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Large scale ivermectin distribution and its epidemiological consequences.

J Remme1, G De Sole, K Y Dadzie

  • 1Onchocerciasis Control Programme in West Africa, Ouagadougou, Burkina Faso.

Acta Leidensia
|January 1, 1990
PubMed
Summary
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Community trials show ivermectin significantly reduces microfilariae (mf) in skin and eyes, aiding onchocerciasis control. However, it is unlikely to eliminate transmission in endemic areas.

Area of Science:

  • Tropical Medicine
  • Epidemiology
  • Public Health

Background:

  • Community trials investigated ivermectin's safety and efficacy for onchocerciasis control.
  • Large-scale ivermectin treatment aimed to assess transmission control and ocular disease prevention.

Purpose of the Study:

  • To evaluate the short-term epidemiological impact of large-scale ivermectin treatment.
  • To assess ivermectin's role in preventing ocular onchocerciasis and controlling transmission.

Main Methods:

  • Analysis of data from eight community trials in the Onchocerciasis Control Programme in West Africa (OCP).
  • Quantification of an epidemiological model using trial results and recent research findings.
  • Computer simulations to predict the long-term epidemiological impact of ivermectin treatment.

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Main Results:

  • Ivermectin treatment reduced skin microfilariae (mf) by 96%-99%, with repopulation reaching over 40% after 12 months.
  • Ocular mf loads decreased significantly, and early anterior segment eye lesions showed regression.
  • Onchocerca volvulus transmission reduced by approximately 60% in the first year, with no further reduction after the second round.

Conclusions:

  • Ivermectin is highly effective in reducing microfilarial loads and preventing ocular disease in onchocerciasis patients.
  • While beneficial for disease control, ivermectin is unlikely to be a practical tool for eliminating transmission in endemic areas.
  • Ivermectin is suitable for controlling infection recrudescence, particularly in areas with reduced parasite reservoirs due to vector control.