Community-based ivermectin therapy for onchocerciasis: comparison of three methods of dose assessment.
A new method of assessment based on mid-upper arm circumference (MUAC) is described for dosage adjustment for community-based ivermectin distribution. We studied 878 subjects eligible for ivermectin dosing in Awhum, Nigeria. In a previous preliminary study of 40 persons, MUAC (in cm) correlated with weight (kg) in the first 20 male (r = 0.97, r2 = 0.95, P < 0.0001) and the first 20 female subjects (r = 0.94, r2 = 0.88, P < 0.0001). We therefore studied the use of height, physical appearance, and MUAC for calculating the dose of ivermectin. The MUAC-based schedule underdosed only 4.1% of the population. The methods based on height underdosed 3.3% and 21.1%, and assignment based on physical appearance underdosed 10.2% of the population studied. This MUAC-based method (13-15 cm, 0.5 tablet; 16-20 cm, 1.0 tablet; 21-27 cm, 1.5 tablets; > or = 28 cm, 2.0 tablets) is more convenient and corresponds closely to dosing by weight. An adaptation of this method with reference to other prevalent tropical diseases and their respective drugs is therefore advocated.
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Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Enugu State. shuneba@gmail-microvisions.com
Okonkwo
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D000328:Adult; D000818:Animals; D000969:Antinematodal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001132:Arm / Q000033:anatomy & histology; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009549:Nigeria; D009854:Onchocerca / Q000187:drug effects*; D009855:Onchocerciasis / Q000188:drug therapy*
D000969:Antinematodal Agents; D007559:Ivermectin