Successful treatment of 2 imported cases of Mansonella perstans infection

Ásgeirsson, Hilmir; Harling, A.; Botero-Kleiven, Silvia

doi:10.1371/journal.pntd.0005452

Cited by 7 publications

(10 citation statements)

References 12 publications

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“… 23 , 25 , 44 , 115 , 116 As most of these reports are based on the treatment of tourists and expatriate Europeans and North Americans returning home from endemic areas, and not on people who have lived all their lives in endemic areas, it is not clear whether the symptoms reported from these studies can be used to compile a clinical picture that represents all or even most infections caused by mansonellosis. 23 , 25 , 44 , 116 , 117 Based on these reports, M. perstans can be considered to have little pathogenicity and almost always to be asymptomatic, but it can occasionally cause itching, joint pains, enlarged lymph glands, and vague abdominal symptoms. 5 , 23 , 25 , 116 , 117 …”

Section: Pathology and Symptomatology Of Mansonellosismentioning

confidence: 99%

“… 23 , 25 , 44 , 116 , 117 Based on these reports, M. perstans can be considered to have little pathogenicity and almost always to be asymptomatic, but it can occasionally cause itching, joint pains, enlarged lymph glands, and vague abdominal symptoms. 5 , 23 , 25 , 116 , 117 …”

Section: Pathology and Symptomatology Of Mansonellosismentioning

confidence: 99%

“… 4 , 51 , 124 , 126 – 128 However, two recently published M. perstans studies used generic immunological filariasis assays to support light-microscopy-based diagnoses. 116 …”

Section: Diagnosismentioning

confidence: 99%

“…Among the three types of human mansonellosis, the one caused by M. perstans is usually regarded as the most difficult to treat. 4 , 18 , 23 , 25 , 116 Treatment studies have provided conflicting results, and there are at present no international guidelines on best treatment. 18 , 23 , 25 , 67 , 116 , 136 – 140 Few studies have recruited sufficient patients to provide statistically robust results to support their conclusions, and many are based on the treatment of one or two European or North American expatriates or tourists returning from endemic areas, who may not respond to treatments in the same way as residents of endemic areas.…”

Section: Treatmentmentioning

confidence: 99%

“… 4 , 18 , 23 , 25 , 116 Treatment studies have provided conflicting results, and there are at present no international guidelines on best treatment. 18 , 23 , 25 , 67 , 116 , 136 – 140 Few studies have recruited sufficient patients to provide statistically robust results to support their conclusions, and many are based on the treatment of one or two European or North American expatriates or tourists returning from endemic areas, who may not respond to treatments in the same way as residents of endemic areas. 4 , 23 , 25 , 116 The existence of genetically distinct strains of M. perstans (like Deux or strains that lack Wolbachia ) complicates the formulation of treatment guidelines further, as it also possible that the efficacy of therapeutics varies between these strains.…”

Section: Treatmentmentioning

confidence: 99%

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Mansonellosis: current perspectives

Ta‐Tang

Crainey

Post

et al. 2018

RRTM

161

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Mansonellosis is a filarial disease caused by three species of filarial (nematode) parasites (Mansonella perstans, Mansonella streptocerca, and Mansonella ozzardi) that use humans as their main definitive hosts. These parasites are transmitted from person to person by bloodsucking females from two families of flies (Diptera). Biting midges (Ceratopogonidae) transmit all three species of Mansonella, but blackflies (Simuliidae) are also known to play a role in the transmission of M. ozzardi in parts of Latin America. M. perstans and M. streptocerca are endemic in western, eastern, and central Africa, and M. perstans is also present in the neotropical region from equatorial Brazil to the Caribbean coast. M. ozzardi has a patchy distribution in Latin America and the Caribbean. Mansonellosis infections are thought to have little pathogenicity and to be almost always asymptomatic, but occasionally causing itching, joint pains, enlarged lymph glands, and vague abdominal symptoms. In Brazil, M. ozzardi infections are also associated with corneal lesions. Diagnosis is usually performed by detecting microfilariae in peripheral blood or skin without any periodicity. There is no standard treatment at present for mansonellosis. The combination therapy of diethylcarbamazine plus mebendazole for M. perstans microfilaremia is presently one of the most widely used, but the use of ivermectin has also been proven to be very effective against microfilariae. Recently, doxycycline has shown excellent efficacy and safety when used as an antimicrobial against endosymbiotic Wolbachia bacteria harbored by some strains of M. perstans and M. ozzardi. Diethylcarbamazine and ivermectin have been used effectively to treat M. streptocerca infection. There are at present no estimates of the disease burden caused by mansonellosis, and thus its importance to many global health professionals and policy makers is presently limited to how it can interfere with diagnostic tools used in modern filarial disease control and elimination programs aimed at other species of filariae.

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Section: Pathology and Symptomatology Of Mansonellosismentioning

confidence: 99%

Section: Pathology and Symptomatology Of Mansonellosismentioning

confidence: 99%

“… 4 , 51 , 124 , 126 – 128 However, two recently published M. perstans studies used generic immunological filariasis assays to support light-microscopy-based diagnoses. 116 …”

Section: Diagnosismentioning

confidence: 99%