The Phase 1 semiannual single-dose 6 mg/kg diethylcarbamazine (DEC) treatment program demonstrated a significant reduction for Wuchereria bancrofti in the Ok Tedi area of Western Province, Papua New Guinea. The rate of detectable microfilaraemia was effectively reduced from 39% to 11% and mean microfilarial (mf) densities from 79mf/20 microliters to 19mf/20 microliters. The Phase 2 annual single-dose treatment of 6mg/kg DEC not only maintained the gains made during Phase 1 but reduced the microfilaraemia rate to less than 5% by 1990, with mf densities remaining stable at less than 20mf/20 microliters, amongst all participating villagers screened within the 5 original villages. The annual treatment program was expanded into 7 remote villages not subject to any form of active vector control. The microfilaraemia rate in these villages declined from 41% before treatment to 17% after only two annual administrations of 6mg/kg DEC, and mf blood densities were reduced from 71mf/20 microliters to 20mf/20 microliters. As was observed in the 5 original villages participating in the program, a significant reduction in splenomegaly associated with the DEC treatment was reported for the 7 villages in the expanded program during Phase 2; enlarged spleen rates were reduced from 50% (1986) to 32% (1990) and from 76% (1988) to 48% (1990), respectively. Malaria rates on the other hand increased slightly or remained stable. Malaria infections associated with W. bancrofti (mixed parasite infections) stimulated a greater splenic response than either parasite detected on its own.
Adolescent ; Child, Preschool ; Diethylcarbamazine - administration & ; dosage ; Drug Administration Schedule

OBJECTIVE: Elimination eforts for lymphatic flariasis are underway in the Philippines using mass drug administration (MDA) of diethylcarbamazine and albendazole as one of the main strategies. This cost analysis was done to determine the MDA implementation cost and provide useful information to the control programme on how to best utilize limited resources.

METHODS: This cost analysis study was conducted in the province of Sorsogon, Philippines in 2004. The study was done from a program perspective. Cost data for 2003 was obtained retrospectively via key informant interviews and records review using a standardized guide from a multi-country cost analysis study of flariasis elimination programs. Cost fgures were classifed as either economic or fnancial costs and expressed in real terms using 2002 as base year. Sensitivity analysis was likewise performed.

RESULTS: The total economic cost and cost per person treated with MDA were estimated at US$223,549.55 (Php12,116,385.48) and US$0.40, respectively. The fnancial costs were less than half of the economic costs. The main cost driver was drug distribution. The highest economic and fnancial costs were incurred at the national (54.5%) and municipal (74.4%) levels, respectively. High variation in costs of MDA activities was observed.

CONCLUSION: This cost analysis provides reasonable estimates which may be used to assist government and other stakeholders in program planning and resource generation for flariasis elimination programs in endemic areas.

Diethylcarbamazine ; Albendazole ; Philippines ; Mass Drug Administration ; Costs And Cost Analysis ; Health Resources ; Lymphatic Vessel ; Elephantiasis, Filarial