title: Absence of an association between Plasmodium falciparum infection and post-ivermectin Loa-related non-neurologic serious adverse events.
abstract: Although ivermectin treatment can induce serious adverse events (SAEs) in individuals harboring high Loa loa microfilaremia (mf), not all patients with high mf levels develop such reactions, suggesting that cofactors may be involved. A study was conducted in Cameroon to investigate the possible role of Plasmodium coinfection at the time of ivermectin treatment in the development of SAEs. Before their first ivermectin treatment, thick smears were obtained from 4,175 individuals to determine the burden of Plasmodium sp., L. loa, and Mansonella perstans. After treatment, 18 (4.3 per 1,000) patients developed a non-neurologic SAE. Logistic regression analysis, adjusting for age, sex, P. falciparum infection, and M. perstans infection intensities, confirmed that L. loa mf was the main risk factor for SAEs. We found no evidence that coinfection with P. falciparum at the time of ivermectin treatment was associated with the occurrence of Loa-related SAEs in this population.
authors.affiliation: Center for Research on Filariasis and Other Tropical Diseases, Yaounde, Cameroon; UMI233, Institut de Recherche pour le Développement, Montpellier, France; Faculty of Sciences, University of Yaounde, Yaounde, Cameroon; Helen Keller International, Yaounde, Cameroon; Mectizan Donation Program, Decatur, Georgia; Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
authors.forename: Joël
authors.initials: J
authors.lastname: Fokom-Domgue
authors.forename: Sébastien D
authors.initials: SD
authors.lastname: Pion
authors.forename: Raceline
authors.initials: R
authors.lastname: Gounoue
authors.forename: Julie
authors.initials: J
authors.lastname: Akame
authors.forename: Patrick
authors.initials: P
authors.lastname: Nguipdop-Djomo
authors.forename: Nana A Y
authors.initials: NA
authors.lastname: Twum-Danso
authors.forename: Björn
authors.initials: B
authors.lastname: Thylefors
authors.forename: Michel
authors.initials: M
authors.lastname: Boussinesq
authors.forename: Joseph
authors.initials: J
authors.lastname: Kamgno
mesh_terms: D000328:Adult; D000818:Animals; D060085:Coinfection / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000009:adverse effects*; D008117:Loa / Q000187:drug effects; D016015:Logistic Models; D008118:Loiasis / Q000188:drug therapy* / Q000453:epidemiology*; D008288:Malaria / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008366:Mansonella / Q000302:isolation & purification; D008875:Middle Aged; D015999:Multivariate Analysis; D010963:Plasmodium falciparum / Q000302:isolation & purification; D012307:Risk Factors
chemical_list: D007559:Ivermectin