The effects
of the drugs used to treat LF are particularly
important in contributing to the ehalth of mothers and their children.
© R. Vander Meulen |
Even as communities
in lymphatic filariasis endemic areas look forward to a future free
of LF, they are already reaping immediate and valuable benefits
from the effects of albendazole and ivermectin treatment on the
almost ubiquitous, chronic intestinal worm infections (especially
hookworm and roundworm) of children.
In endemic areas,
both preschool and school-age children have high helminth infection
rates; overall, one third are estimated to have roundworm and one
fourth, either whipworm or hookworm or both. In some areas more
than 90% of children are infected with these parasites! The health
of women and infants is particularly vulnerable due to parasitic |
| infections
as well. In India alone, 10.9 million pregnant women were infected
with hookworms in 1990.
These infections
also have serious clinical consequences for maternal, child and
infant health. Of particular concern is the role the infections
play in exacerbating all forms of malnutrition found in LF-endemic
areas, primarily iron deficiency, anaemia, protein-energy malnutrition,
vitamin A deficiency and low weight gain during and after pregnancy.
Without treatment, these intestinal worm infections lay the groundwork
for poor health, impaired physical and cognitive development and
can cause premature births, stunted growth in children and, all
too often, death. In developing countries, 32% of under-five-year
olds are already stunted due to malnutrition, and over 50% of children
5-14 years old are anaemic. Every year iron deficiency contributes
to 100,000 maternal deaths.
Albendazole
and Mectizan® are administered yearly as part of the initiative
to eliminate LF and these two drugs also have anti-parasitic properties
for treatment of hookworm, roundworm, whipworm, lice, scabies and
other parasities 1. Treatment with albendazole
and Mectizan® has a tremendous impact on the health and economic
conditions, especially of women and children, such as:
- Better health
and nutrition for mothers, during and after pregnancy
- Lower mortality
from severe anaemia, especially in childbirth
- Lower maternal
hospitalization rates for severe anaemia and haemorrhage
- Lower incidence
of low birth weight and neonatal death
- Less time
and money lost due to sickness in mothers and children
- Greater ability
of mothers to care for children and families
- Better work
and earning capacity for mothers
The immediate
clinical effect of albendazole and Mectizan® on intestinal parasite
infections offers longterm gains in health and development for treated
individuals, especially women and children. Furthermore, these benefits
come at no additional cost to the health system or the individual
since albendazole and Mectizan® are distributed as the mainstay
drugs of the LF elimination program. Annually over 100 million women
will be treated for worms through national LF programs. At no extra
cost, this additional benefit further extends the tremendous impact
of albendazole and Mectizan® on the health of millions in LF
and helminth endemic areas.
1 Mectizan®
(ivermectin) has formal regulatory approval for lymphatic filariasis
and onchocerciasis and is donated by Merck & Co., Inc. for those
indications.
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