Project Title

Alternative treatment strategies using anti-wolbachial drugs to accelerate elimination of onchocerciasis and lymphatic filariasis

Project Objectives

The objectives of the ASTAWOL project include: to assess the efficacy of Rifampicin and Albendazole to shorten the time of treatment for onchocerciasis and lymphatic filariasis patients, to analyse the safety of the combination of Rifampicin plus Albendazole in the treatment of onchocerciasis and lymphatic filariasis, to build world-class capacity for the conduct of clinical trials and consolidate earlier gains in research capacity and to disseminate the research findings to scientists, stakeholders such as the Ministry of Health, National NTD programmes, Ghana Health Service, as well as the study communities and the participating volunteers.

Results & Outcomes

Host Organisation

EDCTP Project Call

Senior Fellowship (SF)

Study Design

Prospective, randomized, controlled, monocentric, open-label, parallel-group, interventional phase II pilot trial

Project Summary

The World Health Organization (WHO) aims to eliminate two major neglected tropical diseases—onchocerciasis (river blindness) and lymphatic filariasis (elephantiasis) —along with other similar diseases by 2030. However, this ambitious goal may not be achievable with the current treatments, which rely on mass drug administration (MDA) of medicines like ivermectin (IVM), diethylcarbamazine (DEC), and albendazole. While these treatments have significantly reduced infections, they face challenges, particularly in Africa, where diseases are most common. Current drugs are not very effective at killing adult worms or stopping them from producing new microfilariae permanently. Additionally, after more than 20 years of MDA, some parasites are showing reduced sensitivity to ivermectin. Another major issue is that IVM and DEC cannot be safely used in areas where Loa loa (a different parasitic infection) is common, as they can cause serious side effects. To address these challenges, the ASTAWOL project is exploring a new treatment strategy. Instead of relying solely on current drugs, it focuses on using anti-Wolbachia drugs, which target the bacteria that are essential for survival and reproduction of these worms. These include repurposing existing approved drugs like Rifampicin and Albendazole to treat people living in communities affected by these diseases. Summary of key study design and findings Study Design A phase II randomized clinical trial was conducted to evaluate the efficacy of rifampicin-albendazole (RIF+ALB) combination therapy compared to albendazole (ALB) monotherapy and a no treatment group (other than ivermectin) in – (i) reduction in circulating filarial antigen (CFA) levels and microfilarial (Mf) density among individuals with lymphatic filariasis (LF); (ii) depletion of Wolbachia and interruption of embryogenesis in female adult worms among individuals with onchocerciasis. LF trial participants were followed up at 4, 6, 12, and 18 months, while onchocerciasis trial participants were followed up at 4, 6, 18, and 20 months post-treatment to evaluate treatment efficacy.

Current Organisation

Kwame Nkrumah University of Science and Technology

Current Job Title

Lecturer/Research scientist

Biography