title: Adverse reactions after community treatment of onchocerciasis with ivermectin in Guatemala.
abstract: Male and female residents on a Guatemalan coffee plantation where Onchocerca volvulus infections were hyperendemic were offered oral ivermectin (100-200 micrograms/kg) as part of a community-wide treatment programme for onchocerciasis. Forty-five persons were treated and then questioned daily for 28 d about changes in their health. Those with complaints were monitored until all signs and symptoms had resolved. Sixty-seven percent complained of some adverse event after treatment; 60% developed observable adverse reactions attributed clinically to ivermectin. No reaction was life-threatening; the most common were oedema (53%) and fever (47%). Expulsion of intestinal helminths was reported by 38%. Almost all reactions began 24-48 h after treatment; their mean duration was 5 d, despite treatment with acetaminophen and antihistamines. Three patients had oedematous changes lasting over 2 weeks. Incidence, but not severity, of reactions was related to the pretreatment density of microfilariae in skin.
authors.affiliation: Centro de Investigaciones en Enfermedades Tropicales, Universidad del Valle de Guatemala, Guatemala City.
authors.forename: R
authors.initials: R
authors.lastname: Zea-Flores
authors.forename: F O
authors.initials: FO
authors.lastname: Richards
authors.forename: C
authors.initials: C
authors.lastname: González-Peralta
authors.forename: J
authors.initials: J
authors.lastname: Castro Ramirez
authors.forename: G
authors.initials: G
authors.lastname: Zea-Flores
authors.forename: R C
authors.initials: RC
authors.lastname: Collins
authors.forename: E
authors.initials: E
authors.lastname: Cupp
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004487:Edema / Q000139:chemically induced*; D005260:Female; D005334:Fever / Q000139:chemically induced; D006166:Guatemala; D006801:Humans; D007559:Ivermectin / Q000009:adverse effects*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017181:Onchocerca volvulus; D009855:Onchocerciasis / Q000188:drug therapy*
chemical_list: D007559:Ivermectin