Community-based ivermectin therapy for onchocerciasis: comparison of three methods of dose assessment.

Shu, En; Okonkwo, P. O.

doi:10.4269/ajtmh.2001.65.184

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Although only 46.5% individuals would have taken the correct dose with the height assessment, underdosage was extremely limited (0.5% cases), and most cases would have deviated from the correct dose by half tablet. Shu et al [ 11 ] confirmed the good performance of the method proposed by Alexander et al [ 19 ] in relation to the small proportion (3.3%) of underdosage, although overdosage was up to 54%. Shu et al also tested another method of assessment by height, with different dosing levels, which however showed worse performance (21% underdosage).…”

Section: Discussionmentioning

confidence: 80%

“…Previous studies have evaluated the use of height as a proxy for weight for the administration of ivermectin in the context of elimination programs for either onchocerciasis or LF [ 11 , 19 ]. In the early 1990s, Alexander et al [ 19 ] elaborated four dosing intervals corresponding to different heights, for the administration of ivermectin in the context of a placebo-controlled trial for onchocerciasis.…”

Section: Discussionmentioning

confidence: 99%

“…The use of weighing scales can be difficult in the field, and their reliability is often questionable, in particular in the context of mass administration programs. Hence, the use of “tablet poles” has been proposed as an alternative for drugs with weight-dependent administration, e.g., praziquantel and ivermectin [ 9 – 11 ]. The tablet pole is a tool that permits to estimate the number of tablets to be delivered based on height instead of weight.…”

Section: Introductionmentioning

confidence: 99%

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Use of a “tablet pole” for the administration of ivermectin for strongyloidiasis in a field study in Ecuador

Buonfrate

Anselmi²,

Prandi³

et al. 2023

Infect Dis Poverty

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Background Establishment of efficient control programs for strongyloidiasis, the infection by Strongyloides stercoralis, is among the World Health Organization (WHO) targets for 2030. Ivermectin is a drug of choice for strongyloidiasis, but its weight-based administration can be unfeasible in remote areas. We evaluated a WHO tablet pole for administration of ivermectin in school-age children living in remote villages in Ecuador. Methods Children were enrolled in 16 villages in Esmeraldas Province of Ecuador, between July 2021 and June 2022. The pole identified four height intervals corresponding to ivermectin doses going from one to four tablets. For each child, we calculated the dose (µg/kg) administered with both weight-based and pole-based administration. Results were classified as follows: optimal dose, acceptable, overdose, underdose. Agreement between the two methods for estimating the number of tablets was assessed with Cohen’s kappa coefficient. Estimations were reported with 95% confidence intervals (CIs). Results Total of 778 children (47.3% female) were enrolled, with median age of 9.59 years (interquartile range: 7.42‒11.22). Optimal dose was achieved for a higher proportion of children when assessed with weight (37.9%) than with pole (25.7%). Underdose and overdose were more frequent with the pole (8.3% and 19.2% children, respectively) than with the weight-based (3.7% and 6.0%, respectively) administration. Agreement between weight-based and pole-based administration was moderate: 0.56 (95% CI 0.51, 0.61). The two methods indicated the same number of tablets in 71.6% (95% CI 0.684, 0.748) cases. Conclusions In our setting, the tablet pole could be a valid alternative. The tool needs further evaluation in different populations. Graphical Abstract

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%