National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
Global Health Institute, University of Antwerp, Antwerp, Belgium.
Afr Health Sci. 2022 Sep;22(3):607-616. doi: 10.4314/ahs.v22i3.65.
Despite 20 years of ivermectin mass distribution in the Mahenge area, Tanzania, the prevalence of onchocerciasis and epilepsy has remained high in rural villages.
We investigated the efficacy of ivermectin in reducing Onchocerca volvulus microfilariae and predictors for parasitic load following ivermectin treatment in persons with (PWE) and without epilepsy (PWOE).
Between April and September 2019, 50 PWE and 160 randomly selected PWOE from Msogezi and Mdindo villages participated in a follow-up study. Skin snips were obtained pre (baseline) and three months post-ivermectin treatment.
The overall prevalence of positive skin snips at baseline was 49% (103/210), with no significant difference between PWE (58.0%) and PWOE (46.3%); p=0.197. The overall mean microfilarial density was significantly higher at baseline 1.45(95%CI:0.98-2.04)) than three-month post-ivermectin treatment (0.23(95%CI:0.11-0.37), p<0.001. Three months after ivermectin, the microfilarial density had decreased by ≥80% in 54 (81.8%, 95%CI: 72.3-91.4) of the 66 individuals with positive skin snips at baseline. High microfilarial density at baseline was the only significant predictor associated with higher microfilarial density in the post-ivermectin skin snips.
Our study reports a decrease in microfilarial density following ivermectin treatment in most individuals. Optimizing ivermectin coverage will address the ongoing onchocerciasis transmission in Mahenge.
尽管在坦桑尼亚马亨盖地区进行了 20 年的伊维菌素大规模分发，但农村村庄的盘尾丝虫病和癫痫的患病率仍然很高。
我们调查了伊维菌素在降低盘尾丝虫微丝蚴方面的疗效，并研究了接受伊维菌素治疗后（PWE）和未接受癫痫（PWOE）的个体寄生虫负荷的预测因素。
2019 年 4 月至 9 月期间，来自 Msogezi 和 Mdindo 村的 50 名 PWE 和 160 名随机选择的 PWOE 参加了随访研究。在伊维菌素治疗前（基线）和治疗后三个月采集皮肤切片。
基线时，阳性皮肤切片的总患病率为 49%（103/210），PWE（58.0%）和 PWOE（46.3%）之间无显著差异；p=0.197。总体微丝蚴密度在基线时明显更高，为 1.45（95%CI：0.98-2.04），而在伊维菌素治疗后三个月时为 0.23（95%CI：0.11-0.37），p<0.001。在基线时阳性皮肤切片的 66 名个体中，有 54 名（81.8%，95%CI：72.3-91.4）在伊维菌素治疗后三个月后微丝蚴密度下降了≥80%。基线时的高微丝蚴密度是与伊维菌素治疗后皮肤切片中微丝蚴密度较高相关的唯一显著预测因素。
我们的研究报告了伊维菌素治疗后微丝蚴密度的下降，大多数个体都有这种情况。优化伊维菌素的覆盖范围将解决马亨盖地区持续存在的盘尾丝虫病传播问题。
