{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:10:53Z","timestamp":1788865853750,"version":"build-2803163510"},"reference-count":29,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4_Suppl","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Lymphedema (LE) is one the most disfiguring chronic manifestations of lymphatic filariasis. Its management relies primarily on limb hygiene and local care. A previous study in Ghana demonstrating a beneficial effect of doxycycline on LE led to the current multicenter trial on the efficacy of doxycycline in filarial LE. A randomized placebo-controlled trial was initiated in two rural health districts in Mali. Patients with LE stages 1\u20133 were randomized to receive either doxycycline (200 mg\/day) or placebo over a 6-week monitored treatment period and were then followed every 6 months for 2 years. Both groups received materials for limb hygiene that was carried out daily for the entire 2-year study. The primary endpoint was lack of progression in LE stage at 24 months. One hundred patients were enrolled in each study arm. The baseline sociodemographic characteristics of each group were largely similar. There was no significant difference at month 24 after treatment initiation in the number of subjects showing progression in LE stage between the two treatment arms (<jats:italic>P<\/jats:italic> = 0.5921). Importantly, however, the number of attacks of acute adenolymphangitis (ADLA) was reduced in both arms, but there was no significant difference between the two groups at any follow-up time point (all <jats:italic>P<\/jats:italic> &gt;0.23). Doxycycline was well tolerated in those receiving the drug. When added to daily self-administered limb hygiene, a 6-week course of doxycycline (200 mg) was not superior to placebo in increasing the improvement associated with hygiene alone in LE volume, stage, or frequency of ADLA attacks over a 24-month period.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0908","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T19:25:38Z","timestamp":1721849138000},"page":"22-32","source":"Crossref","is-referenced-by-count":5,"title":["Effect of Adding a Six-Week Course of Doxycycline to Intensive Hygiene-Based Care for Improving Lymphedema in a Rural Setting of Mali: A Double-Blind, Randomized Controlled 24-Month Trial"],"prefix":"10.4269","volume":"111","author":[{"given":"Yaya I.","family":"Coulibaly","sequence":"first","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"},{"name":"Dermatology Hospital of Bamako, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdoul F.","family":"Diabate","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moussa","family":"Sangare","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sekou O.","family":"Thera","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Housseini","family":"Dolo","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salif S.","family":"Doumbia","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siaka Y.","family":"Coulibaly","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayouba","family":"Diarra","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamine","family":"Diarra","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diadje","family":"Tanapo","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel E.","family":"Coulibaly","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamine","family":"Soumaoro","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdallah A.","family":"Diallo","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amatigue","family":"Zeguime","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yacouba","family":"Sanogo","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adama","family":"Berthe","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatoumata Dite Nene","family":"Konipo","sequence":"additional","affiliation":[{"name":"International Center for Excellence in Research, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia;"},{"name":"The Reaching the Last Mile Fund, The End Fund, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Stephens","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Shott","sequence":"additional","affiliation":[{"name":"Division of Neglected Tropical Diseases, Global Health Bureau, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayla","family":"Norman","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Klarmann-Schulz","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Immunology and Parasitology, German Centre for Infection Research (DZIF), Bonn-Cologne Site, University Hospital Bonn, Bonn, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Hoerauf","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Immunology and Parasitology, German Centre for Infection Research (DZIF), Bonn-Cologne Site, University Hospital Bonn, Bonn, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Majewski","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Horton","sequence":"additional","affiliation":[{"name":"Tropical Projects, Hitchin, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Ottesen","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas B.","family":"Nutman","sequence":"additional","affiliation":[{"name":"National Institute of Allergy and Infectious Diseases, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Microcirculation","first-page":"349","article-title":"Lymphatic filariasis: Perspectives on lymphatic remodeling and contractile dysfunction in filarial disease pathogenesis","volume":"20","author":"Chakraborty","year":"2013"},{"key":"b2","series-title":"BMC Med","first-page":"31","article-title":"The health stigma and discrimination framework: A global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas","volume":"17","author":"Stangl","year":"2019"},{"key":"b3","series-title":"BMC Public Health","first-page":"174","article-title":"Financial burden impact quality of life among lymphatic filariasis 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treatment of Wuchereria bancrofti: A double-blind, randomised placebo-controlled trial","volume":"365","author":"Taylor","year":"2005"},{"key":"b14","series-title":"Clin Infect Dis","first-page":"621","article-title":"Doxycycline improves filarial lymphedema independent of active filarial infection: A randomized controlled trial","volume":"55","author":"Mand","year":"2012"},{"key":"b15","series-title":"N Engl J Med","first-page":"1448","article-title":"A randomized trial of doxycycline for Mansonella perstans infection","volume":"361","author":"Coulibaly","year":"2009"},{"key":"b16","series-title":"PLoS Pathog","first-page":"e92","article-title":"Doxycycline reduces plasma VEGF-C\/sVEGFR-3 and improves pathology in lymphatic filariasis","volume":"2","author":"Debrah","year":"2006"},{"key":"b17","series-title":"Parasit Vectors","first-page":"155","article-title":"The design and development of a multicentric protocol to investigate the impact of adjunctive doxycycline on the management of peripheral lymphoedema caused by lymphatic filariasis and podoconiosis","volume":"13","author":"Horton","year":"2020"},{"key":"b18","series-title":"BMC Infect Dis","first-page":"48","article-title":"Lymphedema in three previously Wuchereria bancrofti-endemic health districts in Mali after cessation of mass drug administration","volume":"20","author":"Dolo","year":"2020"},{"key":"b19","series-title":"Lymphoedema Staff Manual: Treatment and Prevention of Problems Associated with Lymphatic Filariasis","year":"2001"},{"key":"b20","year":"2009"},{"key":"b21","year":"2012"},{"key":"b22","series-title":"Am J Trop Med Hyg","first-page":"1836","article-title":"Use of a novel portable three-dimensional imaging system to measure limb volume and circumference in patients with filarial lymphedema","volume":"97","author":"Yahathugoda","year":"2017"},{"key":"b23","series-title":"J Biomed Inform","first-page":"377","article-title":"Research electronic data capture (REDCap)\u2013a metadata-driven 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