Microfilaridermia assessment of the efficacy of Ivermectin alone and Ivermectin plus Albendazole against Onchocerciasis
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Date
August 2015
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Abstract
Onchocerciasis, commonly known as river blindness, is a vector-borne parasitic
disease which affects approximately 37 million people world wide, mostly in sub-Saharan African countries. In Ghana, the standard treatment of onchocerciasis is
annual mass drug administration with ivermectin at a dose of 150-200µg/kg.
However, this regimen kills only microfilariae and therefore repopulation of
microfilariae by adult female worms resumes 3 to 6 months after ivermectin
treatment. In this study, an open-labelled clinical trial was conducted using
microfilariae levels to assess the efficacy of ivermectin alone and ivermectin plus
albendazole given annually and semi-annually. A total of 272 onchocerciasis-infected volunteers were randomised into ivermectin alone annually, ivermectin
alone semi-annually, ivermectin plus albendazole annually and ivermectin plus
albendazole semi-annual treatment arms. Participants in the annual treatment arms
received vitamin C at 6 months. Microfilariae loads of all study volunteers were
monitored at pre-treatment, 6 months and 18 months using skin biopsies. All four
treatment arms significantly (p=0.0001) reduced microfilariae loads but the bi-annual treatment arms of ivermectin alone and ivermectin plus albendazole were
the most effective regimens for clearing skin microfilariae. Ivermectin is therefore
still effective in clearing microfilariae among participants in the Adansi South
District of Ghana. Bi-annual treatment of ivermectin alone and ivermectin plus
albendazole was found to have additional benefit in reducing microfilariae loads
compared to annual treatment. However, co-administration of ivermectin
(200µg/kg) and albendazole (800µg/kg) did not have additional effect of reducing
microfilariae loads.
Description
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Philosophy In the Department of Clinical Microbiology, School of Medical Sciences, College of Health Sciences, 2015