@article{fdi:010092738,
  title = {{A}ssociation between {L}oa loa microfilaremia and anatomical hyposplenia in a rural area of the {R}epublic of {C}ongo : a population-based cross-sectional study},
  author = {{B}oull{\'e}, {C}. and {L}ebredonchel, {E}. and {C}ampillo, {J}{\'e}r{\'e}my and {D}upasquier, {V}. and {H}emilembolo, {M}. {C}. and {P}ion, {S}{\'e}bastien and {D}jontu, {J}. {C}. and {R}ance, {L}. and {S}outeyrand, {P}. and {M}issamou, {F}. and {B}oussinesq, {M}ichel and {N}toumi, {F}. and {C}hesnais, {C}{\'e}dric},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {D}ata suggest excess mortality is associated with loiasis, which is endemic to {C}entral {A}frica, although the underlying mechanisms remain unknown. {W}e hypothesized that there could be an association between {L}oa loa microfilarial densities ({MFD}) and lower spleen volume ({SV}) due to micro-obstruction linked to circulating microfilariae (mf). {T}his could result in functional hyposplenia and a higher burden of infections. {O}ur objective was to investigate the impact of {L}. loa {MFD} and malaria on spleen's bi-dimensional dimensions, volume, and parenchymal lesions. {M}ethods {W}e included 981 participants aged 18-88 years in a cross-sectional study conducted in {M}ay-{J}une 2022 in the {R}epublic of the {C}ongo. {C}entralized ultrasonographic examination was performed. {T}he primary outcomes included {SV}, splenomegaly (cranio-caudal-distance >= 13 cm), and anatomical hyposplenia ({AH}) ({SV} <= 80, <= 110 or <= 150 cm(3)). {B}lood samples were analyzed for {L}. loa {MFD}, {P}lasmodium-{PCR}, {A}nti-{P}lasmodium falciparum-{I}g{G}, total {I}g{M}, sickle-cell disease status, and hematological abnormalities. {L}inear and logistic regressions were used to assess these associations. {R}esults {A}mong 981 participants, 139 (14.1%) had splenomegaly, and 26 (2.7%) and 175 (17.8%) had {SV} <= 80 and <= 150 cm(3), respectively. {L}. loa microfilariae were detected in 353 (35.6%) participants. {A} gradient effect was observed in each model, with the highest {MFD} (> 30,000 mf/ml) having the highest adjusted odds ratio of 17.94 (95% {CI}: 2.91-110.76, {P} = 0.002), 5.94 (95% {CI}: 1.40-25.17, {P} = 0.016), and 5.77 (95% {CI}: 1.95-17.12, {P} = 0.002) for {SV} <= 80, 110, and 150 cm(3), respectively. {A}nti-{P}. falciparum-{I}g{G} levels were gradually associated with splenomegaly. {F}ourteen participants met the criterion for hyper-reactive malarial splenomegaly ({HMS}). {C}onversely, higher {L}. loa {MFD} was correlated with {AH}, with an attributable fraction of 25%, and the presence of splenic parenchymal lesions. {C}onclusions {T}his study provides a detailed description of spleen morphology and the factors influencing its size in a rural central {A}frican population. {I}t demonstrates a strong association between {L}. loa {MFD} and reduced {SV}, suggesting that loiasis may lead to {AH}, and potentially to functional hyposplenia, with consequences such as increased susceptibility to bacterial infections. {M}alaria was associated with splenomegaly, with a figure of {HMS} consistent with estimates from other {A}frican countries.},
  keywords = {{L}oiasis ; {S}pleen ; {U}ltrasonographic examination ; {M}alaria ; {P}arasitic diseases ; {S}plenomegaly ; {H}yposplenism ; {REPUBLIQUE} {DEMOCRATIQUE} {DU} {CONGO}},
  booktitle = {},
  journal = {{I}nfectious {D}iseases of {P}overty},
  volume = {14},
  numero = {1},
  pages = {8 [15 p.]},
  ISSN = {2095-5162},
  year = {2025},
  DOI = {10.1186/s40249-025-01277-w},
  URL = {https://www.documentation.ird.fr/hor/fdi:010092738},
}