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Evaluation of Microfilaremic Individuals after Mass Drug Treatment with Ivermectin, Diethylcarbamazine, and Albendazole for Lymphatic Filariasis in Papua New Guinea
Joycelyn Salo
Joycelyn Salo
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea;
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Simon Westby
simon.westby@pngimr.org.pg
Simon Westby
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea;
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Ronnie Wakol
Ronnie Wakol
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea;
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Nelly Sanuku
Nelly Sanuku
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea;
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Krufinta Bun
Krufinta Bun
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea;
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Moses Laman
Moses Laman
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea;
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Christopher L. King
Christopher L. King
Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio;
Veterans Affairs Medical Center, Cleveland, Ohio
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Veterans Affairs Medical Center, Cleveland, Ohio
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After mass drug administration (MDA) for lymphatic filariasis, which involved a single coadministered dose of ivermectin plus diethylcarbamazine and albendazole (IDA), concerns arose regarding individuals who remained microfilaremic. This situation raised questions about the efficacy of the drugs and whether some individuals had not ingested them. In East New Britain Province, Papua New Guinea (PNG), where 81.7% of the population received IDA, 10 individuals were found to have microfilaremia 12 months after the first round of MDA in an area that had a high baseline of microfilaremia (n = 29 microfilariae [Mf] positive pre-MDA). Of these 10 individuals, 7 reported having taken the IDA medication. When Mf detection was repeated 18 months later, all 10 individuals remained Mf positive. Additionally, three more Mf-positive household members were identified, and they also reported taking the IDA. These Mf-positive individuals were then retreated with IDA under direct observation. At 7 and/or 14 months after retreatment, all initially Mf-positive individuals, except for one, were found to be Mf free. Upon further questioning, it was revealed that all but one individual admitted to not taking the initial MDA. Thus, IDA effectively clears Mf in this region of PNG, and the persistent microfilaremia after MDA is primarily because of individuals failing to take the medications as prescribed.
Author Notes
Financial support: Financial support for this study was provided by the
Disclosures: The protocol was approved by the Medical Research Advisory Council of Papua New Guinea (MRAC 174 19.14) and the Case Western Reserve University Institutional Review Board (STUDY20191141). Adults ages 18 years old and older provided written informed consent. If they could not read or write, a village member who could read or write served as a witness and cosigned the informed consent form. Children’s participation required the consent of their parents and documented assent for children older than 12 years of age.
Current contact information: Joycelyn Salo, Simon Westby, and Ronnie Wakol, Papua New Guinea Institute of Medical Research, Kokopo Branch, Takubar, Papua New Guinea, E-mails: joycelyn.salo@pngimr.org.pg, simon.westby@pngimr.org.pg, and ronniewakol3@gmail.com. Nelly Sanuku, Papua New Guinea Institute of Medical Research, Wewak Branch, Maprik, Papua New Guinea, E-mail: nellysanuku@gmail.com. Krufinta Bun and Moses Laman, Papua New Guinea Institute of Medical Research, Port Moresby Branch, National Capital District, Port Moresbuy, Papua New Guinea, E-mails: krufinta.bun@gmail.com and moses.laman@pngimr.org.pg. Christopher L. King, Case Western Reserve University, Cleveland, OH, E-mail: cxk21@case.edu.
| Past two years | Past Year | Past 30 Days | |
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| Full Text Views | 3195 | 3195 | 620 |
| PDF Downloads | 146 | 146 | 90 |