A longitudinal analysis of the effect of mass drug administration on acute inflammatory episodes and disease progression in lymphedema patients in Leogane, Haiti.

We conducted a longitudinal analysis of 117 lymphedema patients in a filariasis-endemic area of Haiti during 1995-2008. No difference in lymphedema progression between those who received or did not receive mass drug administration (MDA) was found on measures of foot (P = 0.24), ankle (P = 0.87), or leg (P = 0.46) circumference; leg volume displacement (P = 0.09), lymphedema stage (P = 0.93), or frequency of adenolymphangitis (ADL) episodes (P = 0.57). Rates of ADL per year were greater after initiation of MDA among both groups (P < 0.01). Nevertheless, patients who received MDA reported improvement in four areas of lymphedema-related quality of life (P ≤ 0.01). Decreases in foot and ankle circumference and ADL episodes were observed during the 1995-1998 lymphedema management study (P ≤ 0.01). This study represents the first longitudinal, quantitative, leg-specific analysis examining the clinical effect of diethylcarbamazine on lymphedema progression and ADL episodes.

[1]  D. Addiss,et al.  Feasibility and Effectiveness of Basic Lymphedema Management in Leogane, Haiti, an Area Endemic for Bancroftian Filariasis , 2010, PLoS neglected tropical diseases.

[2]  Shannon K. McClintock,et al.  A Community-Based Study of Factors Associated with Continuing Transmission of Lymphatic Filariasis in Leogane, Haiti , 2010, PLoS neglected tropical diseases.

[3]  P. Lammie,et al.  Assessing the Impact of a Missed Mass Drug Administration in Haiti , 2009, PLoS neglected tropical diseases.

[4]  R. K. Shenoy,et al.  Antifilarial drugs, in the doses employed in mass drug administrations by the Global Programme to Eliminate Lymphatic Filariasis, reverse lymphatic pathology in children with Brugia malayi infection , 2009, Annals of tropical medicine and parasitology.

[5]  D. Addiss,et al.  Predictors of compliance in mass drug administration for the treatment and prevention of lymphatic filariasis in Leogane, Haiti. , 2008, The American journal of tropical medicine and hygiene.

[6]  A. Wickremasinghe,et al.  Efficacy of a limb-care regime in preventing acute adenolymphangitis in patients with lymphoedema caused by bancroftian filariasis, in Colombo, Sri Lanka , 2007, Annals of tropical medicine and parasitology.

[7]  R. K. Shenoy,et al.  Preliminary findings from a cross-sectional study on lymphatic filariasis in children, in an area of India endemic for Brugia malayi infection , 2007, Annals of tropical medicine and parasitology.

[8]  Molly A Brady,et al.  Morbidity management in the Global Programme to Eliminate Lymphatic Filariasis: a review of the scientific literature , 2007, Filaria journal.

[9]  A. Hoerauf,et al.  Doxycycline Reduces Plasma VEGF-C/sVEGFR-3 and Improves Pathology in Lymphatic Filariasis , 2006, PLoS pathogens.

[10]  D. Addiss,et al.  Participation in three consecutive mass drug administrations in Leogane, Haiti , 2006, Tropical medicine & international health : TM & IH.

[11]  R. Hay,et al.  Interdigital lesions and frequency of acute dermatolymphangioadenitis in lymphoedema in a filariasis‐endemic area , 2006, The British journal of dermatology.

[12]  L. Ward.  Bioelectrical impedance analysis: proven utility in lymphedema risk assessment and therapeutic monitoring. , 2006, Lymphatic research and biology.

[13]  D. Addiss,et al.  The Leogane, Haiti demonstration project: decreased microfilaremia and program costs after three years of mass drug administration. , 2005, The American journal of tropical medicine and hygiene.

[14]  A. N. Nayak,et al.  A randomized clinical trial to compare the efficacy of three treatment regimens along with footcare in the morbidity management of filarial lymphoedema , 2005, Tropical medicine & international health : TM & IH.

[15]  A. N. Nayak,et al.  Epidemiology of episodic adenolymphangitis: a longitudinal prospective surveillance among a rural community endemic for bancroftian filariasis in coastal Orissa, India , 2005, BMC public health.

[16]  P. Mony,et al.  The efficacies of affected-limb care with penicillin, diethylcarbamazine, the combination of both drugs or antibiotic ointment, in the prevention of acute adenolymphangitis during bancroftian filariasis , 2004, Annals of tropical medicine and parasitology.

[17]  L. Waller,et al.  Community- and individual-level determinants of Wuchereria bancrofti infection in Leogane Commune, Haiti. , 2004, The American journal of tropical medicine and hygiene.

[18]  S. Pani,et al.  Some observations on the effect of Daflon (micronized purified flavonoid fraction of Rutaceae aurantiae) in bancroftian filarial lymphoedema , 2003, Filaria journal.

[19]  R. K. Shenoy,et al.  A qualitative study on the feasibility and benefits of foot hygiene measures practiced by patients with brugian filariasis. , 2003, The Journal of communicable diseases.

[20]  T. McPherson.  Impact on the quality of life of lymphoedema patients following introduction of a hygiene and skin care regimen in a Guyanese community endemic for lymphatic filariasis: A preliminary clinical intervention study , 2003, Filaria journal.

[21]  M. Alpers,et al.  Mass treatment to eliminate filariasis in Papua New Guinea. , 2002, The New England journal of medicine.

[22]  R. K. Shenoy,et al.  Efficacy and sustainability of a footcare programme in preventing acute attacks of adenolymphangitis in Brugian filariasis , 2002, Tropical medicine & international health : TM & IH.

[23]  D. Addiss,et al.  Progression of lymphatic vessel dilatation in the presence of living adult Wuchereria bancrofti. , 2002, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[24]  M. Lemnge,et al.  A randomized, double-blind, placebo-controlled study with diethylcarbamazine for the treatment of hydrocoele in an area of Tanzania endemic for lymphatic filariasis. , 2001, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[25]  N. Leal,et al.  Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes. , 1999, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[26]  R. K. Shenoy,et al.  A double-blind, placebo-controlled study of the efficacy of oral penicillin, diethylcarbamazine or local treatment of the affected limb in preventing acute adenolymphangitis in lymphoedema caused by brugian filariasis. , 1999, Annals of tropical medicine and parasitology.

[27]  R. K. Shenoy,et al.  Prevention of acute adenolymphangitis in brugian filariasis: comparison of the efficacy of ivermectin and diethylcarbamazine, each combined with local treatment of the affected limb. , 1998, Annals of tropical medicine and parasitology.

[28]  M. Alpers,et al.  Transmission intensity and its relationship to infection and disease due to Wuchereria bancrofti in Papua New Guinea. , 1997, Journal of Infectious Diseases.

[29]  T. Nutman,et al.  Diethylcarbamazine-induced reversal of early lymphatic dysfunction in a patient with bancroftian filariasis: assessment with use of lymphoscintigraphy. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[30]  D. Rubin.  Multiple Imputation After 18+ Years , 1996 .

[31]  Ch'en Cc,et al.  Follow-up investigations on clinical manifestations after filariasis eradication by diethylcarbamazine medicated common salt on Kinmen (Quemoy) Islands, Republic of China. , 1995 .

[32]  P. Vanamail,et al.  Limb circumference measurement for recording edema volume in patients with filarial lymphedema. , 1995, Lymphology.

[33]  A. Srividya,et al.  Clinical manifestations of bancroftian filariasis with special reference to lymphoedema grading. , 1995, The Indian journal of medical research.

[34]  R. K. Shenoy,et al.  A preliminary study of filariasis related acute adenolymphangitis with special reference to precipitating factors and treatment modalities. , 1995, The Southeast Asian journal of tropical medicine and public health.

[35]  D. Freedman,et al.  Lymphoscintigraphic assessment of the effect of diethylcarbamazine treatment on lymphatic damage in human bancroftian filariasis. , 1995, The American journal of tropical medicine and hygiene.

[36]  Purnomo,et al.  Towards a filariasis-free community: evaluation of filariasis control over an eleven year period in Flores, Indonesia. , 1989, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[37]  S. Zeger,et al.  Longitudinal data analysis using generalized linear models , 1986 .

[38]  J. Kessel,et al.  A filariasis-control program in American Samoa. , 1969, The American journal of tropical medicine and hygiene.

[39]  H. N. March,et al.  Reduction in the prevalence of clinical filariasis in Tahiti following adoption of a control program. , 1960, The American journal of tropical medicine and hygiene.

[40]  J. Kessel,et al.  Preliminary observations on the prevalence, clinical manifestations and control of filariasis in the Society Islands. , 1952, The American journal of tropical medicine and hygiene.

[41]  R. Hewitt,et al.  Follow-up observations on the treatment of bancroftian filariasis with hetrazan in British Guiana. , 1950, The American journal of tropical medicine and hygiene.

[42]  D. Addiss,et al.  Evaluation of antibacterial soap in the management of lymphoedema in Leogane, Haiti. , 2011, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[43]  E. Ottesen.  Global programme to eliminate lymphatic filariasis. , 2009, Releve epidemiologique hebdomadaire.

[44]  G. Dreyer.  Basic lymphoedema management : treatment and prevention of problems associated with lymphatic filariasis , 2002 .

[45]  Yu Yizhen,et al.  Studies on the recurrent attacks of acute adenolymphangitis due to Malayan filariasis , 2000 .

[46]  B. Shen,et al.  [Studies on the recurrent attacks of acute adenolymphangitis due to Malayan filariasis]. , 2000, Zhongguo ji sheng chong xue yu ji sheng chong bing za zhi = Chinese journal of parasitology & parasitic diseases.

[47]  D. Meyrowitsch,et al.  Mass diethylcarbamazine chemotherapy for control of bancroftian filariasis: comparative efficacy of standard treatment and two semi-annual single-dose treatments. , 1996, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[48]  D. Meyrowitsch,et al.  Mass diethylcarbamazine chemotherapy for control of bancroftian filariasis through community participation: comparative efficacy of a low monthly dose and medicated salt. , 1996, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[49]  B. Grenfell,et al.  Episodic adenolymphangitis and lymphoedema in patients with bancroftian filariasis. , 1995, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[50]  C. C. Chen,et al.  Follow-up investigations on clinical manifestations after filariasis eradication by diethylcarbamazine medicated common salt on Kinmen (Quemoy) Islands, Republic of China. , 1995, The Journal of tropical medicine and hygiene.

[51]  J. Kessel.  An effective programme for the control of filariasis in Tahiti. , 1957, Bulletin of the World Health Organization.

[52]  R. Hewitt,et al.  Treatment of bancroftian filariasis with hetrazan in British Guiana. , 1949, The American journal of tropical medicine and hygiene.