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February 13, 2008

Treatment for Lymphatic Filariasis and Elephantiasis—Reply

JAMA. 2008;299(6):632-633. doi:10.1001/jama.299.6.633-a

In Reply: We thank Dr Fox and colleagues for bringing attention to several key issues related to our systematic review and for their clarification of points relating to the management of neglected tropical diseases.

We regret any confusion related to the terminology in our review. Although the terms elephantiasis and lymphatic filariasis are sometimes used interchangeably,1 this practice should be avoided. Filariasis refers to infection with nematode worms (such as Wuchereria bancrofti) transmitted by mosquitoes. Elephantiasis represents only 1 severe manifestation of lymphatic filariasis. We agree with the need for RCTs evaluating filariasis treatment to include prespecified standardized definitions of end points.