Parasitology Research

, Volume 116, Issue 10, pp 2683–2694 | Cite as

Efficacy and tolerability of treatment with single doses of diethylcarbamazine (DEC) and DEC plus albendazole (ABZ) for three consecutive years in lymphatic filariasis: a field study in India

  • Nilima A. KshirsagarEmail author
  • N. J. Gogtay
  • B. S. Garg
  • P. R. Deshmukh
  • D. D. Rajgor
  • V. S. Kadam
  • P. A. Thakur
  • A. Gupta
  • N. S. Ingole
  • J. K. Lazdins-Helds
Original Paper


Lymphatic filariasis (LF) affects 73 countries, causes morbidity and impedes socioeconomic development. We had found no difference in safety and micro (Mf) and macro filarial action of single-dose diethylcarbamazine (DEC) and DEC + albendazole (ABZ) in an F01 study done in India (year 2000). There was a programmatic need to evaluate safety and efficacy of multiple annual treatments (F02). Subjects (155) from the F01 study, meeting inclusion-exclusion criteria, were enrolled in F02 and treated with further two annual doses of DEC or DEC + ABZ. Efficacy was evaluated for Mf positivity by peripheral smear (PS) and nucleopore (NP) filter, circulating filarial antigen (CFA) and filarial dance sign (FDS) positivity and Mf count at yearly follow-up. Safety was assessed for 5 days after drug administration. Total of 139 subjects evaluated for efficacy (69 DEC and 70 DEC + ABZ group). Mf positivity prevalence declined progressively by 95% (PS), 66% (NP), and 95% (PS) and 86% (NP); CFA positivity prevalence declined by 15% and 9%; FDS by 100% each; Mf count declined by 75.5 and 76.9% with three annual treatment of DEC and DEC + ABZ, respectively. Addition of ABZ did not show any advantage over DEC given as three annual rounds for LF. DEC and DEC + ABZ were well tolerated. There was no correlation between result of CFA and FDS, (both claimed to be indicative of adult worm). Analysis of published studies and our data indicate that macrofilaricidal effect of DEC/DEC + ABZ may be seen in children and not adults, with three or more annual dosing.


Lymphatic filariasis Diethylcarbamazine Albendazole Efficacy Safety Mass drug administration Retreatments Microfilaria Circulating filarial antigen Filarial dance sign 



Pravin Bhusari and other social workers, all medical officers and research staff from the Department of Clinical Pharmacology who assisted at various follow-ups. Bowalekar for statistical analysis, Cipla for Drug packaging and randomization, and Glaxo Smithkline for DEC supply.

Compliance with ethical standards


This investigation received financial support from the UNDP/World bank/WHO Special Program for Research and Training in Tropical Diseases (TDR).


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Nilima A. Kshirsagar
    • 1
    • 2
    Email author
  • N. J. Gogtay
    • 1
  • B. S. Garg
    • 3
  • P. R. Deshmukh
    • 3
  • D. D. Rajgor
    • 1
  • V. S. Kadam
    • 1
  • P. A. Thakur
    • 1
  • A. Gupta
    • 1
  • N. S. Ingole
    • 4
  • J. K. Lazdins-Helds
    • 5
  1. 1.Department of Clinical PharmacologySeth GS Medical College and KEM HospitalMumbaiIndia
  2. 2.National Chair Clinical Pharmacology, ICMR Govt. of IndiaNational Institute for Research in Reproductive Health (NIRRH)MumbaiIndia
  3. 3.Department of Community MedicineMahatma Gandhi Institute of Medical SciencesWardhaIndia
  4. 4.Department of PathologyMahatma Gandhi Institute of Medical SciencesWardhaIndia
  5. 5.World Health Organization (WHO), Special Program for Research and Training in Tropical Diseases, Product Research and DevelopmentGenevaSwitzerland

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