Concurrent Parasitic Infections in Onchocerciasis and the Occurrence of Adverse Reactions after Ivermectin Treatment

Njoo, F. L.; Belling, G. A. C.; Oosting, J.; Vetter, J. C. M.; Stilma, J. S.; Kijlstra, A.

doi:10.4269/ajtmh.1993.48.652

Cited by 23 publications

(17 citation statements)

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“…It is thought, however, that side effects are associated with microfilarial destruction, which is in agreement with the observation that side effects are more pronounced in patients with high microfilarial loads [2,3,5]. How mf disintegrate following therapy is not known.…”

supporting

confidence: 67%

“…The high degree of infection, as evidenced by the high overall geometric mean of 43 1 mf/mg skin snip may account for this finding [5]. The occurrence of side effects was related to skin snip counts and also to elastase-x1AT levels, therefore we would expect elastase and skin snip counts to be related.…”

mentioning

confidence: 85%

“…Before treatment, all persons Onchocerca volvulus which is transmitted to man via blackflies received a general and an ophthalmological examination, and belonging to the family Simuliidae. In addition to eye lesions, skin snips were taken [5]. The controls lived in the same villages skin manifestations are also part of the disease.…”

Section: Introduction Patients and Methodsmentioning

confidence: 99%

“…Ivermectin has proved to be an acceptable, safe and effective treatment were graded as described previously [5]. Briefly, drug to treat onchocerciasis.…”

Section: Adverse Reactions Occurring During 3 Days After Ivermectinmentioning

confidence: 99%

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Neutrophil activation in ivermectin-treated onchocerciasis patients

Njoo

Hack

Oosting

et al. 1993

Clinical and Experimental Immunology

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SUMMARY Invermectin is a safe and effective drug for onchocerciasis treatment. In certain individuals, however, therapy is accompanied by adverse reactions. The mechanisms underlying these reactions are not yet known. The aim of the present study was to investigate whether neutrophils are involved in the development of these adverse reactions. Elastase and lactoferrin, two markers for the release of neutrophil azurophilic and specific granule contents respectively, were measured by radioimmunoassays in plasma of onchocerciasis patients with varying degrees of side effects, as well as in control subjects before and 1 and 2 days after ivermectin treatment. A considerable increase of elastase levels after treatment was observed, whereas lactoferrin levels did not change. The percentage of patients with elevated elastase levels was significantly correlated with the degree of side effects. These findings suggest that neutrophil activation may be involved in the development of adverse reactions in these patients.

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supporting

confidence: 67%

mentioning

confidence: 85%

Section: Introduction Patients and Methodsmentioning

confidence: 99%

“…Ivermectin has proved to be an acceptable, safe and effective treatment were graded as described previously [5]. Briefly, drug to treat onchocerciasis.…”

Section: Adverse Reactions Occurring During 3 Days After Ivermectinmentioning

confidence: 99%

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Neutrophil activation in ivermectin-treated onchocerciasis patients

Njoo

Hack

Oosting

et al. 1993

Clinical and Experimental Immunology

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“…[1][2][3][4] Community trials indicate that a single dose (150 g/kg) markedly reduces skin microfilarial levels for up to 12 months, with a transient fall in transmission levels. 5 It also reduces the prevalence of some intestinal nematodes 6 and ectoparasitic infections. 7 Distribution of ivermectin based on the subject's body weight has several inherent problems.…”

Section: Introductionmentioning

confidence: 99%

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

Shu¹,

Okonkwo²

2001

The American Journal of Tropical Medicine and Hygiene

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Abstract.A new method of assessment based on mid-upper arm circumference (MUAC) is described for dosage adjustment for community-based ivermectin distribution. We studied 878 subjects eligible for ivermectin dosing in Awhum, Nigeria. In a previous preliminary study of 40 persons, MUAC (in cm) correlated with weight (kg) in the first 20 male (r ϭ 0.97, r 2 ϭ 0.95, P Ͻ 0.0001) and the first 20 female subjects (r ϭ 0.94, r 2 ϭ 0.88, P Ͻ 0.0001). We therefore studied the use of height, physical appearance, and MUAC for calculating the dose of ivermectin. The MUAC-based schedule underdosed only 4.1% of the population. The methods based on height underdosed 3.3% and 21.1%, and assignment based on physical appearance underdosed 10.2% of the population studied. This MUACbased method (13-15 cm, 0.5 tablet; 16-20 cm, 1.0 tablet; 21-27 cm, 1.5 tablets; Ն 28 cm, 2.0 tablets) is more convenient and corresponds closely to dosing by weight. An adaptation of this method with reference to other prevalent tropical diseases and their respective drugs is therefore advocated.

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Considering ivermectin for treatment of schistosomiasis

Golenser,

Birman,

Gold

2024

Parasitol Res

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Because of recent reports of praziquantel resistance in schistosome infections, there have been suggestions to employ ivermectin as a possible alternative, especially as its chemical composition is different from that of praziquantel, so cross-resistance is not expected. In order to ascertain possible damage and elimination of worms, we used ivermectin by oral gavage in infected mice, at a high dose (30.1 mg/kg, bordering toxicity). We also tested the efficacy of the drug at various times postinfection (PI), to check on possible effect on young and mature stages of the parasites. Thus, we treated mice on days 21 and 22 or on days 41 and 42 and even on days 21, 22, 41, and 42 PI. None of the treatment regimens resulted in cure rates or signs of lessened pathology in the mice. We also compared the effect of ivermectin to that of artemisone, an artemisinin derivative which had served us in the past as an effective anti-schistosome drug, and there was a stark difference in the artemisone’s efficacy compared to that of ivermectin; while ivermectin was not effective, artemisone eliminated most of the worms, prevented egg production and granulomatous inflammatory response. We assume that the reported lack of activity of ivermectin, in comparison with praziquantel and artemisinins, originates from the difference in their mode of action. In wake of our results, we suggest that ivermectin is not a suitable drug for treatment of schistosomiasis.

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Concurrent Parasitic Infections in Onchocerciasis and the Occurrence of Adverse Reactions after Ivermectin Treatment

Cited by 23 publications

References 0 publications

Neutrophil activation in ivermectin-treated onchocerciasis patients

Neutrophil activation in ivermectin-treated onchocerciasis patients

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

Considering ivermectin for treatment of schistosomiasis

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