@article{fdi:010071413,
  title = {{M}acrofilaricidal efficacy of repeated doses of ivermectin for the treatment of river blindness},
  author = {{W}alker, {M}. and {P}ion, {S}{\'e}bastien and {F}ang, {H}. {W}. and {G}ardon, {J}acques and {K}amgno, {J}. and {B}asanez, {M}. {G}. and {B}oussinesq, {M}ichel},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {M}ass drug administration ({MDA}) with ivermectin is the cornerstone of efforts to eliminate human onchocerciasis by 2020 or 2025. {T}he feasibility of elimination crucially depends on the effects of multiple ivermectin doses on {O}nchocerca volvulus. {A} single ivermectin (standard) dose clears the skin-dwelling microfilarial progeny of adult worms (macrofilariae) and temporarily impedes the release of such progeny by female macrofilariae, but a macrofilaricidal effect has been deemed minimal. {M}ultiple doses of ivermectin may cumulatively and permanently reduce the fertility and shorten the lifespan of adult females. {H}owever, rigorous quantification of these effects necessitates interrogating longitudinal data on macrofilariae with suitably powerful analytical techniques. {M}ethods. {U}sing a novel mathematical modeling approach, we analyzed, at an individual participant level, longitudinal data on viability and fertility of female worms from the single most comprehensive multiple-dose clinical trial of ivermectin, comparing 3-monthly with annual treatments administered for 3 years in {C}ameroon. {R}esults. {M}ultiple doses of ivermectin have a partial macrofilaricidal and a modest permanent sterilizing effect after 4 or more consecutive treatments, even at routine {MDA} doses (150 mu g/kg) and frequencies (annual). {T}he life expectancy of adult {O}. volvulus is reduced by approximately 50% and 70% after 3 years of annual or 3-monthly (quarterly) exposures to ivermectin. {C}onclusions. {O}ur quantification of macrofilaricidal and sterilizing effects of ivermectin should be incorporated into transmission models to inform onchocerciasis elimination efforts in {A}frica and residual foci in {L}atin {A}merica. {I}t also provides a framework to assess macrofilaricidal candidate drugs currently under development.},
  keywords = {onchocerciasis ; river blindness ; ivermectin ; macrofilaricide ; multiple dose ; {CAMEROUN} ; {MBAM} {COURS} {D}'{EAU}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {65},
  numero = {12},
  pages = {2026--2034},
  ISSN = {1058-4838},
  year = {2017},
  DOI = {10.1093/cid/cix616},
  URL = {https://www.documentation.ird.fr/hor/fdi:010071413},
}