OBJECTIVE: To determine the effects of ivermectin in annual, 3-monthly and 6-monthly doses on onchocercal skin p6isease (OSD) and severe itching. METHOD: A multicentre, double-blind placebo controlled trial was conducted among 4072 residents of rural communities in Ghana, Nigeria and Uganda. Baseline clinical examination categorized reactive skin lesions as acute papular onchodermatitis, chronic papular onchodermatitis and lichenified onchodermatitis. Presence and severity of itching was determined by open-ended and probing questions. Clinical examination and interview took place at baseline and each of 5 subsequent 3-monthly follow-up visits. RESULTS: While prevalence and severity of reactive lesions decreased for all 4 arms, those receiving ivermectin maintained a greater decrease in prevalence and severity over time. The difference between ivermectin and placebo groups was significant for prevalence at 9 months and for severity at 3 months. Differences between placebo and ivermectin groups were much more pronounced for itching. From 6 months onward, the prevalence of severe itching was reduced by 40-50% among those receiving ivermectin compared to the trend in the placebo group. CONCLUSION: This is an important effect on disease burden as severe itching is for the affected people the most troubling complication of onchocerciasis. The difference among regimens was not significant, and the recommended regimen of annual treatment for the control of ocular onchocerciasis appears also the most appropriate for onchocerciasis control in areas where the skin manifestations predominate. The final determination of the effect on skin lesions requires a longer period of study.
RCT Entities:
OBJECTIVE: To determine the effects of ivermectin in annual, 3-monthly and 6-monthly doses on onchocercal skin p6isease (OSD) and severe itching. METHOD: A multicentre, double-blind placebo controlled trial was conducted among 4072 residents of rural communities in Ghana, Nigeria and Uganda. Baseline clinical examination categorized reactive skin lesions as acute papular onchodermatitis, chronic papular onchodermatitis and lichenified onchodermatitis. Presence and severity of itching was determined by open-ended and probing questions. Clinical examination and interview took place at baseline and each of 5 subsequent 3-monthly follow-up visits. RESULTS: While prevalence and severity of reactive lesions decreased for all 4 arms, those receiving ivermectin maintained a greater decrease in prevalence and severity over time. The difference between ivermectin and placebo groups was significant for prevalence at 9 months and for severity at 3 months. Differences between placebo and ivermectin groups were much more pronounced for itching. From 6 months onward, the prevalence of severe itching was reduced by 40-50% among those receiving ivermectin compared to the trend in the placebo group. CONCLUSION: This is an important effect on disease burden as severe itching is for the affected people the most troubling complication of onchocerciasis. The difference among regimens was not significant, and the recommended regimen of annual treatment for the control of ocular onchocerciasis appears also the most appropriate for onchocerciasis control in areas where the skin manifestations predominate. The final determination of the effect on skin lesions requires a longer period of study.
Authors: Sunday Isiyaku; Michael Igbe; Suzie Madaki; Louise C Hamill; Patrick Ndongmo; William Adamani; Simon Bush; Joy Shu'aibu; Elizabeth Elhassan; Yisa Saka; Chukwuma Anyaike; Nse Michael Akpan; Akilah Joel; Audrey Nyior; Alhassan Abdullahi; Attahiru Aleiro; Abdullahi Labbo; Hayward Babale Mafuyai; Bertram E B Nwoke Journal: Int Health Date: 2022-09-21 Impact factor: 3.131
Authors: Mike Y Osei-Atweneboana; Daniel A Boakye; Kwablah Awadzi; John O Gyapong; Roger K Prichard Journal: Int J Parasitol Drugs Drug Resist Date: 2012-02-12 Impact factor: 4.077
Authors: Luc E Coffeng; Wilma A Stolk; Honorat G M Zouré; J Lennert Veerman; Koffi B Agblewonu; Michele E Murdoch; Mounkaila Noma; Grace Fobi; Jan Hendrik Richardus; Donald A P Bundy; Dik Habbema; Sake J de Vlas; Uche V Amazigo Journal: PLoS Negl Trop Dis Date: 2014-06-05