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Annual mass treatment with antifilarial drugs is the cornerstone of the global program to eliminate lymphatic filariasis (LF). Although the primary goal of the program is to interrupt transmission of LF, additional public health benefits also are expected because of the known anthelminthic properties of these drugs. Since rapid re-infection with intestinal helminths occurs following treatment, annual de-worming may not be sufficient to produce a lasting reduction in the prevalence and intensity of these infections. We conducted stool examinations in four sentinel communities before and approximately nine months after each of two rounds of mass drug administration (MDA) with diethylcarbamazine and albendazole in the context of an LF elimination program in Leogane, Haiti. At baseline, overall Ascaris, Trichuris, and hookworm infection prevalences were 20.9%, 34.0%, and 11.2%, respectively (n = 2,716 stools). Nine months after the second MDA, Ascaris, Trichuris and hookworm prevalences had decreased significantly, to 14.1%, 14.6%, and 2.0%, respectively (n = 814 stools). Infection intensity decreased significantly for all three parasites as well. These results demonstrate that substantial reductions in intestinal helminth infections are associated with mass treatment of filariasis in Haiti and are consistent with the conclusion that high levels of coverage for the LF program can decrease transmission of geohelminths.
Received March 11, 2004. Accepted for publication May 31, 2004.
Acknowledgments: We thank the demonstration project staff in Leogane, the people living in the sentinel sites, and especially our colleagues at GlaxoSmithKline for their generous support for the LF program in Haiti and in other countries through their donation of albendazole.
Financial support: This study was supported by the Emerging Infections Program of the Centers for Disease Control and Prevention and by a grant from the Bill & Melinda Gates Foundation to the University of Notre Dame.
Authors’ addresses: Madsen Beau de Rochars, Hopital Ste. Croix, Leogane, Haiti, Telephione: 509-555-5246, Fax: 509-235-1845, E-mail: mbeauder{at}nd.edu. Abdel N. Direny, Hopital Ste. Croix, Leogane, Haiti, Telephone: 509-551-6445, Fax: 509-235-1845, E-mail: adireny{at}nd.edu. Jacquelin M. Roberts, Division of Parasitic Diseases, Mailstop F22, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, Telephone: 488-7733, Faxs: 770-488-7794, E-mail: jmr1{at}cdc.gov. David G. Addiss, Division of Parasitic Diseases, Mailstop F22, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, Telephone: 770-488-7770, Fax: 770-488-7761, E-mail: dga1{at}cdc.gov. Jeanne Rad-day, Division of Parasitic Diseases, Mailstop F22, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, Telephone: 770-488-7538, Fax: 770- 488-7761, E-mail: jradday{at}hotmail.com. Michael J. Beach, Division of Parasitic Diseases, Mailstop F22, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, Telephone: 770-488-7763, Fax: 770-488-7761, E-mail: mjb3{at}cdc.gov. Thomas G. Streit, Center for Tropical Diseases, University of Notre Dame, 351 Galvin Hall, Notre Dame, IN 46556, Telephone: 574-631-3273, Fax: 574-631-7413, E-mail: streit1{at}nd.edu. Desire Dardith, Hopital Ste. Croix, Leogane, Haiti. Jack Guy Lafontant, Hopital Ste. Croix, Leogane, Haiti, Telephone: 509-555-7692, Fax: 509-235-1845, E-mail: gastro{at}hospital-stecroix.org. Patrick J. Lammie, Division of Parasitic Diseases, Mail-stop F13, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, Telephone: 770-488-4054, Fax: 770-488-4108, E-mail: pjl1{at}cdc.gov.
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