Abstract:
From November 1999 to February 2000 a community survey was carried out in the
south district - Zanzibar and a total of 2839 individuals were screened. The purpose
of this survey was (apart from detecting the magnitude and intensity of bancroftian
filariasis and geohelminth infections) to determine safety and efficacy of co-
administration of albendazole and Ivermectin on lymphatic filariasis and its
secondary benefits on geohelminth and related factors in a sampled population in
Unguja Island Zanzibar.
A sample of 418 participants positive for bancroftian filariasis and or with clinical
filarial disease were recruited. Pre and post treatment levels of microfilaria were
determined by night blood sample collection and geohelminth infection was
determined indirectly by egg counts. Out of these 418,259 (62%) were found to have
at least one specie of geohelminth infection. These were physically examined and
were randomly assigned to the two treatment aIDlS (ivermectin -albendazole or
ivermectin placebo) and followed for 96 hours to monitor for any drug related side
effects. Those who developed side effects were managed accordingly.
Results showed that the overall prevalence of bancroftian filariasis and geohelminth
was 13.7% and 44.7% respectively. The overall reduction on percentage and
intensity of bancroftian filariasis and geohelminth infections were found to be higher
in ivermectin-albendazole treatment arm (100% and 78.4% respectively) compared
to ivermectin -placebo regime (reduced lymphatic and geohelminth by 97.8% and
Vll!
45.83 % respectively). Similar levels of reductions were noted on infections with
different geohelminth species.
Side effects were reported from six hours after drug administration reaching peak at
24 hours and declined from 72 hours. Headache and changes in respiratory rates
were the major side effects associated with ivermectin -albendazole arm while high
fever and dizziness were associated with ivermectin -placebo treatment regime.
In conclusion, at short-term observation, the ivermectin -albendazole combination
was noted to be more efficacious and safe in treatment of both parasites than
ivennectin placebo regime.
It is recommended that a long term evaluation on sustainability of these reduced
parasites levels are conducted at three and six months respectively.
