Anti-filarial drugs in doses employed in mass drug administration in lymphatic filariasis elimination programme provide sustained benefits to children with Brugia Malayi i nfection: A long-term follow up study.

Shenoy, R.K.; Suma, T.K.; Kumaraswami, V.; Rahmah, N.; Dhananjayan, G.; Padma, S.

Journal of Communicable Diseases; 2013; 45; 123-134.

Abstract: The disfigurement and stigma associated with lymphatic filariasis remain a major public health problem in several countries. It is now known that lymphatic damage, the underlying pathology of this disease, starts in childhood. We recently showed that such subclinical lymphatic pathology could be reversed using drugs in doses used in Mass Drug Administration. We identified infection in children living in a B. malayi endemic area by night blood examination and presence of filariasis specific IgG4 antibodies using 'Brugia Rapid' test. Doppler ultrasonography and lymphoscintigraphy were employed to identify the sub-clinical lymphatic pathology. One hundred children enrolled to the study were treated every six months with single combined doses of DEC (6 mg/kg) and albendazole (400 mg) and followed up for three years, showed total clearance of microfilaraemia, absence of the 'Filarial Dance Sign', clearance of IgG4 antibodies and significant reversal of subclinical pathology. Presently, further two year extension of the study showed that the MDA drugs employed in GPELF are effective in sustaining the clearance of filarial infection and reversing subclinical lymphatic damage. These finidings strongly argue for strengthening efforts to target children in MDA programmes and support advocacy efforts to increase coverage and acceptance, since they highlight the preventive role for MDA as an additional benefit.

Keywords: Lymphatic filariasis in children; Subclinical lymphatic pathology; Mass drug administration in children; Brugia malayi infection in children; Fiariasis specific IgG4; Reversal of subclinical lymphatic pathology

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