Adverse reactions after community treatment of onchocerciasis with ivermectin in Guatemala.
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.
Zea-Flores
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R
Centro de Investigaciones en Enfermedades Tropicales, Universidad del Valle de Guatemala, Guatemala City.
Richards
F O
FO
González-Peralta
C
C
Castro Ramirez
J
J
Zea-Flores
G
G
Collins
R C
RC
Cupp
E
E
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*
D007559:Ivermectin