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Efficacy of ivermectin in the treatment of Wuchereria bancrofti infection: a model-based analysis of trial results

Published online by Cambridge University Press:  01 October 1999

A. P. PLAISIER ,
W. C. CAO ,
G. J. VAN OORTMARSSEN  and
J. D. F. HABBEMA
A. P. PLAISIER
Affiliation:
Centre for Decision Sciences in Tropical Disease Control, Department of Public Health, Faculty of Medicine and Health Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
W. C. CAO
Affiliation:
Department of Epidemiology, Institute of Microbiology and Epidemiology, 20 Dongda Street, Beijing 100071, China
G. J. VAN OORTMARSSEN
Affiliation:
Centre for Decision Sciences in Tropical Disease Control, Department of Public Health, Faculty of Medicine and Health Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
J. D. F. HABBEMA
Affiliation:
Centre for Decision Sciences in Tropical Disease Control, Department of Public Health, Faculty of Medicine and Health Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
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Abstract

Ivermectin is a promising drug for the treatment of lymphatic filariasis. A meta-analysis of trials investigating the effects of a single treatment suggested a dose-dependent effect on the production of microfilariae (mf) by adult Wuchereria bancrofti parasites. A mathematical model that describes the parasite dynamics in the human host and the impact of ivermectin treatment is presented and its outputs compared with these trials. The calculated trend in mf density after treatment appears to be particularly sensitive to the assumption about the mean life-span of mf. Adopting 0.5–2 years as a range of plausible values for this mf life-span, the model is used to estimate the impact of treatment on the parasite. It is found that irrespective of dosage, ivermectin eliminates 100% of the blood mf from a patient. Furthermore, at a dosage level of 400 μg/kg a single treatment irreversibly reduces the mf production of the adult parasites by at least 65%. For a dosage of 200 μg/kg this reduction is at least 35%. No such effect can be concluded from the results of trials using lower dosages.

Keywords

Wuchereria bancroftilymphatic filariasisivermectinmathematical model
Type
Research Article
Information
Parasitology , Volume 119 , Issue 4 , October 1999 , pp. 385 - 394
Copyright
1999 Cambridge University Press

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