Management and Treatment
M. perstans is one of the most difficult human filarial infections to treat. Effective treatment for mansonelliasis is lacking, with no consensus among the scientific community on the optimal approach. Numerous trials evaluating traditional antifilarial drugs such as ivermectin and DEC, as well as other benzimidazoles such as mebendazole, albendazole, levamizole, and thiabendazole, have been conducted. Recently, clinical trials assessing the effectiveness of doxycycline to treat M. perstans infection have also been documented.
Generally, DEC is ineffective in the treatment of M. perstans infection. Other drugs such as ivermectin and praziquantel have been tried, but are neither reliable nor rapidly effective. Mebendazole and thiabendazole have a greater effect than previously described drugs, but are not sufficient for treatment alone. Combination treatments with DEC and mebendazole have had the most success. In the most recent clinical trials, doxycycline has had success comparable to, if not better than, that that of combination treatments. However, because it is a relatively recent discovery, the use of doxycycline is relatively limited to clinical trials. If the patient is asymptomatic, no treatment is necessary. An analysis of the results of various clinical trials for each drug is illustrated below:
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