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Oral drug therapy for multiple neglected tropical diseases: a systematic review.
[dracunculiasis]
The
neglected
tropical
diseases
include
13
conditions
that
occur
in
areas
of
extreme
poverty
and
are
poverty
promoting
.
The
neglected
tropical
diseases
produce
a
disease
burden
almost
as
great
as
that
associated
with
human
immunodeficiency
virus
/
AIDS
,
tuberculosis
,
or
malaria
,
yet
are
virtually
unknown
by
health
care
workers
in
North
America
,
because
they
occur
almost
exclusively
in
the
poorest
regions
of
the
world
.
Seven
of
the
most
prevalent
diseases
have
existing
oral
drug
treatments
.
Identifying
treatments
that
are
effective
against
more
than
1
disease
could
facilitate
efficient
and
inexpensive
treatment
.
To
systematically
review
the
evidence
for
drug
treatments
and
to
increase
awareness
that
neglected
tropical
diseases
exist
and
that
treatments
are
available
.
Using
a
MEDLINE
search
(
1966
through
June
2007
)
,
randomized
controlled
trials
(
RCTs
)
were
reviewed
that
examined
simultaneous
treatment
of
2
or
more
of
the
7
most
prevalent
neglected
tropical
diseases
using
oral
drug
therapy
.
Twenty
-
nine
RCTs
were
identified
,
of
which
3
targeted
4
diseases
simultaneously
,
20
targeted
3
diseases
,
and
6
targeted
2
diseases
.
Trials
were
published
between
1972
and
2005
and
baseline
prevalence
of
individual
diseases
varied
among
RCTs
.
Albendazole
plus
diethylcarbamazine
significantly
reduced
prevalence
of
elephantiasis
(
16
.
7
%
to
5
.
3
%
)
,
hookworm
(
10
.
3
%
to
1
.
9
%
)
,
roundworm
(
34
.
5
%
to
2
.
3
%
)
,
and
whipworm
(
55
.
5
%
to
40
.
3
%
)
.
Albendazole
plus
ivermectin
significantly
reduced
prevalence
of
elephantiasis
(
12
.
6
%
to
4
.
6
%
)
,
hookworm
(
7
.
8
%
to
0
%
)
,
roundworm
(
33
.
5
%
to
6
.
1
%
)
,
and
whipworm
(
42
.
7
%
to
8
.
9
%
)
.
Levamisole
plus
mebendazole
significantly
reduced
prevalence
of
hookworm
(
94
.
0
%
to
71
.
8
%
)
,
roundworm
(
62
.
0
%
to
1
.
4
%
)
,
and
whipworm
(
93
.
1
%
to
74
.
5
%
)
.
Pyrantel-oxantel
significantly
reduced
hookworm
(
93
.
4
%
to
85
.
2
%
)
,
roundworm
(
22
.
8
%
to
1
.
4
%
)
,
and
whipworm
(
86
.
8
%
to
59
.
5
%
)
,
while
albendazole
alone
significantly
reduced
prevalence
of
hookworm
(
8
.
1
%
to
1
.
3
%
)
,
roundworm
(
28
.
4
%
to
0
.
9
%
)
,
and
whipworm
(
51
.
9
%
to
31
.
9
%
)
.
No
RCT
examined
treatment
of
river
blindness
or
trachoma
as
part
of
an
intervention
to
target
2
or
more
neglected
tropical
diseases
.
Adverse
events
were
generally
inadequately
reported
.
At
least
2
of
the
most
prevalent
neglected
tropical
diseases
can
be
treated
simultaneously
with
existing
oral
drug
treatments
,
facilitating
effective
and
efficient
treatment
.
Increasing
awareness
about
neglected
tropical
diseases
,
their
global
impact
,
and
the
availability
of
oral
drug
treatments
is
an
essential
step
in
controlling
these
diseases
.
Diseases
Validation
Diseases presenting
"significantly reduced hookworm"
symptom
dracunculiasis
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