'New method may fast-track Elephantiasis elimination in India'

A disabling parasitic disease which causes elephantiasis and threatens around one billion people globally - with a large proportion in India, Indonesia and Myanmar - could be eliminated more quickly, using fewer rounds of a proposed triple drug combination, researchers claim.
The new modelling work by researchers from University of Warwick in the UK shows that the number of rounds of mass drug administration needed to treat the disease may fall from many rounds to only two or three.
The World Health Organisation (WHO) has targeted the disease for elimination as a public health problem by the year 2020, researchers said.

Lymphatic filariasis is a neglected tropical disease, which causes serious damage to the lymphatic system. It is caused by parasitic worms and is transmitted to humans by mosquitoes.
Many people with the disease develop elephantiasis or lymphoedema, causing pain and profound disfigurement - such as large swelling of the arms, legs or genitals - and leading to permanent disability.
These patients are not only physically disabled, but suffer mental, social and financial losses contributing to stigma and poverty.

A large proportion of the billion people living with the threat of transmission are in India, Indonesia and Myanmar where the triple drug combination could be used, researchers said.

Currently, people with Lymphatic filariasis require multiple rounds of treatment - but if the drugs ivermectin, diethylcarbamazine and albendazole are used together recent clinical studies have shown that the drugs are more effective at killing the worms.
Initial studies show the triple drug regimen is far more effective at clearing the parasite from its human host and that it has a good safety profile.
However, experts note that campaigns can run into trouble when they go on for too long because populations can lose interest in taking the drug when the disease is not very common.
Mathematical models were used to simulate a mass drug administration campaign in different settings.

As there are many unknowns about the transmission of the disease and how a population responds to intervention, three independently-developed models were used to estimate the impact of the new regimen.
The researchers noted that more effective treatment with fewer drugs rounds is crucial in poorer countries where transmission is high but resources are low.
"This more effective treatment has the potential to revolutionise the control of this disease, but it will require that in over a few rounds of treatment the programmes are able to treat almost the whole population, even the most inaccessible," said Deirdre Hollingsworth from University of Warwick.

The study was published in The Lancet Infectious Diseases journal.