Absence of an Association Between Plasmodium falciparum Infection and Post-Ivermectin Loa-Related Non-Neurologic Serious Adverse Events

Domgue, Joël Fokom; Pion, Sébastien; Gounoue, Racéline Kamkumo; Akame, Julie; Nguipdop-Djomo, Patrick; Twum-Danso, Nana A.Y.; Thylefors, B; Boussinesq, Michel; Kamgno, Joseph

doi:10.4269/ajtmh.13-0189

Cited by 6 publications

(8 citation statements)

References 8 publications

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“…But no statistical association and no significant difference in parasitemia of these single infections and co-infection situations were found, thereby outlining the absence of any negative interaction between these pathogens agents. This finding is consistent with that of Fokom-Domgue et al [27]. The interaction between these parasites could involve a mechanism other than a competition for blood resources.…”

Section: Discussionsupporting

confidence: 93%

Mansonella perstans and Plasmodium falciparum Co-infection in the Akonolinga Health District, Centre Region, Cameroon

Lehman¹,

Oyono²,

Fosso³

et al. 2019

AJBLS

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Mansonella perstans and Plasmodium falciparum are among the most common human parasites in Sub-Saharan Africa. They pass through the bloodstream during their life in human host. This study aimed at determining the prevalence, determinants of co-infection with M. perstans and P. falciparum and their possible interaction mechanism. A cross-sectional study was conducted in the Akonolinga Health District among pupils. Each of them was screened for the presence of peripheral blood parasites stages using Giemsa-stained thick and thin blood films. Socio-demographic information was documented using a questionnaire forms. A total of 416 pupils aged 4-15 years (average: 9.17 ± 0.27) were recruited. The overall prevalence was 4.32% and 37.26% for M. perstans and P. falciparum respectively, and prevalence of co-infection was 1.92%. Mean parasite density was 508.7±310.3 (min: 430-max: 1300) µF/ml for M. perstans and 5240.38±2037.42 (min: 857-max: 10400) T/µl for P. falciparum. Risks of single infections (aOR = 0.46, P = 0.0264 for M. perstans and aOR = 0.64, P = 0.0432 for P. falciparum) and co-infection (aOR = 0.10, P = 0.0371) were lower for pupils living in urban area than those living in rural area. Parasitemia of both parasite species were similar in single and co-infection situations (P> 0.05). The interaction between these parasites could involve another mechanism than a competition for blood resources. This study outlined that M. perstans and P. falciparum are co-endemic in the Akonolinga health District. In order to guarantee future success in control and eradication of malaria, a bigger attention should be given to M. perstans or other filarial where it is coendemic with P. falciparum.

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Section: Discussionsupporting

confidence: 93%

Mansonella perstans and Plasmodium falciparum Co-infection in the Akonolinga Health District, Centre Region, Cameroon

Lehman¹,

Oyono²,

Fosso³

et al. 2019

AJBLS

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“…The second trial was carried out in 2005 in the Lom-et-Djerem and Haut-Nyong divisions (East Region) of Cameroon to evaluate whether coinfection with Plasmodium sp. is a risk cofactor for Loa -related post-IVM SAE [6] . This study included 4956 IVM-naïve subjects aged ≥13 years living in 74 villages.…”

Section: Methodsmentioning

confidence: 99%

“…This study included 4956 IVM-naïve subjects aged ≥13 years living in 74 villages. Both studies were approved by the Cameroon National Ethics Committee for Research in Human Health [ 1 , 6 ]. For the study conducted in the East Region, all voluntary participants provided a signed informed consent.…”

Section: Methodsmentioning

confidence: 99%

Individual risk of post-ivermectin serious adverse events in subjects infected with Loa loa

et al. 2020

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Background Implementation of onchocerciasis elimination programmes has been delayed in Central Africa because of the risk of ivermectin-related serious adverse events (SAEs) in individuals with high Loa loa microfilarial densities (MFD). We developed the first statistical models enabling prediction of SAE risk in individuals with a given MFD. Methods We used individual participant data from two trials conducted in loiasis-onchocerciasis co-endemic areas in Cameroon. among the 10 506 ivermectin-treated subjects included in the analysis, 38 (0·36%) developed an ivermectin-related SAE. To predict individual-level risk of SAE, we developed mixed multivariate logistic models including subjects’ sex, age, pre-treatment L loa and Mansonella perstans MFDs, and study region. Findings The models predicted that regardless of sex, about 1% of people with 20 000 L loa microfilariae per millilitre of blood (mf/mL), 10% of people with 50 000 mf/mL and about one third of those with 100 000 mf/mL will develop an SAE. For a given MFD, males have a three-fold higher risk of developing an SAE than females. Interpretation By enabling the prediction of post-ivermectin SAE risk in communities with known distribution of L loa MFDs, our results can guide decisions on the choice of ivermectin-based treatment strategies. They also predict that 37 SAEs were prevented in 2015 by using a Test-and-Treat strategy in the Okola District of Cameroon. Funding UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases; Institut de Recherche pour le Développement; Mectizan Donation Program; Bill & Melinda Gates Foundation .

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“…Diethylcarbamazine (DEC) is only moderately effective and has to be administered under supervision, due to its toxicity. DEC or ivermectin treatment may cause serious adverse reactions due to microfilarial disintegration triggering a cytokine release [ 8 ]. This underscores the need for new drugs for the treatment of helminth infections.…”

Section: Introductionmentioning

confidence: 99%

Impact of Anti-Retroviral Treatment and Cotrimoxazole Prophylaxis on Helminth Infections in HIV-Infected Patients in Lambaréné, Gabon

et al. 2015

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BackgroundFoci of the HIV epidemic and helminthic infections largely overlap geographically. Treatment options for helminth infections are limited, and there is a paucity of drug-development research in this area. Limited evidence suggests that antiretroviral therapy (ART) reduces prevalence of helminth infections in HIV-infected individuals. We investigated whether ART exposure and cotrimoxazole preventive therapy (CTX-P) is associated with a reduced prevalence of helminth infections.Methodology and Principal FindingsThis cross-sectional study was conducted at a primary HIV-clinic in Lambaréné, Gabon. HIV-infected adults who were ART-naïve or exposed to ART for at least 3 months submitted one blood sample and stool and urine samples on 3 consecutive days. Outcome was helminth infection with intestinal helminths, Schistosoma haematobium, Loa loa or Mansonella perstans. Multivariable logistic regression was used to assess associations between ART or CTX-P and helminth infection. In total, 408 patients were enrolled. Helminth infection was common (77/252 [30.5%]). Filarial infections were most prevalent (55/310 [17.7%]), followed by infection with intestinal helminths (35/296 [11.8%]) and S. haematobium (19/323 [5.9%]). Patients on CTX-P had a reduced risk of Loa loa microfilaremia (adjusted odds ratio (aOR) 0.47, 95% CI 0.23-0.97, P = 0.04), also in the subgroup of patients on ART (aOR 0.36, 95% CI 0.13-0.96, P = 0.04). There was no effect of ART exposure on helminth infection prevalence.Conclusions/SignificanceCTX-P use was associated with a decreased risk of Loa loa infection, suggesting an anthelminthic effect of antifolate drugs. No relation between ART use and helminth infections was established.

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Absence of an Association Between Plasmodium falciparum Infection and Post-Ivermectin Loa-Related Non-Neurologic Serious Adverse Events

Cited by 6 publications

References 8 publications

<i>Mansonella perstans</i> and <i>Plasmodium falciparum</i> Co-infection in the Akonolinga Health District, Centre Region, Cameroon

<i>Mansonella perstans</i> and <i>Plasmodium falciparum</i> Co-infection in the Akonolinga Health District, Centre Region, Cameroon

Individual risk of post-ivermectin serious adverse events in subjects infected with Loa loa

Impact of Anti-Retroviral Treatment and Cotrimoxazole Prophylaxis on Helminth Infections in HIV-Infected Patients in Lambaréné, Gabon

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Absence of an Association Between Plasmodium falciparum Infection and Post-Ivermectin Loa-Related Non-Neurologic Serious Adverse Events

Cited by 6 publications

References 8 publications

&lt;i&gt;Mansonella perstans&lt;/i&gt; and &lt;i&gt;Plasmodium falciparum&lt;/i&gt; Co-infection in the Akonolinga Health District, Centre Region, Cameroon

&lt;i&gt;Mansonella perstans&lt;/i&gt; and &lt;i&gt;Plasmodium falciparum&lt;/i&gt; Co-infection in the Akonolinga Health District, Centre Region, Cameroon

Individual risk of post-ivermectin serious adverse events in subjects infected with Loa loa

Impact of Anti-Retroviral Treatment and Cotrimoxazole Prophylaxis on Helminth Infections in HIV-Infected Patients in Lambaréné, Gabon

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<i>Mansonella perstans</i> and <i>Plasmodium falciparum</i> Co-infection in the Akonolinga Health District, Centre Region, Cameroon

<i>Mansonella perstans</i> and <i>Plasmodium falciparum</i> Co-infection in the Akonolinga Health District, Centre Region, Cameroon