The Efficacy of Doxycycline Treatment on Infection: An Open-Label, Randomized Trial in Ghana.

Treating is challenged by the low efficacy of registered antihelminthics. endobacteria provide an alternative treatment target because depletion results in amicrofilaremia in filarial infections with and infections. This open-label, randomized study sought to confirm that i) are present in in Ghana and ii) doxycycline treatment will deplete and cause a slow, sustained decline in microfilariae (MF). Two hundred and two Ghanaians with infection were randomized into early (immediate) and delayed (6 months deferred) treatment groups, given doxycycline 200 mg/day for 6 weeks, and monitored for MF and levels at baseline, 4, 12, and 24 months after the study onset (= time of randomization and start of treatment for the early group). Per protocol analysis revealed that the median MF/mL in the early group declined from 138 at baseline to 64 at month 4 and further to 0 at month 12. In the delayed group, MF load did not change from a baseline median of 97 to 102 at month 4 but declined to 42 at month 12, that is, 6 months after receiving treatment, trailing the early group as expected. By month 24, both treatment groups had reached a median MF level of 0. After treatment, were depleted from MF by ≥ 1-log drop compared with baseline levels. We conclude that in Ghana harbor that are effectively depleted by doxycycline with subsequent reduction in MF loads, most likely because of interruption of fertility of adult worms.

PMID: 31162017