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Bruyère researcher Dr. Alison Krentel is working with international partners, including the World Health Organization (WHO), to stop the spread of lymphatic filariasis, a debilitating and neglected tropical disease. The global community has set a target of 2020 to eliminate lymphatic filariasis as a public health problem through the mass distribution of the drug regimen to eligible individuals living in communities where the disease is present.
Within the last 12 months, researchers from the DOLF (Death to Onchocerciasis and Lymphatic Filariasis) Project situated at Washington University in St. Louis conducted a community-based drug safety trial using a combination of ivermectin, diethylcarbamazine citrate and albendazole in five countries. This combination is more effective than a previous treatment plan, which consisted of only two of the three drugs. This research was funded by the Bill and Melinda Gates Foundation.
Dr.Krentel’s work is to find out whether community members accept the three-drug regimen in the community-based safety trial. In the past, community members have been reluctant to take the treatment, often due to fear of side effects related to the drugs, or an overall lack of understanding of the benefits of the drugs. The challenge is to find out whether communities have the same reservations about the new three-drug treatment regimen, as this could have a bearing on how government health programs distribute the medications in target countries.
Dr. Krentel conducted her study in Fiji, Haiti, India, Indonesia and Papua New Guinea in collaboration with local and national partners. One of these partners is the uOttawa WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in health equity, which is hosted at the Bruyère Research Institute.
Using a mixed method approach, Dr. Krentel and her team have yielded some interesting results. For one, side effects related to the drugs were not as important as thought in determining people’s acceptance of the three-drug regimen. Acceptability was assessed as high across all countries, although with some marked differences between them. Overall, Dr. Krentel’s findings suggest that communities will accept the new drug regimen should governments choose to implement it in their respective countries.
On November 6, 2017, the World Health Organization approved new treatment guidelines for lymphatic filariasis that include the use of the triple drug regimen. Dr. Krentel’s research contributed to the findings considered by the WHO guidelines review committee in making their decision. These new guidelines have led to a commitment on November 30, 2017 from Merck & Co.—a pharmaceutical company—to expand their donation of ivermectin, a key drug in WHO’s new treatment regimen for lymphatic filariasis. The company’s expanded donation program should help treatment reach an additional 100 million people per year through the year 2025.
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