Prevalences of Loa loa microfilaraemia throughout the area endemic for the infection

Boussinesq, Michel; Gardon, Jacques

doi:10.1080/00034989760671

Cited by 49 publications

(20 citation statements)

References 37 publications

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“…Gabon is thus a highly endemic country and a zone at high risk of fatal treatment complications. These prevalence rates are similar to those reported in southern Cameroon (up to 38% in the district of Elig-Mfomo) [13] and Equatorial Guinea (27%). This contrasts with Central African Republic (CAR) and Chad, where prevalence is lower (11% and 8.4% respectively).…”

Section: Discussionsupporting

confidence: 89%

“…This contrasts with Central African Republic (CAR) and Chad, where prevalence is lower (11% and 8.4% respectively). In DRC-Congo, Republic of Congo and Nigeria the prevalence rates range from 1.2% to 97% [13]. It should be noted that these prevalence rates are for specific regions of these countries, whereas our survey covered the whole of Gabon.…”

Section: Discussionmentioning

confidence: 88%

“…The prevalence of L. loa microfilaremia varies from country to country [13], as well as within a given country and even a given geographic area [14]. The highest prevalence is observed in forest areas and the lowest in savannah areas of both Gabon [15], [16] and Cameroon [17], [18], for example.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Concomitant Infection Due to Loa loa and Mansonella perstans in Gabon

Akué

Nkoghe²,

Padilla³

et al. 2011

PLoS Negl Trop Dis

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BackgroundThe filarial parasites Loa loa and Mansonnella perstans are endemic in the central and western African forest block. Loa loa is pathogenic and represents a major obstacle to the control of co-endemic filariae because its treatment can cause fatal complications such as encephalitis.Methodology/Principal Findings4392 individuals aged over 15 years were studied both by direct examination and a concentration technique. The overall prevalence rates were 22.4% for Loa loa microfilaremia, 10.2% for M. perstans microfilaremia, and 3.2% for mixed infection. The prevalence of both filariae was higher in the forest ecosystem than in savannah and lakeland (p<0.0001). The intensity of microfilariae (mf) was also higher in the forest ecosystem for both parasites. The prevalence and intensity of microfilaria were both influenced by age and gender. Correlations were found between the prevalence and intensity of Loa loa microfilariae (r = 0.215 p = 0.036), and between the prevalence of Loa loa and the prevalence of individuals with microfilaria >8000 mf/ml (r = 0.624; p<0.0001) and microfilariae >30 000 mf/ml (r = 0.319, p = 0.002). In contrast, the prevalence of pruritis and Calabar swellings correlated negatively with the prevalence of Loa loa microfilaria (r = −0.219, p = 0.032; r = −0.220; p = 0.031, respectively). Pruritis, Calabar swellings and eye worm were not associated with L. loa mf intensity (r = −0.144, p = 0.162; r–0.061, p = 0.558; and r = 0.051, p = 0.624, respectively), or with the prevalence or intensity of M. perstans microfilariae.Conclusions/SignificanceThis map of the distribution of filariae in Gabon should prove helpful for control programs. Our findings confirm the spatial uniformity of the relationship between parasitological indices. Clinical manifestations point to a relationship between filariae and allergy.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 88%

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Epidemiology of Concomitant Infection Due to Loa loa and Mansonella perstans in Gabon

Akué

Nkoghe²,

Padilla³

et al. 2011

PLoS Negl Trop Dis

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“…The site in Orientale Province is near the eastern limits of the overall zone in Africa where loiasis may be endemic, while the site in Bas-Congo Province is in the South West of the loiasis zone [7,14]. Together with the original study sites in Cameroon and Nigeria, located in the North West of the loiasis zone, the RAPLOA sites provide a fair representation of the principal areas in Africa where loiasis is endemic.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of severe adverse reactions has been a major preoccupation for ivermectin treatment programmes throughout the central African sub-region where L. loa coexists with Onchocerca volvulus [7]. Several treatment programmes have been interrupted in Cameroon and the Democratic Republic of Congo (DRC).…”

Section: Introductionmentioning

confidence: 99%

Validation of the rapid assessment procedure for loiasis (RAPLOA) in the democratic republic of Congo

et al. 2012

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BackgroundA simple method called RAPLOA, to rapidly assess what proportion of people in a community are infected with L. loa and hence which communities are at high risk of severe adverse reactions following ivermectin treatment, was developed in Cameroon and Nigeria. The method needed further validation in other geographical and cultural contexts before its application in all endemic countries. The present study was designed to validate RAPLOA in two regions in the North East and South West of the Democratic Republic of Congo.MethodsIn each study region, villages were selected from different bio-ecological zones in order to cover a wide range of loiasis endemicity. In each selected community, 80 people above the age of 15 years were interviewed for a history of eye worm (migration of adult L. loa under the conjunctiva of the eye) and parasitologically examined for the presence and intensity of L. loa infection. In total, 8100 individuals from 99 villages were enrolled into the study.ResultsThe results confirmed the findings of the original RAPLOA study: i) the eye worm phenomenon was well-known in all endemic areas, ii) there was a clear relationship between the prevalence of eye worm history and the prevalence and intensity of L. loa microfilaraemia, and iii) using a threshold of 40%, the prevalence of eye worm history was a sensitive and specific indicator of high-risk communities.ConclusionFollowing this successful validation, RAPLOA was recommended for the assessment of loiasis endemicity in areas targeted for ivermectin treatment by lymphatic filariasis and onchocerciasis control programmes.

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Albendazole alone or in combination with microfilaricidal drugs for lymphatic filariasis

Macfarlane

Budhathoki

Johnson

et al. 2019

Cochrane Database of Systematic Reviews

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Background The Global Programme to Eliminate Lymphatic Filariasis recommends mass treatment of albendazole co‐administered with the microfilaricidal (antifilarial) drugs diethylcarbamazine (DEC) or ivermectin; and recommends albendazole alone in areas where loiasis is endemic. Objectives To assess the effects of albendazole alone, and the effects of adding albendazole to DEC or ivermectin, in people and communities with lymphatic filariasis. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, the Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Embase (OVID), LILACS (BIREME), and reference lists of included trials. We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform and ClinicalTrials.gov to identify ongoing trials. We performed all searches up to 15 January 2018. Selection criteria We included randomized controlled trials (RCTs) and cluster‐RCTs that compared albendazole to placebo or no placebo, or compared albendazole combined with a microfilaricidal drug to a microfilaricidal drug alone, given to people known to have lymphatic filariasis or communities where lymphatic filariasis was known to be endemic. We sought data on measures of transmission potential (microfilariae (mf) prevalence and density); markers of adult worm infection (antigenaemia prevalence and density, and adult worm prevalence detected by ultrasound); and data on clinical disease and adverse events. Data collection and analysis At least two review authors independently assessed the trials, evaluated the risks of bias, and extracted data. The main analysis examined albendazole overall, whether given alone or added to a microfilaricidal drug. We used data collected from all randomized individuals at time of longest follow‐up (up to 12 months) for meta‐analysis of outcomes. We evaluated mf density data up to six months and at 12 months follow‐up to ensure that we did not miss any subtle temporal effects. We conducted additional analyses for different follow‐up periods and whether trials reported on individuals known to be infected or both infected and uninfected. We analysed dichotomous data using the risk ratio (RR) with a 95% confidence interval (CI). We could not meta‐analyse data on parasite density outcomes and we summarized them in tables. Where data were missing, we contacted trial authors. We used GRADE to assess the certainty of evidence. Main results We included 13 trials (12 individually‐randomized and one small cluster‐randomized trial) with 8713 participants in total. No trials evaluated population‐level effects of albendazole in mass drug administration programmes. Seven trials enrolled people with a variety of inclusion criteria related to filarial infection, and six trials enrolled individuals from endemic areas. Outcomes were reported as end or change values. Mf and anti...

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Prevalences of Loa loa microfilaraemia throughout the area endemic for the infection

Cited by 49 publications

References 37 publications

Epidemiology of Concomitant Infection Due to Loa loa and Mansonella perstans in Gabon

Epidemiology of Concomitant Infection Due to Loa loa and Mansonella perstans in Gabon

Validation of the rapid assessment procedure for loiasis (RAPLOA) in the democratic republic of Congo

Albendazole alone or in combination with microfilaricidal drugs for lymphatic filariasis

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