The effect of a single dose of oral ivermectin on pruritus in the homeless.
BACKGROUND
Homeless people commonly present with ectoparasite-based pruritus. We evaluated the efficacy of a single dose of ivermectin to reduce the pruritus prevalence in a homeless population.


METHODS
We conducted a randomized, double-blind, placebo-controlled trial from January 2006 to April 2006 in two homeless shelters in the city of Marseille, France. Homeless people complaining of pruritus were randomized to receive either ivermectin (24 mg) or placebo. Follow-up visits were planned at day 14 and day 28 after the inclusion to assess the outcome of pruritus.


RESULTS
Forty-two subjects with pruritus were randomized to the ivermectin group and 40 to the placebo group. On day 14, pruritus was reported by significantly more subjects in the placebo group than those in the ivermectin group for both the per-protocol (PP) population (91.42% versus 68.57%, P = 0.014) and the intention-to-treat (ITT) population (92.5% versus 73.80%, P = 0.038). No significant effect was observed at day 28. Ivermectin was the only independent factor associated with the absence of pruritus at day 14 in both PP population [OR: 4.60 (95% CI:1.13; 18.73), P = 0.033] and ITT population [OR: 4.38 (95% CI: 1.07; 17.77), P = 0.039].


CONCLUSIONS
A single dose of oral ivermectin has a transient beneficial effect on the reduction of the prevalence of pruritus in the homeless population. More studies are required to assess the efficacy of multiple repeated treatments with ivermectin to reduce scabies and body lice endemic among homeless people with pruritus and the impact of such treatment on this population.
Badiaga
Sékéné
S
Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, 13185 Marseille, France.
Foucault
Cédric
C
Rogier
Christophe
C
Doudier
Barbara
B
Rovery
Clarisse
C
Dupont
Hervé Tissot
HT
Castro
Pierre
P
Raoult
Didier
D
Brouqui
Philippe
P
D000284:Administration, Oral; D000328:Adult; D000818:Animals; D004311:Double-Blind Method; D005602:France; D006703:Ill-Housed Persons; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage / Q000627:therapeutic use*; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use*; D010373:Lice Infestations / Q000188:drug therapy*; D008875:Middle Aged; D010374:Pediculus / Q000187:drug effects*; D010919:Placebos / Q000008:administration & dosage; D011537:Pruritus / Q000188:drug therapy*
D007306:Insecticides; D010919:Placebos; D007559:Ivermectin