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February 13, 2008

Treatment for Lymphatic Filariasis and Elephantiasis

JAMA. 2008;299(6):632-633. doi:10.1001/jama.299.6.632

To the Editor: Dr Reddy and colleagues1 reviewed the randomized controlled trials (RCTs) of treatment of multiple neglected tropical diseases. Clarification of several important points in their review is needed.

The article comments that combined drug therapy (diethylcarbamazine and albendazole or ivermectin and albendazole) significantly reduced the prevalence of “elephantiasis” and references our studies.2,3Elephantiasis is not the appropriate term to describe studies of lymphatic filariasis and can lead to confusion. Both studies showed a significant decrease in microfilaremia, the presence of parasites found in the blood of patients infected with filarial parasites. None of the children in our studies had elephantiasis or lymphedema, although many were infected with filarial parasites and exhibited microfilaria in blood smears and filarial antigenemia.