Individual risk of post-ivermectin serious adverse events in subjects infected with Loa loa

Individual risk of post-ivermectin serious adverse events in subjects infected with Loa loa Chesnais Cédric auteur aut IRD Pion Sébastien auteur aut IRD Boullé C. auteur aut IRD Gardon Jacques auteur aut IRD Gardon-Wendel N. auteur aut IRD Fokom-Domgue J. auteur aut IRD Kamgno J. auteur aut IRD Boussinesq Michel auteur aut IRD text journalArticle eng text/pdf reformatted digital access Background:Implementation of onchocerciasis elimination programmes has been delayed in Central Africa because of the risk of ivermectin-related serious adverse events (SAEs) in individuals with high Loa loamicrofilarial densities (MFD). We developed the first statistical models enabling prediction of SAE risk in individuals with a given MFD. Methods:We used individual participant data from two trials conducted in loiasis-onchocerciasis co-endemicareas in Cameroon. among the 10 506 ivermectin-treated subjects included in the analysis, 38 (0¢36%) devel-oped an ivermectin-related SAE. To predict individual-level risk of SAE, we developed mixed multivariatelogistic models including subjects'sex, age, pre-treatment L loa and Mansonella perstans MFDs, and study region. Findings:The models predicted that regardless of sex, about 1% of people with 20 000L loa microfilariae permillilitre of blood (mf/mL), 10% of people with 50 000 mf/mL and about one third of those with 100 000 mf/mL will develop an SAE. For a given MFD, males have a three-fold higher risk of developing an SAE than females. Interpretation:By enabling the prediction of post-ivermectin SAE risk in communities with known distribution of L loa MFDs, our results can guide decisions on the choice of ivermectin-based treatment strategies.They also predict that 37 SAEs were prevented in 2015 by using a Test-and-Treat strategy in the Okola District of Cameroon.Funding:UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases; Institut de Recherche pour le Developpement; Mectizan Donation Program; Bill and Melinda Gates Foundation specialized CAMEROUN CENTRE CAMEROUN EST 052MALTRA05 050MEDECI EClinicalMedecine 28 100582 [7 ] 2020 2589-5370 https://www.documentation.ird.fr/hor/fdi:010081576 10.1016/j.eclinm.2020.100582 2589-5370 [F B010081576] https://www.documentation.ird.fr/hor/fdi:010081576 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers21-04/010081576.pdf IRD - Base Horizon / Pleins textes 2021-02-26 2025-02-24 fdi:010081576 fre