Filariasis in Africa—treatment challenges and prospects

Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease burden in the African continent. Disease symptoms are induced by the immune reactions of the host, with lymphoedema and hydrocoele in LF, and dermatitis and ocular inflammation in...

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Published in:	Clinical microbiology and infection Vol. 17; no. 7; pp. 977 - 985
Main Authors:	Hoerauf, A., Pfarr, K., Mand, S., Debrah, A.Y., Specht, S.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Elsevier Ltd 01-07-2011 Blackwell Publishing Ltd Elsevier Limited
Subjects:	Africa - epidemiology Albendazole Albendazole - adverse effects Albendazole - pharmacology Albendazole - therapeutic use Animals AWOL diethylcarbamazine DOLF Elephantiasis, Filarial - drug therapy Elephantiasis, Filarial - epidemiology filarial diseases Filaricides - pharmacology Filaricides - therapeutic use Humans ivermectin Ivermectin - adverse effects Ivermectin - pharmacology Ivermectin - therapeutic use Nematoda Onchocerca volvulus Onchocerca volvulus - microbiology Onchocerca volvulus - pathogenicity Onchocerca volvulus - physiology Onchocerciasis - drug therapy Onchocerciasis - epidemiology Symbiosis treatment and research aspects Wolbachia Wolbachia - physiology Wuchereria bancrofti Wuchereria bancrofti - microbiology Wuchereria bancrofti - pathogenicity Wuchereria bancrofti - physiology Africa Albendazole DOLF Wolbachia treatment and research aspects filarial diseases AWOL ivermectin diethylcarbamazine
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Abstract	Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease burden in the African continent. Disease symptoms are induced by the immune reactions of the host, with lymphoedema and hydrocoele in LF, and dermatitis and ocular inflammation in onchocerciasis. Wuchereria bancrofti and Onchocerca volvulus, the species causing LF and onchocerciasis in Africa, live in mutual symbiosis with Wolbachia endobacteria, which cause a major part of the inflammation leading to symptoms and are antibiotic targets for treatment. The standard microfilaricidal drugs ivermectin and albendazole are used in mass drug administration programmes, with the aim of interrupting transmission, with a consequent reduction in the burden of infection and, in some situations, leading to regional elimination of LF and onchocerciasis. Co-endemicity of Loa loa with W. bancrofti or O. volvulus is an impediment to mass drug administration with ivermectin and albendazole, owing to the risk of encephalopathy being encountered upon administration of ivermectin. Research into new treatment options is exploring several improved delivery strategies for the classic drugs or new antibiotic treatment regimens for anti-wolbachial chemotherapy.
AbstractList	Clin Microbiol Infect 2011; 17: 977-985 Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease burden in the African continent. Disease symptoms are induced by the immune reactions of the host, with lymphoedema and hydrocoele in LF, and dermatitis and ocular inflammation in onchocerciasis. Wuchereria bancrofti and Onchocerca volvulus, the species causing LF and onchocerciasis in Africa, live in mutual symbiosis with Wolbachia endobacteria, which cause a major part of the inflammation leading to symptoms and are antibiotic targets for treatment. The standard microfilaricidal drugs ivermectin and albendazole are used in mass drug administration programmes, with the aim of interrupting transmission, with a consequent reduction in the burden of infection and, in some situations, leading to regional elimination of LF and onchocerciasis. Co-endemicity of Loa loa with W. bancrofti or O. volvulus is an impediment to mass drug administration with ivermectin and albendazole, owing to the risk of encephalopathy being encountered upon administration of ivermectin. Research into new treatment options is exploring several improved delivery strategies for the classic drugs or new antibiotic treatment regimens for anti-wolbachial chemotherapy. [PUBLICATION ABSTRACT] Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease burden in the African continent. Disease symptoms are induced by the immune reactions of the host, with lymphoedema and hydrocoele in LF, and dermatitis and ocular inflammation in onchocerciasis. Wuchereria bancrofti and Onchocerca volvulus, the species causing LF and onchocerciasis in Africa, live in mutual symbiosis with Wolbachia endobacteria, which cause a major part of the inflammation leading to symptoms and are antibiotic targets for treatment. The standard microfilaricidal drugs ivermectin and albendazole are used in mass drug administration programmes, with the aim of interrupting transmission, with a consequent reduction in the burden of infection and, in some situations, leading to regional elimination of LF and onchocerciasis. Co-endemicity of Loa loa with W. bancrofti or O. volvulus is an impediment to mass drug administration with ivermectin and albendazole, owing to the risk of encephalopathy being encountered upon administration of ivermectin. Research into new treatment options is exploring several improved delivery strategies for the classic drugs or new antibiotic treatment regimens for anti-wolbachial chemotherapy. Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease burden in the African continent. Disease symptoms are induced by the immune reactions of the host, with lymphoedema and hydrocoele in LF, and dermatitis and ocular inflammation in onchocerciasis. Wuchereria bancrofti and Onchocerca volvulus, the species causing LF and onchocerciasis in Africa, live in mutual symbiosis with Wolbachia endobacteria, which cause a major part of the inflammation leading to symptoms and are antibiotic targets for treatment. The standard microfilaricidal drugs ivermectin and albendazole are used in mass drug administration programmes, with the aim of interrupting transmission, with a consequent reduction in the burden of infection and, in some situations, leading to regional elimination of LF and onchocerciasis. Co-endemicity of Loa loa with W. bancrofti or O. volvulus is an impediment to mass drug administration with ivermectin and albendazole, owing to the risk of encephalopathy being encountered upon administration of ivermectin. Research into new treatment options is exploring several improved delivery strategies for the classic drugs or new antibiotic treatment regimens for anti-wolbachial chemotherapy.Original Abstract: Clin Microbiol Infect 2011; 17: 977-985 Clin Microbiol Infect 2011; 17: 977–985 Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease burden in the African continent. Disease symptoms are induced by the immune reactions of the host, with lymphoedema and hydrocoele in LF, and dermatitis and ocular inflammation in onchocerciasis. Wuchereria bancrofti and Onchocerca volvulus, the species causing LF and onchocerciasis in Africa, live in mutual symbiosis with Wolbachia endobacteria, which cause a major part of the inflammation leading to symptoms and are antibiotic targets for treatment. The standard microfilaricidal drugs ivermectin and albendazole are used in mass drug administration programmes, with the aim of interrupting transmission, with a consequent reduction in the burden of infection and, in some situations, leading to regional elimination of LF and onchocerciasis. Co‐endemicity of Loa loa with W. bancrofti or O. volvulus is an impediment to mass drug administration with ivermectin and albendazole, owing to the risk of encephalopathy being encountered upon administration of ivermectin. Research into new treatment options is exploring several improved delivery strategies for the classic drugs or new antibiotic treatment regimens for anti‐wolbachial chemotherapy.
Author	Pfarr, K. Mand, S. Specht, S. Hoerauf, A. Debrah, A.Y.
Author_xml	– sequence: 1 givenname: A. surname: Hoerauf fullname: Hoerauf, A. email: hoerauf@microbiology-bonn.de organization: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Strasse, Bonn, Germany – sequence: 2 givenname: K. surname: Pfarr fullname: Pfarr, K. organization: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Strasse, Bonn, Germany – sequence: 3 givenname: S. surname: Mand fullname: Mand, S. organization: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Strasse, Bonn, Germany – sequence: 4 givenname: A.Y. surname: Debrah fullname: Debrah, A.Y. organization: Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana – sequence: 5 givenname: S. surname: Specht fullname: Specht, S. organization: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Strasse, Bonn, Germany
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Copyright	2011 European Society of Clinical Infectious Diseases 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.
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Snippet	Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease burden in the African continent.... Clin Microbiol Infect 2011; 17: 977–985 Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease... Clin Microbiol Infect 2011; 17: 977-985 Lymphatic filariasis (LF) and onchocerciasis are parasitic nematode infections that are responsible for a major disease...
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SubjectTerms	Africa - epidemiology Albendazole Albendazole - adverse effects Albendazole - pharmacology Albendazole - therapeutic use Animals AWOL diethylcarbamazine DOLF Elephantiasis, Filarial - drug therapy Elephantiasis, Filarial - epidemiology filarial diseases Filaricides - pharmacology Filaricides - therapeutic use Humans ivermectin Ivermectin - adverse effects Ivermectin - pharmacology Ivermectin - therapeutic use Nematoda Onchocerca volvulus Onchocerca volvulus - microbiology Onchocerca volvulus - pathogenicity Onchocerca volvulus - physiology Onchocerciasis - drug therapy Onchocerciasis - epidemiology Symbiosis treatment and research aspects Wolbachia Wolbachia - physiology Wuchereria bancrofti Wuchereria bancrofti - microbiology Wuchereria bancrofti - pathogenicity Wuchereria bancrofti - physiology
Title	Filariasis in Africa—treatment challenges and prospects
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