Baraka O Z, Khier M M, Ahmed K M, Ali M M, el Mardi A E, Mahmoud B M, Ali M H, Homeida M M, Williams J F
Department of Medicine, Faculty of Medicine, University of Khartoum, Sudan.
Trans R Soc Trop Med Hyg. 1995 May-Jun;89(3):316-8. doi: 10.1016/0035-9203(95)90560-x.
A study to monitor ivermectin acceptability and post-treatment reactions during mass community distribution was carried out in eastern Sudan, where severe reactive onchodermatitis is prevalent. Of 1081 individuals eligible for treatment, 1076 (99.5%) accepted the ivermectin. Post-treatment reactions were monitored by self reporting, 5 d after a single dose of about 150 micrograms/kg (range 103-200 micrograms/kg); 230 persons reported adverse events (21.4%). No reaction was rated as severe. The most common problem was itching with cutaneous papular eruptions (16.2%). Local oedematous swelling was the second most common and the most slowly resolving complaint (5.4%), followed by musculoskeletal pain. There was a high acceptance rate of the treatment and remarkable tolerance of the post-treatment effects, probably due to efforts made to prepare the community to expect reactions to ivermectin, widespread awareness of the beneficial effects of treatment by villagers who had participated in clinical trials previously, and the encouragement we gave to the population to become involved in improvement of their health care services. Single doses of ivermectin resulted in good clinical responses and created much goodwill among villagers. Improvements in physical fitness, ability to work, and freedom from musculoskeletal pain were reported at the 3 months' follow-up. We recommend that, during mass distribution of ivermectin, community involvement in planning overall health improvement should be included, since the treatment initiates the process well. In areas where sowda syndrome is prevalent, medical surveillance for 3 d or more should be considered.
在苏丹东部开展了一项关于群体社区分发伊维菌素期间监测其可接受性及治疗后反应的研究，该地区严重反应性盘尾丝虫性皮炎流行。在1081名符合治疗条件的个体中，1076人（99.5%）接受了伊维菌素。通过自我报告在单剂量约150微克/千克（范围103 - 200微克/千克）给药5天后监测治疗后反应；230人报告了不良事件（21.4%）。没有反应被评为严重。最常见的问题是伴有皮肤丘疹疹的瘙痒（16.2%）。局部水肿性肿胀是第二常见且消退最慢的主诉（5.4%），其次是肌肉骨骼疼痛。该治疗的接受率很高，对治疗后效应的耐受性也很显著，这可能归因于为让社区做好接受伊维菌素反应的准备所做的努力、先前参与临床试验的村民对治疗有益效果的广泛认知以及我们对民众参与改善其医疗服务的鼓励。单剂量伊维菌素产生了良好的临床反应，并在村民中赢得了很多好感。在3个月的随访中，报告了身体健康、工作能力以及摆脱肌肉骨骼疼痛方面的改善。我们建议，在大规模分发伊维菌素期间，应纳入社区参与总体健康改善规划，因为该治疗能很好地启动这一进程。在索达综合征流行的地区，应考虑进行3天或更长时间的医学监测。
