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Tamarozzi F, Rodari P, Salas-Coronas J, Bottieau E, Salvador F, Soriano-Pérez MJ, Cabeza-Barrera MI, Van Esbroeck M, Treviño B, Buonfrate D, Gobbi FG. A large case series of travel-related Mansonella perstans (vector-borne filarial nematode): a TropNet study in Europe. J Travel Med 2022; 29:6567953. [PMID: 35417002 PMCID: PMC9635058 DOI: 10.1093/jtm/taac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/25/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Infection with Mansonella perstans is a neglected filariasis, widely distributed in sub-Saharan Africa, characterized by an elusive clinical picture; treatment for mansonellosis is not standardized. This retrospective study aimed to describe the clinical features, treatment schemes and evolution, of a large cohort of imported cases of M. perstans infection seen in four European centres for tropical diseases. METHODS Mansonella perstans infections, diagnosed by identification of blood microfilariae in migrants, expatriates and travellers, collected between 1994 and 2018, were retrospectively analysed. Data concerning demographics, clinical history and laboratory examinations at diagnosis and at follow-up time points were retrieved. RESULTS A total of 392 patients were included in the study. Of the 281 patients for whom information on symptoms could be retrieved, 150 (53.4%) reported symptoms, abdominal pain and itching being the most frequent. Positive serology and eosinophilia were present in 84.4% and 66.1%, respectively, of those patients for whom these data were available. Concomitant parasitic infections were reported in 23.5% of patients. Treatment, administered to 325 patients (82.9%), was extremely heterogeneous between and within centres; the most commonly used regimen was mebendazole 100 mg twice a day for 1 month. A total of 256 (65.3%) patients attended a first follow-up, median 3 months (interquartile range 2-12) after the first visit; 83.1% of patients having received treatment based on mebendazole and/or doxycycline, targeting Wolbachia, became amicrofilaremic, 41.1-78.4% of whom within 12 months from single treatment. CONCLUSIONS Lack of specific symptoms, together with the inconstant positivity of parasitological and antibody-based assays in the infected population, makes the clinical suspicion and screening for mansonellosis particularly difficult. Prospective studies evaluating prevalence of infection in migrants from endemic areas, infection-specific morbidity, presence of Wolbachia endosymbionts in M. perstans populations from different geographical areas and efficacy of treatment regimens are absolutely needed to optimize the clinical management of infection.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Paola Rodari
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | | | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Fernando Salvador
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | | | | | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Begoña Treviño
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Federico G Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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Chai JY, Jung BK, Hong SJ. Albendazole and Mebendazole as Anti-Parasitic and Anti-Cancer Agents: an Update. THE KOREAN JOURNAL OF PARASITOLOGY 2021; 59:189-225. [PMID: 34218593 PMCID: PMC8255490 DOI: 10.3347/kjp.2021.59.3.189] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022]
Abstract
The use of albendazole and mebendazole, i.e., benzimidazole broad-spectrum anthelmintics, in treatment of parasitic infections, as well as cancers, is briefly reviewed. These drugs are known to block the microtubule systems of parasites and mammalian cells leading to inhibition of glucose uptake and transport and finally cell death. Eventually they exhibit ovicidal, larvicidal, and vermicidal effects on parasites, and tumoricidal effects on hosts. Albendazole and mebendazole are most frequently prescribed for treatment of intestinal nematode infections (ascariasis, hookworm infections, trichuriasis, strongyloidiasis, and enterobiasis) and can also be used for intestinal tapeworm infections (taeniases and hymenolepiasis). However, these drugs also exhibit considerable therapeutic effects against tissue nematode/cestode infections (visceral, ocular, neural, and cutaneous larva migrans, anisakiasis, trichinosis, hepatic and intestinal capillariasis, angiostrongyliasis, gnathostomiasis, gongylonemiasis, thelaziasis, dracunculiasis, cerebral and subcutaneous cysticercosis, and echinococcosis). Albendazole is also used for treatment of filarial infections (lymphatic filariasis, onchocerciasis, loiasis, mansonellosis, and dirofilariasis) alone or in combination with other drugs, such as ivermectin or diethylcarbamazine. Albendazole was tried even for treatment of trematode (fascioliasis, clonorchiasis, opisthorchiasis, and intestinal fluke infections) and protozoan infections (giardiasis, vaginal trichomoniasis, cryptosporidiosis, and microsporidiosis). These drugs are generally safe with few side effects; however, when they are used for prolonged time (>14-28 days) or even only 1 time, liver toxicity and other side reactions may occur. In hookworms, Trichuris trichiura, possibly Ascaris lumbricoides, Wuchereria bancrofti, and Giardia sp., there are emerging issues of drug resistance. It is of particular note that albendazole and mebendazole have been repositioned as promising anti-cancer drugs. These drugs have been shown to be active in vitro and in vivo (animals) against liver, lung, ovary, prostate, colorectal, breast, head and neck cancers, and melanoma. Two clinical reports for albendazole and 2 case reports for mebendazole have revealed promising effects of these drugs in human patients having variable types of cancers. However, because of the toxicity of albendazole, for example, neutropenia due to myelosuppression, if high doses are used for a prolonged time, mebendazole is currently more popularly used than albendazole in anti-cancer clinical trials.
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Affiliation(s)
- Jong-Yil Chai
- Institute of Parasitic Diseases, Korea Association of Health Promotion, Seoul 07649,
Korea
- Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, Seoul 03080,
Korea
| | - Bong-Kwang Jung
- Institute of Parasitic Diseases, Korea Association of Health Promotion, Seoul 07649,
Korea
| | - Sung-Jong Hong
- Department of Environmental Medical Biology, Chung-Ang University College of Medicine, Seoul 06974,
Korea
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Asgeirsson H, Harling A, Botero-Kleiven S. Successful treatment of 2 imported cases of Mansonella perstans infection. PLoS Negl Trop Dis 2017; 11:e0005452. [PMID: 28542192 PMCID: PMC5444592 DOI: 10.1371/journal.pntd.0005452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hilmir Asgeirsson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Andreas Harling
- Department of Infectious Diseases, Karlstad Central Hospital, Karlstad, Sweden
| | - Silvia Botero-Kleiven
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
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4
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Kabego L, Kasengi JB, Mirindi P, Ruhanya V, Lupande D, Bulabula A, Ngoma P. Pulmonary localization of Mansonella perstans in a 16 months-old male patient in a tertiary care hospital in Bukavu, Democratic Republic of Congo. Germs 2016; 6:151-154. [PMID: 28053918 DOI: 10.11599/germs.2016.1101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/15/2016] [Accepted: 09/02/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Mansonella perstans is a human filarial parasite transmitted by biting midges (Diptera: Ceratopogonidae) belonging to the genus Culicoides and it is widely spread in sub-Saharan Africa. While most cases are asymptomatic, mansonelliasis can be associated with angioedema, arthralgia, swellings, pain in the scrotum or in serous cavities such as the pleura, the peritoneum, the pericardium, etc. Mansonelliasis can be really hard to treat, but it has been shown that an intensive treatment using albendazole can clear the parasite. CASE REPORT Here we describe a case of a 16 months-old malnourished child with pneumonia due to M. perstans in the east of the Democratic Republic of Congo. CONCLUSION Although our investigations confirmed M. perstans infection, this case shows that it is very difficult to come to a conclusive diagnosis.
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Affiliation(s)
- Landry Kabego
- MD, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo, Department of Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Joe Bwija Kasengi
- MD, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Patrick Mirindi
- MD, MPH, Université Catholique de Bukavu, Bukvau, Democratic Republic of Congo
| | - Vurayai Ruhanya
- MSc, Department of Medical Microbiology, University of Zimbabwe, Avondale, Harare, Zimbabwe
| | - David Lupande
- MD, Université Catholique de Bukavu, Bukvau, Democratic Republic of Congo, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - André Bulabula
- MD, Université Catholique de Bukavu, Bukvau, Democratic Republic of Congo, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Patrick Ngoma
- MD, Université Catholique de Bukavu, Bukvau, Democratic Republic of Congo, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
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Simonsen PE, Onapa AW, Asio SM. Mansonella perstans filariasis in Africa. Acta Trop 2011; 120 Suppl 1:S109-20. [PMID: 20152790 DOI: 10.1016/j.actatropica.2010.01.014] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 01/27/2010] [Accepted: 01/29/2010] [Indexed: 11/19/2022]
Abstract
Mansonella perstans is a vector-borne human filarial nematode, transmitted by tiny blood-sucking flies (biting midges). It is widespread in many parts of Sub-Saharan Africa and also occurs in parts of Central and South America. Despite the commonness of this parasite very few studies have been carried out on its epidemiology and on the morbidity resulting from it, and only few thorough drug trials have been conducted to look for effective and suitable drugs and drug regimens for treatment and control. Here, we review currently available knowledge on M. perstans infections in Africa, including documented aspects of biology, vectors, transmission, diagnosis, epidemiology, morbidity and treatment. It is concluded that there is an urgent need for more research on this widespread but greatly neglected infection in order to properly assess its public health significance and as a background for identifying and recommending optimal means and strategies for treatment and control.
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Affiliation(s)
- Paul E Simonsen
- DBL-Centre for Health Research and Development, Faculty of Life Sciences, University of Copenhagen, Thorvaldsensvej 57, 1871 Frederiksberg C, Denmark.
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Horton J. The development of albendazole for lymphatic filariasis. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2010; 103 Suppl 1:S33-40. [PMID: 19843396 DOI: 10.1179/000349809x12502035776595] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The history of the development of ivermectin and diethylcarbamazine for the treatment of human filarial infections is relatively well known and documented. The story of how albendazole became involved in the global elimination programmes is, however, less well known. This review examines the thinking and the processes behind the development of albendazole, from the first ideas in the mid 1980s to the establishment of the Global Programme to Eliminate Lymphatic Filariasis. Throughout, the approaches were essentially different from those of traditional drug development and, in the end, there was a recommendation for a particular public-health use that was not formally approved by the regulatory authorities. While there is no doubt about the efficacy of albendazole for the treatment of many helminth diseases, as a single agent it could never be recommended for filariasis.
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Affiliation(s)
- J Horton
- Tropical Projects, 24 The Paddock, Hitchin SG4 9EF, UK.
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Asio SM, Simonsen PE, Onapa AW. Mansonella perstans: safety and efficacy of ivermectin alone, albendazole alone and the two drugs in combination. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2009; 103:31-7. [PMID: 19173774 DOI: 10.1179/136485909x384929] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The safety and efficacy of a single dose of ivermectin alone (150-200 microg/kg bodyweight), albendazole alone (400 mg) or the combination of these two drugs was assessed, in Uganda, in three groups of individuals infected with Mansonella perstans (with 15, 13 and 15 subjects in each group, respectively). No side-effects were observed or reported during the first 7 days post-treatment and every subject remained microfilaraemic during the 12 months of follow-up. In the subjects given ivermectin alone or albendazole alone, the microfilarial intensities consistently remained close to their pre-treatment levels. In the subjects given both drugs, however, the microfilarial intensities decreased slightly after treatment and at 1 and 3 months post-treatment (but not at 6, 9 or 12 months) they were significantly lower than in the two other groups combined. The three single-dose drug regimens investigated were thus well tolerated but had disappointingly low efficacies in the treatment of M. perstans microfilaraemias.
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Affiliation(s)
- S M Asio
- Kyambogo University, Kyambogo, Kampala, Uganda
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A randomised, double-blind field trial of ivermectin alone and in combination with albendazole for the treatment of Mansonella perstans infections in Uganda. Trans R Soc Trop Med Hyg 2009; 103:274-9. [DOI: 10.1016/j.trstmh.2008.10.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 10/29/2008] [Accepted: 10/29/2008] [Indexed: 11/23/2022] Open
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9
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[Treatment of opportunistic infections in adolescent and adult patients infected with the human immunodeficiency virus during the era of highly active antiretroviral therapy. AIDS Study Group (GESIDA) and National AIDS Plan Expert Committee]. Enferm Infecc Microbiol Clin 2008; 26:356-79. [PMID: 18588819 DOI: 10.1157/13123842] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite the huge advance that highly active antiretroviral therapy has represented for the prognosis of infection by human immunodeficiency virus (HIV), opportunistic infections continue to be a cause of morbidity and mortality in HIV-infected patients. This is often the case because of severe immunodepression, poor adherence to antiretroviral therapy, failure of therapy, or the fact that patients are unaware of their HIV-positive status and debut with an opportunistic infection. This article updates the guidelines on treatment of acute episodes of various opportunistic infections in HIV-infected patients, including infections due to parasites, fungi, viruses, mycobacteria, and bacteria. This edition has a new chapter on imported parasite infections as well as additional information on endemic mycoses in the chapter on fungal infections, taking into account the growing number of immigrants in our setting. Lastly, the chapter on the immune reconstitution syndrome has also been updated, providing relevant data on a phenomenon that has clinical and diagnostic repercussions in patients who start antiretroviral therapy while they are severely immunodepressed (English version available at http://www.gesida.seimc.org).
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Bregani ER, Rovellini A, Mbaïdoum N, Magnini MG. Comparison of different anthelminthic drug regimens against Mansonella perstans filariasis. Trans R Soc Trop Med Hyg 2005; 100:458-63. [PMID: 16257021 DOI: 10.1016/j.trstmh.2005.07.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2005] [Revised: 07/13/2005] [Accepted: 07/13/2005] [Indexed: 11/15/2022] Open
Abstract
Mansonella perstans filariasis is widely present in Africa and equatorial America and its pathogenicity has recently been reconsidered. Effective treatment is lacking and there is no consensus on the optimal therapeutic approach. The aim of this study was to compare the effects of different drug regimens on M. perstans infection. Six different anthelminthic therapeutic protocols were undertaken on 165 subjects with M. perstans infection and their effects on microfilariae burden were evaluated. Diethylcarbamazine (DEC) was able to reduce microfilariae density in the majority of cases, but it seldom eliminated infection after a single treatment. Mebendazole appeared to be more active than DEC in eliminating the infection, with a comparable rate of overall responses. Ivermectin and praziquantel showed no modification of microfilariae concentration. Thiabendazole showed a small but significant activity against the infection. Combination treatments (DEC plus mebendazole) resulted in a significantly higher activity than the single drugs.
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Affiliation(s)
- Enrico Rino Bregani
- Department of Internal Medicine, Division of Emergency Medicine, Ospedale Maggiore IRCCS, via Francesco Sforza 35, 20122 Milan, Italy.
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Chen X, Zhao L, Xu H, Zhong D. Simultaneous determination of albendazole and its major active metabolite in human plasma using a sensitive and specific liquid chromatographic–tandem mass spectrometric method. J Pharm Biomed Anal 2004; 35:829-36. [PMID: 15193727 DOI: 10.1016/j.jpba.2004.02.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2003] [Revised: 12/11/2003] [Accepted: 02/13/2004] [Indexed: 11/25/2022]
Abstract
A method for the simultaneous determination of albendazole (ABZ) and its major active metabolite albendazole sulfoxide (ABZ-SO) was developed and validated. The analytes were extracted from plasma samples by liquid-liquid extraction and analyzed using liquid chromatography-tandem mass spectrometry with an electrospray ionization interface. Estazolam was used as the internal standard. The assay was linear in the concentration range 0.4-200 ng/ml for ABZ and 4.0-2000 ng/ml for ABZ-SO. The intra- and inter-run precision (R.S.D.), calculated from quality control (QC) samples was less than 7.1 and 9.4% for ABZ and ABZ-SO, respectively. The accuracy as determined from QC samples was within +/- 3% for the analytes. Recoveries of ABZ and ABZ-SO were greater than 77 and 53%, respectively, over the calibration curve range. The method developed was successfully applied to pharmacokinetic studies of ABZ and ABZ-SO after an oral dose of 400 mg albendazole to healthy volunteers.
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Affiliation(s)
- Xiaoyan Chen
- Laboratory of Drug Metabolism and Pharmacokinetics, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, PR China
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12
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Gardon J, Kamgno J, Gardon-Wendel N, Duke BOL, Boussinesq M. Efficacy of repeated doses of ivermectin against Mansonella perstans. Trans R Soc Trop Med Hyg 2002; 96:325-6. [PMID: 12174789 DOI: 10.1016/s0035-9203(02)90112-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Treatment of Mansonella perstans infection, although seldom necessary, is difficult. In a 3 year's trial of normal and high-dose annual and 3-monthly ivermectin treatment against Onchocerca volvulus, the effects on M. perstans were recorded and related to the cumulative dose received. The World Health Organization's African Programme for Onchocerciasis Control may thus reduce the endemicity of M. perstans.
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Affiliation(s)
- J Gardon
- Institut Pasteur de la Guyane, B.P. 6010, 97306 Cayenne, French, Guiana
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13
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Duong TH, Kombila M, Ferrer A, Nguiri C, Richard-Lenoble D. Decrease in Mansonella perstans microfilaraemia after albendazole treatment. Trans R Soc Trop Med Hyg 1998; 92:459. [PMID: 9850409 DOI: 10.1016/s0035-9203(98)91093-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- T H Duong
- Laboratoire de Parasitologie, Mycologie et Médecine Tropicale, Faculté de Médecine, Tours, France
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