Additional Treatment

What are the additional benefits of LF treatment?

Even as communities in lymphatic filariasis endemic areas look forward to a future free of LF, they are already reaping immediate and valuable benefits from the effects of albendazole and ivermectin treatment on the almost ubiquitous, chronic intestinal worm infections (especially hookworm and roundworm) of children.

In endemic areas, both preschool and school-age children have high helminth infection rates; overall, one third are estimated to have roundworm and one fourth, either whipworm or hookworm or both. In some areas more than 90% of children are infected with these parasites! The health of women and infants is particularly vulnerable due to parasitic infections as well. In India alone, 10.9 million pregnant women were infected with hookworms in 1990.

These infections also have serious clinical consequences for maternal, child and infant health. Of particular concern is the role the infections play in exacerbating all forms of malnutrition found in LF-endemic areas, primarily iron deficiency, anaemia, protein-energy malnutrition, vitamin A deficiency and low weight gain during and after pregnancy. Without treatment, these intestinal worm infections lay the groundwork for poor health, impaired physical and cognitive development and can cause premature births, stunted growth in children and, all too often, death. In developing countries, 32% of under-five-year olds are already stunted due to malnutrition, and over 50% of children 5-14 years old are anaemic. Every year iron deficiency contributes to 100,000 maternal deaths.

Albendazole and Mectizan® are administered yearly as part of the initiative to eliminate LF and these two drugs also have anti-parasitic properties for treatment of hookworm, roundworm, whipworm, lice, scabies and other parasites1. Treatment with albendazole and Mectizan® has a tremendous impact on the health and economic conditions, especially of women and children, such as:

• Better health and nutrition for mothers, during and after pregnancy
• Lower mortality from severe anaemia, especially in childbirth
• Lower maternal hospitalization rates for severe anaemia and haemorrhage
• Lower incidence of low birth weight and neonatal death
• Less time and money lost due to sickness in mothers and children
• Greater ability of mothers to care for children and families
• Better work and earning capacity for mothers

The immediate clinical effect of albendazole and Mectizan® on intestinal parasite infections offers longterm gains in health and development for treated individuals, especially women and children. Furthermore, these benefits come at no additional cost to the health system or the individual since albendazole and Mectizan® are distributed as the mainstay drugs of the LF elimination programme. Annually over 100 million women will be treated for worms through national LF programmes. At no extra cost, this additional benefit further extends the tremendous impact of albendazole and Mectizan® on the health of millions in LF and helminth endemic areas.

1Mectizan® (ivermectin) has formal regulatory approval for lymphatic filariasis and onchocerciasis and is donated by Merck & Co., Inc. for those indications.