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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/11984

Title: The Efficacy of Doxycycline Treatment on Mansonella perstans Infection: An Open-Label, Randomized Trial in Ghana
Authors: Debrah, Linda Batsa
Phillips, Richard O.
Pfarr, Kenneth
Klarmann-Schulz, Ute
Opoku, Vera Serwaa
Nausch, Norman
Owusu, Wellington
Mubarik, Yusif
Sander, Anna-Lena
ammer, Christine L
Ritter, Manuel
Layland, Laura E.
Jacobsen, Marc
Jacobsen, Marc
Debrah, Alexander Yaw
Hoera, Achim
Issue Date: Jun-2019
Publisher: The American journal of tropical medicine and hygiene
Citation: The American journal of tropical medicine and hygiene 101(1)
Abstract: Treating Mansonella perstans is challenged by the low efficacy of registered antihelminthics. Wolbachia endobacteria provide an alternative treatment target because depletion results in amicrofilaremia in filarial infections with Wuchereria bancrofti and Onchocerca volvulus infections. This open-label, randomized study sought to confirm that i) Wolbachia are present in M. perstans in Ghana and ii) doxycycline treatment will deplete Wolbachia and cause a slow, sustained decline in microfilariae (MF). Two hundred and two Ghanaians with M. perstans infection were randomized into early (immediate) and delayed (6 months deferred) treatment groups, given doxycycline 200 mg/day for 6 weeks, and monitored for MF and Wolbachia levels at baseline, 4, 12, and 24 months after the study onset (= time of randomization and start of treatment for the early group). Per protocol analysis revealed that the median MF/mL in the early group declined from 138 at baseline to 64 at month 4 and further to 0 at month 12. In the delayed group, MF load did not change from a baseline median of 97 to 102 at month 4 but declined to 42 at month 12, that is, 6 months after receiving treatment, trailing the early group as expected. By month 24, both treatment groups had reached a median MF level of 0. After treatment, Wolbachia were depleted from MF by ≥ 1-log drop compared with baseline levels. We conclude that M. perstans in Ghana harbor Wolbachia that are effectively depleted by doxycycline with subsequent reduction in MF loads, most likely because of interruption of fertility of adult worms.
Description: This article is published in The American journal of tropical medicine and hygiene and also available at DOI: 10.4269/ajtmh.18-0491
URI: 10.4269/ajtmh.18-0491
http://hdl.handle.net/123456789/11984
Appears in Collections:College of Health Sciences

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