{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:20:47Z","timestamp":1788355247511,"version":"build-2803163510"},"reference-count":33,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Lymphatic filariasis is a vector-borne infectious disease, most commonly caused by\n                    <jats:italic>Wuchereria bancrofti<\/jats:italic>\n                    , that affects 120 million people. It invades the lymphatic system of humans, who are the definitive hosts. We compared the administration of doxycycline with intensified hygiene measures alone in patients diagnosed with bancroftian filariasis. We searched PubMed, Scopus, and Embase and included 12 randomized controlled trials. A random-effects model was used to calculate the mean difference (MD)\/risk ratio (RR) and\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    for heterogeneity. The risk of bias and GRADE evaluated the certainty of evidence. Pooled analysis showed a significant reduction in the number of\n                    <jats:italic>Wolbachia<\/jats:italic>\n                    per microfilaria (MD = \u22123.09; 95% CI: \u22123.94 to \u22122.25;\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.00001,\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 42%). Although initial analysis suggested a reduction in microfilarial count, this finding was highly heterogeneous (\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 99%) and became nonsignificant upon sensitivity analysis, indicating unstable results. Regarding adverse events, vomiting was significantly more common in the doxycycline group (RR = 6.25; 95% CI: 2.14\u201318.24;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.0008,\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 0%). In conclusion, doxycycline combined with intensified hygiene protocols reduces the\n                    <jats:italic>Wolbachia<\/jats:italic>\n                    burden but shows a limited role in clinically significant lymphedema reduction, and the evidence for microfilarial reduction is not robust. Large-scale trials are required to better combat this neglected tropical disease in endemic populations worldwide.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0134","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:41:01Z","timestamp":1784828461000},"page":"430-435","source":"Crossref","is-referenced-by-count":0,"title":["Does Doxycycline Benefit Intensified Hygiene Measures in Patients with Filarial Lymphedema? A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.4269","volume":"115","author":[{"given":"Asia","family":"Batool","sequence":"first","affiliation":[{"name":"Sir Syed College of Medical Sciences Karachi, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makhzan Ali","family":"Akbar","sequence":"additional","affiliation":[{"name":"North Sichuan Medical College, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fakhar E.","family":"Mahin","sequence":"additional","affiliation":[{"name":"Fatima Jinnah Medical University, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Sharjeel","family":"Abbas","sequence":"additional","affiliation":[{"name":"Gomal Medical College, Dera Ismail Khan, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Huzaifa","family":"Khattak","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal Wazir","family":"Khan","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meer","family":"Murtaza","sequence":"additional","affiliation":[{"name":"Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayab","family":"Magsi","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University, Karachi, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayyaba Ikram","family":"Kazi","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Maaz","family":"Amjad","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humaira","family":"Bibi","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohaa","family":"Fazal","sequence":"additional","affiliation":[{"name":"University of Home Economics, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Ahsan","sequence":"additional","affiliation":[{"name":"Ziauddin University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehtab","family":"Ali","sequence":"additional","affiliation":[{"name":"Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"3","key":"b1","series-title":"Korean J Parasitol","first-page":"119","article-title":"Clinical and pathological aspects of filarial lymphedema 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Faso","volume":"120","author":"Jullien","year":"2011"},{"key":"b33","article-title":"Lymphatic Filariasis: Managing Morbidity and Preventing Disability: An Aide-M\u00e9moire for National Programme Managers.","year":"2013"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p430.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p430.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p430.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:54:16Z","timestamp":1788353656000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p430.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":33,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0134","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}