Development of reactive onchocercal skin lesions during a placebo-controlled trial with ivermectin among persons without lesions at baseline.
Clinical trials of the effects of ivermectin on onchocercal skin disease have documented reduction in itching, but a less than clear benefit on reactive skin lesions. It has been suggested that one of the positive effects might be the prevention of new lesions. A study among a rural adult farming population in southwestern Nigeria provided ivermectin in three treatment groups and a placebo to community members who were examined and treated at 3-monthly intervals over a 15-month period. Among the 1206 people recruited for the study, 627 (52%) had no lesions at baseline examination. Atotal of 291 participants without baseline lesions attended all five follow-up examinations, and only their results were analysed. Members of all four groups developed new lesions, but those receiving ivermectin had a consistently lower proportion of lesions than the placebo group. This difference reached statistical significance at the 5% level in three of the five periods and was below the 10% level at the other two periods. These findings are suggestive of an inhibiting effect of ivermectin among those without lesions at the beginning of a community treatment programme, and justify community treatment as a way of limiting morbidity and social stigma associated with these lesions.
Brieger
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Department of Preventive and Social Medicine, University of Ibadan, Nigeria. bbbrieger@yahoo.com
Kale
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Ososanya
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D000328:Adult; D000969:Antinematodal Agents / Q000627:therapeutic use*; D000977:Antiparasitic Agents; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D009855:Onchocerciasis / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012876:Skin Diseases, Parasitic / Q000453:epidemiology
D000969:Antinematodal Agents; D000977:Antiparasitic Agents; D007559:Ivermectin