Abstract:
Many trials have explored the efficacy of individual drugs and drug combinations
to treat bancroftian filariasis. This narrative review summarizes the current
evidence for drug management of bancroftian filariasis. Diethylcarbamazine (DEC)
remains the prime antifilarial agent with a well-established microfilaricidal and
some macrofilaricidal effects. Ivermectin (IVM) is highly microfilaricidal but
minimally macrofilaricidal. The role of albendazole (ALB) in treatment regimens
is not well established though the drug has a microfilaricidal effect. The
combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials
have shown that doxycycline therapy against Wolbachia, an endosymbiotic bacterium
of the parasite, is capable of reducing microfilaria rates and adult worm
activity. Followup studies on mass drug administration (MDA) are yet to show a
complete interruption of transmission, though the infection rates are reduced to
a very low level.
