Chesnais C. B., Takougang I., Paguele M., Pion Sébastien, Boussinesq Michel. (2017). Excess mortality associated with loiasis : a retrospective population-based cohort study. Lancet Infectious Diseases, 17 (1), p. 108-116. ISSN 1473-3099.
Titre du document
Excess mortality associated with loiasis : a retrospective population-based cohort study
Année de publication
Chesnais C. B., Takougang I., Paguele M., Pion Sébastien, Boussinesq Michel
Lancet Infectious Diseases, 2017,
17 (1), p. 108-116 ISSN 1473-3099
Background The burden of loiasis has received limited attention and loiasis is still considered a benign condition. To assess whether loiasis bears any excess mortality, we did a retrospective cohort study in Cameroon. Methods In 2001, 3627 individuals living in 28 villages were examined for Loa loa infection. In 2016, these villages were revisited and the vital status was determined for 3301 individuals (91%). The data were analysed at community level to assess the relation between the level of L loa infection in 2001 and standardised mortality rates (SMRs), and at individual level to assess the excess mortality relative to the 2001 microfilaraemia and to calculate the population-attributable fraction of mortality associated with L loa microfilaraemia. Findings 915 deaths occurred during the follow-up time (mean time of 12.5 years [IQR 10.2-14.9]) between April, 2001, and March 22, 2016. Crude mortality rate was 20.3 deaths per 1000 person-years. SMRs increased by 4.1% when the proportion of participants infected with greater than 30 000 microfilariae per mL increased by 1% (p=0.030). People aged older than 25 years with greater than 30 000 microfilariae per mL in 2001 died significantly earlier than did amicrofilaraemic people (time ratio 0.67, 95% CI 0.48-0.95, p=0.024). The population-attributable fraction of mortality associated with presence of L loa microfilaraemia was 14.5% (95% CI 6.5-21.8, p=0.001). Interpretation High-grade L loa microfilaraemia is associated with an increased mortality risk, suggesting that loiasis is not a benign condition and merits more attention because of its effect on onchocerciasis and lymphatic control strategies. Loiasis should be considered for inclusion in the WHO's list of neglected tropical diseases.
Plan de classement
Entomologie médicale / Parasitologie / Virologie 
Fonds IRD [F B010068786]