Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection

Gardon, Jacques; Gardon-Wendel, Nathalie; Demanga-Ngangue,; Kamgno, Joseph; Chippaux, Jean-Philippe; Boussinesq, Michel

doi:10.1016/s0140-6736(96)11094-1

Cited by 526 publications

(431 citation statements)

References 9 publications

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“…Franz et al, 1984). However, the side effects of filaricidal therapy in patients infected by L. loa (Gardon et al, 1997) might suggest that a bacterial component (i.e. W. pipientis) is implicated in these pathological outcomes.…”

Section: Discussionmentioning

confidence: 99%

Mapping the presence of Wolbachia pipientis on the phylogeny of filarial nematodes: evidence for symbiont loss during evolution

Casiraghi

Bain

Guerrero

et al. 2004

International Journal for Parasitology

230

215

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Section: Discussionmentioning

confidence: 99%

Mapping the presence of Wolbachia pipientis on the phylogeny of filarial nematodes: evidence for symbiont loss during evolution

Casiraghi

Bain

Guerrero

et al. 2004

International Journal for Parasitology

230

215

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“…1 The major risk factor for the development of post-ivermectin SAEs is a high L. loa microfilarial (mf) density. 2 It has been estimated that the relative risk of developing non-neurologic marked adverse events or SAEs, as defined previously, 3 is significantly increased when the Loa density exceeds 8,100 or 30,000 mf/mL blood, respectively. 3 However, most individuals potentially at risk because of their high mf density do not develop an SAE after ivermectin treatment.…”

mentioning

confidence: 94%

“…2 It has been estimated that the relative risk of developing non-neurologic marked adverse events or SAEs, as defined previously, 3 is significantly increased when the Loa density exceeds 8,100 or 30,000 mf/mL blood, respectively. 3 However, most individuals potentially at risk because of their high mf density do not develop an SAE after ivermectin treatment. Therefore, cofactors related to the host or the parasite are likely involved in the development of SAEs.…”

mentioning

confidence: 94%

“…This procedure was then complemented by passive surveillance up to 30 days after treatment. Patients who did not show any disorders of consciousness or objective neurologic signs 3,8 but developed a functional impairment with severity that was such that it would have probably required at least 1 week of full-time assistance at home by their family to undertake normal activities and hospitalization was, thus, considered necessary were considered as having a nonneurologic SAE. All individuals presenting with a non-SAE were closely monitored and benefitted from free management until complete recovery.…”

mentioning

confidence: 99%

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

Domgue¹,

Pion

Gounoue

et al. 2014

The American Journal of Tropical Medicine and Hygiene

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Abstract. Although ivermectin treatment can induce serious adverse events (SAEs) in individuals harboring high Loa loa microfilaremia (mf), not all patients with high mf levels develop such reactions, suggesting that cofactors may be involved. A study was conducted in Cameroon to investigate the possible role of Plasmodium coinfection at the time of ivermectin treatment in the development of SAEs. Before their first ivermectin treatment, thick smears were obtained from 4,175 individuals to determine the burden of Plasmodium sp., L. loa, and Mansonella perstans. After treatment, 18 (4.3 per 1,000) patients developed a non-neurologic SAE. Logistic regression analysis, adjusting for age, sex, P. falciparum infection, and M. perstans infection intensities, confirmed that L. loa mf was the main risk factor for SAEs. We found no evidence that coinfection with P. falciparum at the time of ivermectin treatment was associated with the occurrence of Loa-related SAEs in this population.

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“…31 The majority of such events have been restricted to a relatively small area of central Cameroon. The analysis of data from patients suggest that the risk of Loa loa encephalopathy is dependent on the existence of a microfilaraemia of 43000 mf/ml.…”

Section: Loa Loa and Onchocerciasismentioning

confidence: 99%

Public–private partnerships in blindness prevention: reaching beyond the eye

Molyneux

Nantulya

2005

Eye

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The control of river blindness (onchocerciasis) has been one of the major public health achievements of recent decades. Initially, vector control was used to stop transmission of the parasite Onchocerca volvulus by blackflies (Simulium) but the introduction of ivermectin (Mectizan) as a means of morbidity control enabled new strategies of distribution to be developed based on community directed treatment. The donation of Mectizan by Merck & Co. Inc. for onchocerciasis control in 1987 'as long as needed' was a public health landmark to be followed by a donation from GlaxoSmithKline of albendazole in 1997 for lymphatic filariasis to which Merck also responded by agreeing to extend their donation to include the coadministration of Mectizan and albendazole. Both the drugs, however, have wider impacts than those specific to filarial parasites and are effective against a range of intestinal parasites, whilst ivermectin has an important effect on ectoparasites. The wider benefits of the annual public health intervention-collateral benefitsFtherefore include deworming, improved nutritional status, increased growth, improved school performance and attendance, and improved haemoglobin status as a result of the impact of albendazole on hookworm, a major cause of anaemia. More recently, studies suggest that worm-free children have a significantly reduced frequency of malaria specific episodes of fever and Ascaris-infected children have a two-fold higher frequency of cerebral or severe malaria than those without Ascaris. These findings suggest that programmes based on annual interventions to control river blindness and lymphatic filariasis can contribute disproportionately more to a range of public health problems than has been hitherto recognized, thereby assisting in attaining the millennium development goal targets.

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Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection

Cited by 526 publications

References 9 publications

Mapping the presence of Wolbachia pipientis on the phylogeny of filarial nematodes: evidence for symbiont loss during evolution

Mapping the presence of Wolbachia pipientis on the phylogeny of filarial nematodes: evidence for symbiont loss during evolution

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

Public–private partnerships in blindness prevention: reaching beyond the eye

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