinetic and pharmacodynamic interactions. An unanswered question is which combinations are most effective for seizure control. Not all patients are appropriate for polytherapy; some are reasonable candidates for additional monotherapy trials. However, if a polytherapy regimen is working, the wisest plan is often to continue it. Monotherapy still rules, but ‘polypharmacy’ as a pejorative term should be scrapped.

scholarly journals A Rare Case of Lymphatic Filariasis

2021 ◽  
pp. 30-32
Author(s):  
J. Vijay ◽  
N. Anuradha ◽  
Viknesh Prabhu ◽  
Patel Harshvardhan Anilbhai
Keyword(s):  
Case Report ◽  
Lymphatic Filariasis ◽  
Rare Case ◽  
Parasitic Infection ◽  
Brugia Malayi ◽  
Wuchereria Bancrofti ◽  
Pulmonary Eosinophilia ◽  
Rare Presentation ◽  
Systemic Manifestation ◽  
Nephritic Syndrome

Lymphatic filariasis is a parasitic infection caused by Wuchereria bancrofti, Brugia malayi and Brugia timori.Asymptomatic microfilaria, acute lymphatic filariasis, chronic lymphatic filariasis, tropical pulmonary eosinophilia are the different presentations of lymphatic filariasis. Systemic manifestation can involve joint, kidney, heart and nerve. This article is a case report of lymphatic filariasis with a rare presentation of anasarca and nephritic syndrome.

scholarly journals Potential strategies for strengthening surveillance of lymphatic filariasis in American Samoa after mass drug administration: targeting older age groups, hotspots, and household members of infected persons

2020 ◽  
Author(s):  
Colleen Lau ◽  
Meru Sheel ◽  
Katie Gass ◽  
Saipale Fuimaono ◽  
Michael David ◽  
...  
Keyword(s):  
High Risk ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Disease Transmission ◽  
Parasitic Infection ◽  
American Samoa ◽  
Community Survey ◽  
World Health ◽  
Surveillance Strategy

ABSTRACTBackgroundUnder the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted mass drug administration (MDA) from 2000-2006. Despite passing Transmission Assessment Surveys (TAS) in 2011/2012 and 2015, American Samoa failed TAS-3 in 2016, with antigen (Ag) prevalence of 0.7% (95%CI 0.3-1.8%) in 6-7 year-olds. A 2016 community survey (Ag prevalence 6.2% (95%CI 4.4-8.5%) in age ≥8 years) confirmed resurgence. Here, we explore the potential of targeted strategies to strengthen post-MDA surveillance.Methodology/Principal FindingsUsing Ag data plus new antibody data (Wb123, Bm14, Bm33) from the 2016 surveys, we identified risk factors for seropositivity using multivariable logistic regression. We compared TAS with strategies that targeted high-risk subpopulations (older ages, householders of Ag-positive TAS children [index children]) and/or known hotspots, and used NNTestav (average number needed to test to identify one positive) to compare sampling efficiency.Antibody prevalence in TAS-3 (n=1143) were 1.6% for Bm14 (95%CI 0.9-2.9%), 7.9% for Wb123 (95%CI 6.4-9.6%), and 20.2% for Bm33 (95%CI 16.7-24.3%); and in the community survey (n=2507), 13.9% for Bm14 (95%CI 11.2-17.2%), 27.9% for Wb123 (95%CI 24.6-31.4%), and 47.3% for Bm33 (95%CI 42.1-52.6%). Ag prevalence was 20.7% (95%CI 9.7-53.5%) in households of index children. Higher Ag prevalence was found in males (adjusted odds ratio [aOR] 3.01), age ≥18 years (aOR 2.18), residents of Fagali’i (aOR 15.81), and outdoor workers (aOR 2.61). Using Ag, NNTestav ranged from 142.5 for TAS, to <5 for households of index children. NNTestav was lower in older ages, and highest for Ag, followed by Bm14, Wb123 and Bm33 antibodies.Conclusions/SignificanceWe propose a multi-stage surveillance strategy, starting with population-representative sampling (e.g. TAS), followed by targeted strategies in subgroups and locations with low NNTestav. This approach could potentially improve the efficiency of identifying remaining infected persons and residual hotspots. The utility of antibodies in surveillance should also be explored.AUTHOR SUMMARYLymphatic filariasis (LF) is a parasitic infection transmitted by mosquito bites. Globally, tens of millions are infected, with many disfigured and disabled by severe damage to their lymphatic systems, such as severe swelling of the legs (elephantiasis) or scrotum (hydrocele). The Global Programme to Eliminate LF (GPELF) aims to interrupt disease transmission through mass drug administration (MDA), and to control illness and suffering in affected persons. The World Health Organization recommends conducting Transmission Assessment Surveys (TAS) in school children aged 6 to 7 years, to determine if infection rates have dropped to levels where disease transmission is no longer sustainable. From 2000-2006, American Samoa conducted MDA and made significant progress towards eliminating LF. However, despite passing TAS in 2011/2012 and 2015, surveys in 2016 showed evidence of resurgence. Our study explored alternative surveillance strategies and compared their efficiency with TAS. Based on our findings, we recommended that in addition to TAS, strategies that target high-risk populations and hotspots would strengthen surveillance and help countries achieve their goals of LF elimination.

COMBINATION OF POTASSIUM PERCHLORATE AND PROPYLTHIOURACIL IN THE TREATMENT OF THYROTOXICOSIS

1968 ◽  
Vol 57 (4) ◽  
pp. 565-577 ◽  
Author(s):  
K. E. Røkke ◽  
J. H. Vogt
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Metabolic Rate ◽  
Total Cholesterol ◽  
Basal Metabolic Rate ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Control Measures ◽  
Potassium Perchlorate ◽  
Plasma Total Cholesterol

ABSTRACT A report is given on 95 thyrotoxic patients treated with a combination of 400 mg propylthiouracil and 400 mg of potassium perchlorate. Perchlorate was stopped when a marked remission of symptoms was obtained, on an average after less than 7 weeks. Euthyroidism was found on an average after 7.2 weeks. The basal metabolic rate, PBI, plasma total cholesterol and weight showed a fairly rapid normalization. Thirteen of the 95 patients were given radio-iodine therapy shortly before drug therapy was started. The remaining 82 cases were grouped together with the 23 cases previously reported. Of the total of 105 cases, 96 became euthyroid on combined therapy. For the frequency of side-effects, the thirteen cases mentioned above were included, giving a total of 118 cases. Eight cases showed an increase in goitre size and 15 cases had other side-effects, of which three were granulocytopenia due to propylthiouracil. The possibility of a higher frequency of mainly minor side-effects on combined therapy has to be balanced against the seemingly rapid and reliable therapeutic effect. Combined treatment, perhaps with even smaller doses than reported here, can be recommended in selected cases of thyrotoxicosis where a shortening of the thyrotoxic state seems of importance, or possibly where difficulties due to iodine exposure may be anticipated, provided adequate control measures are taken.

scholarly journals Progress towards elimination of lymphatic filariasis in the Americas region

2020 ◽  
Vol 13 (Supplement_1) ◽  
pp. S33-S38
Author(s):  
Gilberto Fontes ◽  
Eliana Maria Mauricio da Rocha ◽  
Ronaldo Guilherme Carvalho Scholte ◽  
Rubén Santiago Nicholls
Keyword(s):  
Dominican Republic ◽  
Lymphatic Filariasis ◽  
Wuchereria Bancrofti ◽  
World Health ◽  
Vector Species ◽  
Effective Coverage ◽  
The Third ◽  
Assessment Survey ◽  
Health Organization ◽  
Important Progress

Abstract In South and Central America, lymphatic filariasis (LF) is caused by Wuchereria bancrofti, which is transmitted by Culex quinquefasciatus, the only vector species in this region. Of the seven countries considered endemic for LF in the Americas in the last decade, Costa Rica, Suriname and Trinidad and Tobago were removed from the World Health Organization list in 2011. The remaining countries, Brazil, Dominican Republic, Guyana and Haiti, have achieved important progress in recent years. Brazil was the first country in the Americas to stop mass drug administration (MDA) and to establish post-MDA surveillance. Dominican Republic stopped MDA in all LF-endemic foci: La Ciénaga and Southwest passed the third Transmission Assessment Survey (TAS) and the Eastern focus passed TAS-1 in 2018. Haiti passed the TAS and interrupted transmission in &gt;80% of endemic communes, achieving effective drug coverage. Guyana implemented effective coverage in MDAs in 2017 and 2018 and in 2019 scaled up the treatment for 100% of the geographical region, introducing ivermectin in the MDA in order to achieve LF elimination by the year 2026. The Americas region is on its way to eliminating LF transmission. However, efforts should be made to improve morbidity management to prevent disability of the already affected populations.

Semiannual Treatment of Albendazole Alone is Efficacious for Treatment of Lymphatic Filariasis: A Randomized Open-label Trial in Cote d'Ivoire

2021 ◽  
Author(s):  
Allassane F Ouattara ◽  
Catherine M Bjerum ◽  
Méité Aboulaye ◽  
Olivier Kouadio ◽  
Vanga K Marius ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Primary Outcome ◽  
Central Africa ◽  
Wuchereria Bancrofti ◽  
Bancroftian Filariasis ◽  
Loa Loa ◽  
Open Label ◽  
Treatment Groups ◽  
Open Label Trial ◽  
To Receive

Abstract Background Ivermectin (IVM) plus albendazole (ALB), or IA, is widely used in mass drug administration (MDA) programs that aim to eliminate lymphatic filariasis (LF) in Africa. However, IVM can cause severe adverse events in persons with heavy Loa loa infections that are common in Central Africa. ALB is safe in loiasis, but more information is needed on its efficacy for LF. This study compared the efficacy and safety of three years of semiannual treatment with ALB to annual IA in persons with bancroftian filariasis. Methods Adults with Wuchereria bancrofti microfilaremia (Mf) were randomized to receive either three annual doses of IA (N=52), six semiannual doses of ALB 400mg (N=45), or six semiannual doses of ALB 800mg (N=47). The primary outcome amicrofilaremia at 36 months. Findings IA was more effective for completely clearing Mf than ALB 400mg or ALB 800mg (79%, CI 67-91; vs. 48%, CI 32-66 and 57%, CI 41-73, respectively). Mean % reductions in Mf counts at 36 months relative to baseline tended to be greater after IA (98%, CI 88-100) than after ALB 400mg (88%, CI 78-98) and ALB 800mg (89%, CI 79-99) (P=0.07 and P=0.06, respectively). Adult worm nest numbers (assessed by ultrasound) were reduced in all treatment groups. Treatments were well tolerated. Interpretation Repeated semiannual treatment with ALB is macrofilaricidal for W. bancrofti and leads to sustained reductions in Mf counts. This is a safe and effective regimen that could be used as MDA to eliminate LF in areas ivermectin cannot be used.

scholarly journals Lymphatic filariasis, infection status in Culex quinquefasciatus and Anopheles species after six rounds of mass drug administration in Masasi District, Tanzania

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Eliza Lupenza ◽  
Dinah B. Gasarasi ◽  
Omary M. Minzi
Keyword(s):  
Vector Control ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Wuchereria Bancrofti ◽  
Elimination Phase ◽  
Anopheles Species ◽  
The Status ◽  
Household Environment ◽  
Indoor And Outdoor

Abstract Background Lymphatic filariasis (LF) elimination program in Tanzania started in 2000 in response to the Global program for the elimination of LF by 2020. Evidence shows a persistent LF transmission despite more than a decade of mass drug administration (MDA). It is advocated that, regular monitoring should be conducted in endemic areas to evaluate the progress towards elimination and detect resurgence of the disease timely. This study was therefore designed to assess the status of Wuchereria bancrofti infection in Culex quinqefasciatus and Anopheles species after six rounds of MDA in Masasi District, South Eastern Tanzania. Methods Mosquitoes were collected between June and July 2019 using Center for Diseases Control (CDC) light traps and gravid traps for indoor and outdoor respectively. The collected mosquitoes were morphologically identified into respective species. Dissections and PCR were carried out to detect W. bancrofti infection. Questionnaire survey and checklist were used to assess vector control interventions and household environment respectively. A Poisson regression model was run to determine the effects of household environment on filarial vector density. Results Overall, 12 452 mosquitoes were collected of which 10 545 (84.7%) were filarial vectors. Of these, Anopheles gambiae complex, An. funestus group and Cx. quinquefasciatus accounted for 0.1%, 0.7% and 99.2% respectively. A total of 365 pools of Cx. quinquefasciatus (each with 20 mosquitoes) and 46 individual samples of Anopheles species were analyzed by PCR. For Cx. quinquefasciatus pools, 33 were positive for W. bancrofti, giving an infection rate of 0.5%, while the 46 samples of Anopheles species were all negative. All 1859 dissected mosquitoes analyzed by microscopy were also negative. Households with modern latrines had less mosquitoes than those with pit latrines [odds ratio (OR) = 0.407, P < 0.05]. Houses with unscreened windows had more mosquitoes as compared to those with screened windows (OR = 2.125, P < 0.05). More than 80% of the participants own bednets while 16.5% had no protection. Conclusions LF low transmission is still ongoing in Masasi District after six rounds of MDA and vector control interventions. The findings also suggest that molecular tools may be essential for xenomonitoring LF transmission during elimination phase.

scholarly journals A PROSPECTIVE STUDY TO ANALYSE THE SIDE EFFECTS OF OLMESARTAN MEDOXOMIL AND ENALAPRIL IN HYPERTENSIVE SUBJECTS

2018 ◽  
Vol 11 (12) ◽  
pp. 258
Author(s):  
Parminderpal Singh ◽  
Kiranjit Kiranjit
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Postural Hypotension ◽  
Olmesartan Medoxomil ◽  
National Commission ◽  
Group A ◽  
Group B ◽  
Taste Alteration ◽  
A Prospective Study

Objective: The present study was aimed to analyze the side effects of olmesartan medoxomil and enalapril in hypertensive subjects.Methods: The study consisted of newly diagnosed hypertension categorized according to 7th report of Joint National Commission on prevention, detection, evaluation, and treatment of high blood pressure. The subjects were divided into two groups. The Group A subjects received olmesartan, and Group B subjects received enalapril. Pressure was recorded both in supine and sitting positions. The appearance of side effects was observed in the follow-up, i.e., dry cough, headache, postural hypotension, angioedema, dizziness, skin rashes, taste alterations, and urticaria. A statistical data were prepared on the basis of information obtained and analyzed thoroughly for antihypertensive effects and side effects of olmesartan and enalapril. SPSS software was used for analysis.Results: There was observed an increase in the incidence of taste alteration with drug therapy in Group B (Enalapril). There was observed an increase in the incidence of postural hypotension with drug therapy in both groups. In Group A (Olmesartan), the incidence of postural hypotension at the beginning of trial, 4 weeks, and 8 weeks was 0%, 2%, and 2%, respectively. In Group A (Olmesartan), there was no incidence of a headache at the beginning of trial, at 4 weeks and 8 weeks.Conclusion: From the study, it can be concluded that both olmesartan and enalapril are effective in Stage I and Stage II hypertension, but olmesartan is tolerated well with lesser side effects.

scholarly journals Possibility of oxygen-ozone therapy in the geriatric patient

Ozone Therapy ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. 53
Author(s):  
Marianno Franzini ◽  
Giulia Ionita
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Minimally Invasive ◽  
Elderly Patients ◽  
Geriatric Patient ◽  
Multidisciplinary Care ◽  
Invasive Technique ◽  
Ozone Therapy ◽  
Muscular Pain ◽  
Care Of Elderly

In the context of multidisciplinary care of elderly patients, this work will want to consider the presence of osteo-articular and muscular pain, mostly chronic, of these subjects. The treatment has made use of oxygen-ozone therapy, given the absence of side effects of this minimally invasive technique, and the possibility of its use simultaneously with an already established poly-drug therapy, as typically found in the geriatric patient.

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