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Journal of Tropical Medicine
Volume 2011, Article ID 175941, 12 pages
Review Article

Current Evidence on the Use of Antifilarial Agents in the Management of bancroftian Filariasis

1Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
2University Medical Unit, National Hospital of Sri Lanka, Colombo 08, Sri Lanka
3Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka

Received 25 September 2010; Accepted 29 November 2010

Academic Editor: Thomas R. Unnasch

Copyright © 2011 Sumadhya Deepika Fernando et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Many trials have explored the efficacy of individual drugs and drug combinations to treat bancroftian filariasis. This narrative review summarizes the current evidence for drug management of bancroftian filariasis. Diethylcarbamazine (DEC) remains the prime antifilarial agent with a well-established microfilaricidal and some macrofilaricidal effects. Ivermectin (IVM) is highly microfilaricidal but minimally macrofilaricidal. The role of albendazole (ALB) in treatment regimens is not well established though the drug has a microfilaricidal effect. The combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials have shown that doxycycline therapy against Wolbachia, an endosymbiotic bacterium of the parasite, is capable of reducing microfilaria rates and adult worm activity. Followup studies on mass drug administration (MDA) are yet to show a complete interruption of transmission, though the infection rates are reduced to a very low level.