Combination of ivermectin and diethylcarbamazine for a better control of lymphatic filariasis

Since 1993, a three arm double-blind controlled trial was implemented in French Polynesia to compare the efficacy of single doses of diethylcarbamazine (DEC) 6 mg/kg vs. ivermectin (IVR) 400 mu g/kg vs. the combination IVR 400 + DEC 6 for treatment of Wuchereria bancrofti mf carriers. Of the 57 treated male patients, three groups of 19 were randomly selected and allocated to one of the three treatments. Twelve months after the first then the second treatment (M12 then M24) respectively, 3 (16 %) then 10 (53 %), 3 (16 %) then 5 (26 %), 7 (27 %) then 10 (53 %) of patients were mf negative in groups DEC 6, IVR 400 and IVR + DEC. Mf percent return was significantly lower in the group IVR + DEC (2 % at M12 then M24) than for the groups DEC 6 (15 % at M12 then 4 % at M24) and IVR 400 (12 % at M12 then 10 % at M24). The combination IVR + DEC showed promising results for an annual strategy, to achieve the best results from a control program it is necessary to associate IVR + DEC.