{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:01:38Z","timestamp":1787029298689,"version":"build-2736575974"},"reference-count":43,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership 2","doi-asserted-by":"crossref","award":["TMA2018SF-2451-ASTAWOL"],"award-info":[{"award-number":["TMA2018SF-2451-ASTAWOL"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]},{"name":"German Federal Ministry of Education and Research (Bundesministerium fur Bildung und Forschung -BMBF) under agreement with Gesellschaft f\u00fcr Internationale Zusammenarbeit","award":["81204851"],"award-info":[{"award-number":["81204851"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: The lack of a short-course of safe and effective macrofilaricidal therapy for lymphatic filariasis (LF) hinders elimination efforts, especially in the endgame scenario. Preclinical studies in mice demonstrated that high-dose rifampicin (RIF) plus albendazole (ALB) produced macrofilaricidal effects within seven days, prompting this randomised, open-label, parallel-group, interventional phase II pilot trial to determine the efficacy of high-dose RIF plus ALB against LF in humans. Methods: In three LF-endemic districts of Ghana\u2019s Upper East Region, circulating filarial antigen (CFA)-positive individuals aged 18 to 55 years identified using the Alere Filariasis Test Strip were enrolled into the study. The participants were randomised through a centralized computer-generated randomisation into four treatment arms. They were treated according to the arm they were assigned to and followed up at 4-, 6-, 12-, and 18-months post-treatment to monitor changes in CFA status and levels, as well as adverse events. Outcome assessors were blinded to minimize assessment bias. Results: A total of 69 eligible participants were randomised into four treatment arms: RIF (35 mg\/kg\/day) + ALB (400 mg\/day) for 7 days (n = 17), RIF (35 mg\/kg\/day) + ALB (400 mg\/day) for 14 days (n = 18), ALB alone for 14 days (n = 17), and an untreated controlled group participating in standard mass drug administration (n = 17). All regimens were well tolerated, with no serious adverse events. Even though CFA positivity declined across all groups, with maximal reductions at 18 months, the RIF + ALB 7-day regimen consistently showed the highest decline, while ALB alone was the least effective. RIF + ALB groups exhibited early antigen decline by 4 months, unlike comparator groups, where reductions occurred from 12 months. Conclusions: These findings suggest macrofilaricidal activity of high-dose RIF plus ALB, supporting further trials in larger, microfilaraemic populations. The trial was registered in the Pan African Clinical Trials Registry on 9 September 2020 under the code PACTR202009704006025.Funding was by the European and Developing Countries Clinical Trials Partnership 2 (EDCTP2), with grant code TMA2018SF-2451-ASTAWOL, and by the German Federal Ministry of Education and Research (Bundesministerium fur Bildung und Forschung-BMBF) under agreement with Gesellschaft f\u00fcr Internationale Zusammenarbeit (GIZ) through agreement number: 81204851.<\/jats:p>","DOI":"10.3390\/pathogens15020174","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:35:37Z","timestamp":1770287737000},"page":"174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High-Dose Rifampicin Plus Albendazole Rapidly Clears Lymphatic Filariasis Circulating Filarial Antigen in a Randomised Clinical Trial: A Promising Step Toward Short-Course Macrofilaricidal Therapy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-8616","authenticated-orcid":false,"given":"Emmanuel Donawobuge","family":"Kutu","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"},{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8972-1757","authenticated-orcid":false,"given":"Derrick Adu","family":"Mensah","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"},{"name":"Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"},{"name":"Department of Public Health, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi P.O. Box 1277, Ghana"},{"name":"Department of Medical Laboratory Technology, Royal Ann College of Health, Kumasi P.O. Box KS 6253, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7950-6650","authenticated-orcid":false,"given":"Vera Serwaa","family":"Opoku","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1309-2840","authenticated-orcid":false,"given":"John","family":"Boateng","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"},{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"},{"name":"German-West African Centre for Global Health and Pandemic Prevention (G-WAC), Partner Site Kumasi, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6341-3131","authenticated-orcid":false,"given":"John","family":"Opoku","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3470-2994","authenticated-orcid":false,"given":"Jubin","family":"Osei-Mensah","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"},{"name":"Department of Pathobiology, School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7549-7117","authenticated-orcid":false,"given":"Charles","family":"Gyasi","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prince","family":"Obeng","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, 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University of Health and Allied Sciences, Private Mail Bag 31, Ho, Volta Region, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prince Dennis","family":"Atisu","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"},{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0265-1822","authenticated-orcid":false,"given":"Michael Agyemang","family":"Obeng","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, 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