Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa
Following the first triple-drug mass drug administration (MDA) for lymphatic filariasis in Samoa in 2018, unexpected persistence of microfilaria (Mf) positivity in 18 (15%) of 121 antigen-positive persons was observed in a nationwide household survey 1–2 months later. Of the 18 Mf positive persons,...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-04-01
|
| Series: | Tropical Medicine and Infectious Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2414-6366/6/2/44 |
| _version_ | 1797539095555080192 |
|---|---|
| author | Patricia M. Graves Sarah Sheridan Jessica Scott Filipina Amosa-Lei Sam Take Naseri Robert Thomsen Christopher L. King Colleen L. Lau |
| author_facet | Patricia M. Graves Sarah Sheridan Jessica Scott Filipina Amosa-Lei Sam Take Naseri Robert Thomsen Christopher L. King Colleen L. Lau |
| author_sort | Patricia M. Graves |
| collection | DOAJ |
| description | Following the first triple-drug mass drug administration (MDA) for lymphatic filariasis in Samoa in 2018, unexpected persistence of microfilaria (Mf) positivity in 18 (15%) of 121 antigen-positive persons was observed in a nationwide household survey 1–2 months later. Of the 18 Mf positive persons, 14 reported taking the MDA, raising concerns about MDA efficacy. In 2019, 5–6 months after the 2018 survey, a monitored treatment study was done to evaluate directly observed weight-based treatment in these Mf positive individuals. Mf presence and density were assessed before and 7 days after treatment, using 1 mL membrane filtered venous blood, and 60 uL thick blood films on slides prepared from venous or fingerprick blood. All 14 participants were still Mf positive on filters from venous blood pre-treatment samples, but two were negative by slide made from the same samples. Mf were cleared completely by day 7 in 12 of 13 participants followed up, and by day 30 in the remaining participant. Filtered blood using EDTA samples (to reduce clumping of Mf) is preferred over slides alone for improving the likelihood of detecting Mf and estimating their density. The triple-drug MDA strategy was effective at clearing Mf when given and taken at the correct dose. |
| first_indexed | 2024-03-10T12:40:27Z |
| format | Article |
| id | doaj.art-43886832854649c4832b00e0f8f87543 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-10T12:40:27Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-43886832854649c4832b00e0f8f875432023-11-21T13:54:00ZengMDPI AGTropical Medicine and Infectious Disease2414-63662021-04-01624410.3390/tropicalmed6020044Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in SamoaPatricia M. Graves0Sarah Sheridan1Jessica Scott2Filipina Amosa-Lei Sam3Take Naseri4Robert Thomsen5Christopher L. King6Colleen L. Lau7College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD 4870 and Townsville, QLD 4811, AustraliaSchool of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2033, AustraliaCollege of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD 4870 and Townsville, QLD 4811, AustraliaSchool of Medicine, National University of Samoa, Apia, SamoaMinistry of Health, Apia, SamoaMinistry of Health, Apia, SamoaCenter for Global Health, School of Medicine and Veterans Affairs Administration, Case Western Reserve University, Cleveland, OH 44106, USASchool of Public Health, The University of Queensland, Brisbane, QLD 4006, AustraliaFollowing the first triple-drug mass drug administration (MDA) for lymphatic filariasis in Samoa in 2018, unexpected persistence of microfilaria (Mf) positivity in 18 (15%) of 121 antigen-positive persons was observed in a nationwide household survey 1–2 months later. Of the 18 Mf positive persons, 14 reported taking the MDA, raising concerns about MDA efficacy. In 2019, 5–6 months after the 2018 survey, a monitored treatment study was done to evaluate directly observed weight-based treatment in these Mf positive individuals. Mf presence and density were assessed before and 7 days after treatment, using 1 mL membrane filtered venous blood, and 60 uL thick blood films on slides prepared from venous or fingerprick blood. All 14 participants were still Mf positive on filters from venous blood pre-treatment samples, but two were negative by slide made from the same samples. Mf were cleared completely by day 7 in 12 of 13 participants followed up, and by day 30 in the remaining participant. Filtered blood using EDTA samples (to reduce clumping of Mf) is preferred over slides alone for improving the likelihood of detecting Mf and estimating their density. The triple-drug MDA strategy was effective at clearing Mf when given and taken at the correct dose.https://www.mdpi.com/2414-6366/6/2/44lymphatic filariasisSamoamicrofilariaDECalbendazoleivermectin |
| spellingShingle | Patricia M. Graves Sarah Sheridan Jessica Scott Filipina Amosa-Lei Sam Take Naseri Robert Thomsen Christopher L. King Colleen L. Lau Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa Tropical Medicine and Infectious Disease lymphatic filariasis Samoa microfilaria DEC albendazole ivermectin |
| title | Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa |
| title_full | Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa |
| title_fullStr | Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa |
| title_full_unstemmed | Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa |
| title_short | Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa |
| title_sort | triple drug treatment is effective for lymphatic filariasis microfilaria clearance in samoa |
| topic | lymphatic filariasis Samoa microfilaria DEC albendazole ivermectin |
| url | https://www.mdpi.com/2414-6366/6/2/44 |
| work_keys_str_mv | AT patriciamgraves tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa AT sarahsheridan tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa AT jessicascott tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa AT filipinaamosaleisam tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa AT takenaseri tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa AT robertthomsen tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa AT christopherlking tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa AT colleenllau tripledrugtreatmentiseffectiveforlymphaticfilariasismicrofilariaclearanceinsamoa |