Treatment of co-infection with bancroftian filariasis and onchocerciasis: a safety and efficacy study of albendazole with ivermectin compared to treatment of single infection with bancroftian filariasis

BACKGROUND: In order to use a combination of ivermectin and albendazole for the elimination of lymphatic filariasis, it is important to assess the potential risk of increased adverse events in individuals infected with both lymphatic filariasis and onchocerciasis. We compared the safety and efficacy of albendazole (400 mg) in combination with ivermectin (150 micrograms/kg), for the treatment of co-infections of Wuchereria bancrofti and Onchocerca volvulus with single infection of W. bancrofti. METHODS: The safety study on co-infections was a crossover, double blind design, while for the single infection of bancroftian filariasis an open design comparing two treatments was used. For co-infection, one group was allocated a single dose of ivermectin (150 micrograms/kg) plus albendazole (400 mg) (Group A). The other group received placebo (Group B). Five days later the treatment regime was reversed, with the Group A receiving placebo and Group B receiving treatment. For the single bancroftian filariasis infection, one group received a single dose of albendazole (400 mg) plus ivermectin (150 μg/kg) (Group C) while the other group received a single dose of albendazole (400 mg) alone (Group D). Blood and skin specimens were collected on admission day, day 0, and on days 2, 3, and 7 to assess drug safety and efficacy. Thereafter, blood and skin specimens were collected during the 12 months follow up for the assessment of drug efficacy. Study individuals were clinically monitored every six hours during the first 48 hours following treatment, and routine clinical examinations were performed during the hospitalisation period and follow-up. RESULTS: In individuals co-infected with bancroftian filariasis and onchocerciasis, treatment with ivermectin and albendazole was safe and tolerable. Physiological indices showed no differences between groups with co-infection (W. bancrofti and O. volvulus) or single infection (W. bancrofti). The frequency of adverse events in co-infected individuals was 63% (5/8, Group A, albendazole + ivermectin) and 57% (4/7, Group B, placebo) and of mild or moderate intensity. In single W. bancrofti infection the frequency of adverse events was 50% (6/12, Group C, albendazole + ivermectin) and 38% (5/13, Group D, albendazole) and of a similar intensity to those experienced with co-infection. There were no differences in adverse events between treatment groups. There was no significant difference in the reduction of microfilaraemia following treatment with albendazole and ivermectin in groups with single or co-infection. CONCLUSION: Our findings suggest that ivermectin plus albendazole is a safe and tolerable treatment for co-infection of bancroftian filariasis and onchocerciasis

Willingness to pay for quality traits and implications for sweetpotato variety breeding: case of Mozambique

Despite decades of research and dissemination of improved sweetpotato varieties, uptake at scale remains low and envisaged development goals of food security and livelihoods remain elusive. This is despite demonstrated impacts of such technologies in combating food and nutrition insecurity, amidst global challenges like climate change. Growing evidence show that end-user acceptance of improved varieties is critical in the widespread adoption of such varieties, and inclusion of the heterogenous preferences of diverse sets of end-users in the variety development process is therefore critical. With global changes in weather and consumption patterns, end-users are now demanding varieties that are more suitable to their unique consumption needs, production environments, new market demands and have desired processing characteristics. Such dynamics in demand have necessitated rethinking of breeding programs from the traditional focus on agronomic gains such as increase in yields and yield protection, to consideration of more nuanced quality-related traits that appeal to targeted populations. Against this background, this study sets out to explore the decision-making behavior of Mozambican sweetpotato producers in variety selection, and the implicit value placed on different sweetpotato traits, including the often ignored but crucial quality traits. The aim of the study is to identify the economic valuation of such traits and how they are traded off in variety selection decisions, to allow for prioritization in breeding efforts. To achieve this, an exploratory sequential design in a predominantly quantitative mixed-method design was adopted for the study. First, based on the insights from a gender disaggregated qualitative assessment among sweetpotato growers and consumers and in consultation with breeding experts from Mozambique, the most preferred sweetpotato variety traits in the regions of study were established. These traits were then utilized in the design of a choice experiment, implemented among 860 sweetpotato producers spread across four sweetpotato growing regions in the country. Finally, a generalized multinomial logit model was used to estimate implicit economic valuation of each of the considered trait, as well as heterogenous valuation of such traits across gender, education and age of respondent groups. Results from the study show that producers have a high preference for quality-related traits, with preference for Vitamin A being higher than that for drought tolerance, while dry matter content is valued about the same as drought tolerance. While scoring significantly lower than Vitamin A, drought tolerance and dry matter content, other quality-related traits like root size and sweet taste also have significant positive values implying their importance in informing sweetpotato variety choice. In terms of gender heterogeneity, flesh color is highly valued among the women sub-sample. The study identifies Vitamin A, dry matter content, sweet taste, and medium to big root size, as the key preferred quality traits in Mozambique, in that order. The results imply that these quality traits should be pursued as a suite in breeding objectives, in combination with essential agronomic traits such as high yields and drought tolerance, for higher acceptance and demand of improved sweetpotato varieties across the country

Clinical trial of two regimens of Albendazole and Ivermectin to treat Tanzanian Bancroftian Filariasis and Onchocerciasis

(Tanzania Health Research Bulletin, 2001, Supplement 2(2): 30-32

Assessment of the efficacy of Ivermectin in the treatment of human intestinal Helminths and urinary Trematode infections in North-East Tanzania

(Tanzania Health Research Bulletin, 2001, Supplement 2(2): 28-30

Genotype × environment interaction and selection for drought adaptation in sweetpotato (Ipomoea batatas [L.] Lam.) in Mozambique

Sweetpotato is grown throughout the year in Mozambique but drought affects storage root yield and biomass productivity. The objectives of this research were to estimate the impact of genotype × environment interactions (G × E) in sweetpotato and select genotypes based on drought indices such as geometric mean, percent yield reduction, drought sensitivity index and harvest index. A total of 58 clones were evaluated during the dry season of 2006, 2008 and 2009. Two treatments were applied for this multi-year trial: full irrigation and without irrigation at the middle of root initiation growth stage. The field layout was a randomized complete block design with three replications. ‘Jonathan’, ‘Resisto’ and ‘Tanzania’ were the check cultivars in each treatment. Storage root and vine yields were recorded at harvest in the trials. Harvest index was computed from the yield data. The analysis of variance, regression and the additive main effects multiplicative interaction (AMMI) analyses, plus phenotypic coefficient of variation and ecovalence were used for dissecting the G × E and assessing the stability of each clone. Treatment, genotype × reatment and genotype year (G × Y) interactions had highest contributions to the variation in storage root yield observed among clones. The stability of harvest index was significantly correlated with the absolute AMMI’s IPCA1 and IPCA2 values for storage root yield. Cultivar performance varied within treatments. Four clones had significantly higher storage root yield (t ha-1 ) than ‘Tanzania’, the best check cultivar under drought. In conclusion, storage root yield (t ha-1 ) was negatively affected by drought and G × Y interaction. Harvest index stability and the geometric mean may be key to identify clones with storage root yield stability and high storage root yield under both treatments. At least two environments should be used at early breeding stages to consider harvest index in the early breeding cycle

Current epidemiological assessment of Bancroftian Filariasis in Tanga region, Northeastern Tanzania

Journal of Tropical Medicine, Volume 2016, Article ID 7408187, 5 pagesTanzania started a countrywide lymphatic filariasis elimination programme in 2000 adopting the mass drug administration (MDA) strategy.The drug used for the programme was the combination of ivermectin and albendazole. However, there is limited information on the current epidemiological trend of the infections, where MDA implementation is ongoing. The present study aimed at assessing the current status of Bancroftian filariasis infection rate and morbidity where MDA has been distributed and administered for over eight rounds. Methodology. The study was a cross-sectional descriptive study involving 272 individuals (>18 years) from endemic communities in Tanga region where MDA has been implemented. Clinical, sociodemographic, and circulating filarial antigen (CFA) test was undertaken usingimmune chromatographic card test according to themanufacturer’s instructions. Results. A total of 472 individuals were screened: 307/472 (65.1%) were males while 165/472 (34.9%) were females. The overall prevalence of CFA was 5.51%, that of hydrocoele was 73.2%, and that of lymphoedema was 16.0%. The prevalence of hydrocoele combined with lymphoedema was 5.5%. Conclusion. Our findings demonstrate a considerable reduction in filarial infection. However, there is clear evidence of ongoing transmission despite the 8 rounds of MDA. It is unlikely that the annual MDA would interrupt filarial transmission; therefore, additional strategies are needed to accelerate lymphatic filariasis control and elimination

Current epidemiological assessment of Bancroftian Filariasis in Tanga region, Northeastern Tanzania

Journal of Tropical Medicine, Volume 2016, Article ID 7408187, 5 pagesTanzania started a countrywide lymphatic filariasis elimination programme in 2000 adopting the mass drug administration (MDA) strategy.The drug used for the programme was the combination of ivermectin and albendazole. However, there is limited information on the current epidemiological trend of the infections, where MDA implementation is ongoing. The present study aimed at assessing the current status of Bancroftian filariasis infection rate and morbidity where MDA has been distributed and administered for over eight rounds. Methodology. The study was a cross-sectional descriptive study involving 272 individuals (>18 years) from endemic communities in Tanga region where MDA has been implemented. Clinical, sociodemographic, and circulating filarial antigen (CFA) test was undertaken usingimmune chromatographic card test according to themanufacturer’s instructions. Results. A total of 472 individuals were screened: 307/472 (65.1%) were males while 165/472 (34.9%) were females. The overall prevalence of CFA was 5.51%, that of hydrocoele was 73.2%, and that of lymphoedema was 16.0%. The prevalence of hydrocoele combined with lymphoedema was 5.5%. Conclusion. Our findings demonstrate a considerable reduction in filarial infection. However, there is clear evidence of ongoing transmission despite the 8 rounds of MDA. It is unlikely that the annual MDA would interrupt filarial transmission; therefore, additional strategies are needed to accelerate lymphatic filariasis control and elimination