RESUMEN
Scabies is a prevalent ectoparasitic infectious disease, caused by the mite Sarcoptes scabiei. As a consequence of the infestation, localised cutaneous inflammation, pruritus and polymorphic skin lesions develop. The primary symptoms of scabies manifest as hypersensitivity-like reactions and immune responses, the precise mechanisms of which remain poorly defined. The objective of this study was to evaluate the effects of oral ivermectin treatment in patients with scabies on the systemic immune response and the patient's quality of life (QoL). Patients admitted to the dermatology outpatient clinic and diagnosed with scabies were administered oral ivermectin treatment following diagnosis at week 0 and 2. Laboratory tests were conducted to measure complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels before treatment and at week 4. The systemic immune-inflammation index (SII) was calculated using the platelet, neutrophil and lymphocyte counts. Additionally, data pertaining to the Dermatological Life Quality Index (DLQI) were recorded. In 119 patients (51 males) diagnosed with scabies, increases in ESR, CRP, and SII values and decreases in inflammatory cell counts and DLQI scores were observed one month after treatment with oral ivermectin. The results of the study showed that the use of oral ivermectin, a scabicidal agent, triggered the inflammatory response and improved the QoL of the patients.
Asunto(s)
Proteína C-Reactiva , Ivermectina , Calidad de Vida , Escabiosis , Humanos , Escabiosis/tratamiento farmacológico , Escabiosis/inmunología , Ivermectina/administración & dosificación , Ivermectina/uso terapéutico , Masculino , Femenino , Persona de Mediana Edad , Administración Oral , Adulto , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Anciano , Adulto Joven , Adolescente , Antiparasitarios/administración & dosificación , Antiparasitarios/uso terapéutico , Sarcoptes scabiei/efectos de los fármacos , Sarcoptes scabiei/inmunología , Sedimentación Sanguínea , Inflamación/inmunología , Inflamación/tratamiento farmacológico , Resultado del Tratamiento , AnimalesRESUMEN
Murine fur mites are commonly excluded in modern research animal programs, yet infestations continue to persist due to challenges in detection and control. Because all diagnostic methods and treatment options have limitations, programs must make many operational decisions when trying to eradicate these ectoparasites. The primary aim of this study was to assess various durations of treatment time with an ivermectin-compounded diet in eliminating Radfordia affinis in mice as determined by PCR testing and pelt examination. A shorter treatment duration would be highly advantageous as compared with the current regimen of 8 wk as it would minimize cost and time for animal management programs, impediments to research, and ivermectin drug effects on infested animals. Five experimental groups of R. affinis -positive mice received dietary ivermectin for 0, 2, 4, 6, or 8 wk. A fur mite-negative, naïve mouse was added to each group every 8 wk to perpetuate the infestation and amplify any remaining populations of fur mites. At 16 wk after the respective treatment end, PCR testing was performed for all treated groups in conjunction with the positive control group (no treatment). Visual examination of pelts for mites and eggs via direct microscopy was also performed at each time point. All treated mice were free of R. affinis at 16 wk after the end of treatment as confirmed by both PCR testing and pelt examination. These findings indicate that a dietary ivermectin treatment duration of as little as 2 wk is effective in eliminating R. affinis, making successful eradication initiatives more achievable.
Asunto(s)
Ivermectina , Infestaciones por Ácaros , Animales , Ivermectina/administración & dosificación , Ratones , Infestaciones por Ácaros/tratamiento farmacológico , Infestaciones por Ácaros/veterinaria , Infestaciones por Ácaros/prevención & control , Ácaros/efectos de los fármacos , Antiparasitarios/administración & dosificación , Enfermedades de los Roedores/tratamiento farmacológico , Enfermedades de los Roedores/parasitología , Enfermedades de los Roedores/prevención & control , Femenino , Factores de Tiempo , Dieta/veterinariaRESUMEN
Amblyomma maculatum, the Gulf Coast tick, infests a wide range of vertebrate species including livestock, dogs, cats, and humans. It is a species of significant veterinary and public health importance, especially as a vector of diseases, for instance American canine hepatozoonosis or tidewater spotted fever. An experimental study was conducted to evaluate the efficacy of NexGard® Combo, a topical endectoparasiticide product for cats combining eprinomectin, praziquantel and esafoxolaner, against induced infestations of A. maculatum in cats. This Good Clinical Practice (GCP) study used a randomized, negative controlled, masked design. Ten cats were allocated to an untreated group and ten to a treated group, dosed once on Day 0 at the minimum label dose. On Days -2, 7, 14, 21, 28, 35, and 42, cats were infested with ~50 unfed adult A. maculatum. On Days 3, 10, 17, 24, 31, 38, and 45, i.e., 72 h after treatment and subsequent infestations, ticks were removed, counted and the numbers of live attached tick in each group were used for efficacy calculations. At each time-point, all untreated cats were adequately infested, demonstrating a vigorous tick population and an adequate study model. The curative efficacy after a single application against existing tick infestation, 72 h after treatment, was 98.7%. The preventive efficacy, 72 h after weekly infestations, over the following five weeks ranged from 93.8% to 99.4%.
Title: Efficacité d'une association topique d'esafoxolaner, d'éprinomectine et de praziquantel contre les infestations par Amblyomma maculatum chez le chat. Abstract: Amblyomma maculatum, la tique de la Gulf Coast, infeste un large éventail d'espèces de vertébrés, notamment le bétail, les chiens, les chats et les humains. Il s'agit d'une espèce d'importance significative en médecine vétérinaire et en santé publique, notamment en tant que vecteur de maladies, par exemple l'hépatozoonose canine américaine ou la fièvre pourprée des marées. Une étude expérimentale a été menée pour évaluer l'efficacité de NexGard® Combo, un produit endectoparasiticide topique pour chats associant éprinomectine, praziquantel et esafoxolaner, contre les infestations par A. maculatum provoquées chez le chat. Cette étude de bonnes pratiques cliniques (BPC) a utilisé une conception randomisée, contrôlée négativement et masquée. Dix chats ont été répartis dans un groupe non traité et dix chats dans un groupe traité, traités une fois au jour 0 à la dose minimale indiquée sur l'étiquette. Aux jours −2, 7, 14, 21, 28, 35 et 42, les chats ont été infestés par environ 50 A. maculatum adultes non nourris. Les jours 3, 10, 17, 24, 31, 38 et 45, c'est-à-dire 72 heures après le traitement et les infestations ultérieures, les tiques ont été retirées, comptées et le nombre de tiques vivantes attachées dans chaque groupe a été utilisé pour les calculs d'efficacité. À chaque instant, tous les chats non traités étaient correctement infestés, démontrant une population de tiques vigoureuse et un modèle d'étude adéquat. L'efficacité curative après une seule application contre une infestation de tiques existante, 72 heures après le traitement, était de 98,7%. L'efficacité préventive, 72 heures après les infestations hebdomadaires, au cours des cinq semaines suivantes, variait entre 93,8% et 99,4%.
Asunto(s)
Amblyomma , Enfermedades de los Gatos , Ivermectina , Praziquantel , Infestaciones por Garrapatas , Animales , Praziquantel/administración & dosificación , Praziquantel/uso terapéutico , Gatos , Enfermedades de los Gatos/tratamiento farmacológico , Enfermedades de los Gatos/parasitología , Infestaciones por Garrapatas/veterinaria , Infestaciones por Garrapatas/tratamiento farmacológico , Infestaciones por Garrapatas/parasitología , Ivermectina/administración & dosificación , Ivermectina/uso terapéutico , Ivermectina/análogos & derivados , Femenino , Masculino , Administración Tópica , Combinación de Medicamentos , Resultado del Tratamiento , Acaricidas/administración & dosificación , Acaricidas/uso terapéuticoRESUMEN
The metastrongyloids Aelurostrongylus abstrusus and Troglostrongylus brevior are primary causes of feline clinical respiratory disease. The present field trial evaluated the clinical efficacy of a spot-on formulation containing eprinomectin, esafoxolaner and praziquantel (NexGard® Combo) administered per label recommendations to cats affected with aelurostrongylosis and/or troglostrongylosis. Overall, 36 naturally infected cats were randomly assigned to Group 1 (G1) or Group 2 (G2) of 18 cats each. The two groups included 6 cats with A. abstrusus, T. brevior and mixed infection, each. All cats completed the study. Cats in G1 were treated on study Days (SDs) 0 and 28±2. Cats in G2 served as negative control until SD 56±2 and were then treated on SD 56±2 and 84±2. On SD 0/-7, 28±2 and SD 56±2 all cats were subjected to parasitological (quali-quantitative Baermann) and clinical examinations (physical exams and thoracic X-rays). Hematology and biochemistry analyses were performed on SD 0/-7 and SD 56±2. On SD 84±2 quali-quantitative Baermann, clinical examination and thorax radiography were performed on all G2 cats and on two G1 cats that still had radiographic alterations on SD 56±2. On SD 112±2 all G2 cats were subjected to parasitological and clinical evaluations and one cat from G1 that still had radiographic signs at SD 84±2 was clinically and radiographically evaluated. Efficacy criteria were the reduction of larval shedding in faeces and the clinical response in terms of pathological and radiographic scores after treatment compared to the baseline. An efficacy of 100â¯% based on LPG reduction was recorded after one (20/24 cats) or two (all 24 cats) treatments in cats with single infection by A. abstrusus or T. brevior. For cats with mixed infections, larval shedding was stopped after one (11/12 cats) or two (all 12 cats) treatments. Statistically significant clinical and radiographic improvement was evident in all study cats after 2 treatments. The present data show that two monthly treatments with NexGard® Combo stopped larval shedding and led to a significant clinical recovery and a complete resolution of radiographic abnormalities in cats infected with A. abstrusus and/or T. brevior.
Asunto(s)
Enfermedades de los Gatos , Ivermectina , Metastrongyloidea , Praziquantel , Infecciones por Strongylida , Animales , Gatos , Praziquantel/administración & dosificación , Praziquantel/uso terapéutico , Enfermedades de los Gatos/tratamiento farmacológico , Enfermedades de los Gatos/parasitología , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Ivermectina/análogos & derivados , Infecciones por Strongylida/tratamiento farmacológico , Infecciones por Strongylida/veterinaria , Infecciones por Strongylida/parasitología , Metastrongyloidea/efectos de los fármacos , Masculino , Femenino , Combinación de Medicamentos , Antihelmínticos/administración & dosificación , Antihelmínticos/uso terapéutico , Heces/parasitología , Resultado del TratamientoRESUMEN
Cyathostomins are the largest group of parasites in horses that can be controlled by ivermectin (IVM). This study aimed to run a four-dose titration trial of IVM in 28 naturally infected Thoroughbred yearlings. The local Strongyle population had been recorded to be resistant to IVM (200 µg/kg). The parasite fecal egg count (FEC) was performed to investigate the egg reappearance period (ERP) of two and five weeks (w2pt and w5pt) after IVM treatment. FEC was > 1000 on day zero for all groups. Although 100% FEC reduction was reported at w2pt for all concentrations, the FEC at w5pt revealed < 83% efficacy. This study reports the reduction of ERP using the label dose as well as 300, and 400 µg/kg (double dose) of IVM. The protocol allowed IVM to significantly suppress FEC w2pt although not eliminating adult worms, failing to guarantee an extension of its protection period over 8 weeks. Moreover, the FEC at w5pt possibly means the infection was not cleared, and worms reestablished egg laying. We raised the possibility of withdrawing IVM of control programs when the drug has less than 80% FEC reduction at w5pt.
Asunto(s)
Ivermectina , Recuento de Huevos de Parásitos , Animales , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Caballos/parasitología , Brasil , Enfermedades de los Caballos/parasitología , Enfermedades de los Caballos/tratamiento farmacológico , Enfermedades de los Caballos/diagnóstico , Femenino , Antiparasitarios/uso terapéutico , Antiparasitarios/administración & dosificación , Infecciones Equinas por Strongyloidea/tratamiento farmacológico , Infecciones Equinas por Strongyloidea/parasitología , Infecciones Equinas por Strongyloidea/diagnóstico , Heces/parasitologíaRESUMEN
Treatment of livestock with endectocides such as ivermectin is viewed as a complementary vector control approach to address residual transmission of malaria. However, efficacy of this treatment may vary between animal species. Hence, our purpose was to investigate the effects of ivermectin treatments of common livestock species on life history traits of the opportunistic malaria vector Anopheles coluzzii. Sheep, goats and pigs were treated using injectable veterinary ivermectin formulation at the species-specific doses (recommended dose for all species and high dose in pig). Mosquito batches were exposed to treated and control (not injected) animals at different days after treatment. Daily mosquito mortality was recorded and fecundity assessed through the count of gravid females and the number of eggs they developed. The recommended dose of ivermectin induced a significant decrease in mosquito survival for up to 7 days after injection (DAI), with a decrease of 89.7%, 66.7%, and 48.4% in treated pigs, goats and sheep, respectively, compared to control animals. In treated pigs, the triple therapeutic dose decreased mosquito survival of 68.97% relatively to controls up to 14 DAI. The average number in gravid females Anopheles that survived after feeding on treated animals were reduced when blood-meals were taken on sheep (2.57% and 42.03% at 2 and 7 DAI), or on goats (decrease of the 28.28% and 73.64% respectively at 2 and 7 DAI). This study shows that ivermectin treatments to animals negatively impacts An. coluzzii life history traits and could reduce vector densities in areas where livestock live near humans. However, due to short-term efficacy of single dose treatments, repeated treatments and potentially increased dosages would be required to span the transmission season. The use of long-acting ivermectin formulations is discussed as a mean for extending efficacy while remaining cost effective.
Asunto(s)
Anopheles , Ivermectina , Malaria , Mosquitos Vectores , Animales , Ivermectina/farmacología , Ivermectina/administración & dosificación , Anopheles/efectos de los fármacos , Anopheles/fisiología , Femenino , Mosquitos Vectores/efectos de los fármacos , Mosquitos Vectores/fisiología , Malaria/transmisión , Malaria/prevención & control , Ovinos , Porcinos , Ganado , Cabras , Insecticidas/farmacología , Insecticidas/administración & dosificación , Control de Mosquitos/métodosRESUMEN
The World Health Organization (WHO) endorsed the use of triple-drug mass drug administration (MDA) regimen with ivermectin, diethylcarbamazine (DEC) and albendazole (commonly abbreviated as IDA) to accelerate the elimination of lymphatic filariasis (LF) as a public health problem in settings where onchocerciasis is not co-endemic. The National Programme for Elimination of LF (NPELF) in Kenya was among the first adopters of the IDA-MDA and two annual rounds were provided in 2018 and 2019 to the residents of Lamu County and Jomvu sub-County in the coast region. This study documented the feasibility of successfully delivering the two rounds of IDA-MDA. An operational research study was undertaken to determine efficient sampling strategies, indicators, and the appropriate population groups that could be used for the monitoring and evaluation of LF programs using IDA-MDA for the elimination of the disease as a public health problem. Two cross-sectional surveys were conducted at baseline in 2018 before IDA-MDA and an impact assessment 17 months after the second round of IDA-MDA. The reported epidemiological treatment coverage was at least 80% in all implementation units during each round of IDA-MDA. Blood samples were tested for filarial antigenemia using commercial Filariasis Test Strips (FTS) and any individual found to be positive was tested again at night for the presence of microfilariae in finger prick blood smears using microscopy. The overall prevalence of circulating filarial antigen (CFA) was relatively low at the baseline survey with Jomvu having 1.39% (95% CI: 0.91, 2.11) and Lamu having 0.48% (95% CI: 0.21, 1.13). Significant reduction in CFA prevalence was observed during the impact assessment after the two annual rounds of mass treatment. The overall relative reduction (%) in CFA prevalence following the two rounds of MDA with IDA was significant in both Jomvu (52.45%, Z = -2.46, P < 0.02) and Lamu (52.71%, Z = -1.97, P < 0.05). Heterogeneity, however, was observed in the CFA prevalence reduction between random and purposive clusters, as well as between adult and child populations. The results of the impact assessment survey offered strong evidence that it was safe to stop the IDA-MDA in the two EUs because transmission appears to have been interrupted. It is also important to implement a post-treatment surveillance system which would enable efficient detection of any recrudescence of LF transmission at a sub-evaluation unit level. Our findings show that IDA-MDA may be considered for acceleration of LF elimination in other settings where onchocerciasis is not co-endemic.
Asunto(s)
Albendazol , Dietilcarbamazina , Erradicación de la Enfermedad , Quimioterapia Combinada , Filariasis Linfática , Filaricidas , Ivermectina , Administración Masiva de Medicamentos , Filariasis Linfática/tratamiento farmacológico , Filariasis Linfática/epidemiología , Filariasis Linfática/prevención & control , Humanos , Albendazol/uso terapéutico , Albendazol/administración & dosificación , Dietilcarbamazina/administración & dosificación , Dietilcarbamazina/uso terapéutico , Kenia/epidemiología , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Femenino , Masculino , Adulto , Adolescente , Adulto Joven , Filaricidas/uso terapéutico , Filaricidas/administración & dosificación , Persona de Mediana Edad , Niño , Erradicación de la Enfermedad/métodos , Estudios Transversales , Animales , Prevalencia , Anciano , Preescolar , Wuchereria bancrofti/efectos de los fármacos , Wuchereria bancrofti/aislamiento & purificaciónRESUMEN
BACKGROUND: Evidence on ivermectin as a treatment for Covid-19 is controversial. A Cochrane review concluded that the efficacy and safety of ivermectin is uncertain (evidence up to April 2022) and WHO recommended its use only in the setting of clinical trials. This study aimed to assess the efficacy and safety of oral ivermectin in hospitalized patients with mild to moderate Covid-19. TRIAL DESIGN AND METHODS: A double-blind, randomized placebo-controlled clinical trial was conducted among RT-PCR-confirmed, adults, hospitalised within the first four days of symptoms. Patients received oral ivermectin 24 mg or placebo daily for five days. RT-PCR was repeated on days five and ten. Clinical progression was monitored using the World Health Organization Clinical Progression Scale. Serum ivermectin levels were measured on days three, five, and seven. The primary outcome was the difference in the viral load between day zero and ten in the two groups. RESULTS: Out of 1699 patients screened, 249 underwent randomization and 127 received ivermectin, and 122 placebo. D10 median viral load for E gene (IQR) was 2,000 copies/mL (100 - 20,500) with ivermectin (n = 80) and 4,100 copies/mL (1,000-65,600) with placebo (n = 81, p = 0.028), per protocol analysis. The difference in Log viral load between day zero and ten between ivermectin and placebo was 3.72 and 2.97 respectively (p = 0.022). There was no significant difference in the WHO clinical progression scale or the adverse effects. Ivermectin blood levels taken before or with meals were not significantly different. Only 7 and 17 patients achieved blood levels above 160ng/ML and 100ng/ML respectively and they did not achieve a significantly lower viral load. CONCLUSION: Although ivermectin resulted in statistically significant lower viral load in patients with mild to moderate Covid-19, it had no significant effect on clinical symptoms. TRIAL REGISTRATION NUMBER: SLCTR/2021/020, Sri Lanka Clinical Trials Registry. 19/07/2021.
Asunto(s)
Tratamiento Farmacológico de COVID-19 , Ivermectina , SARS-CoV-2 , Carga Viral , Humanos , Ivermectina/administración & dosificación , Ivermectina/efectos adversos , Ivermectina/uso terapéutico , Método Doble Ciego , Masculino , Femenino , Persona de Mediana Edad , Administración Oral , Carga Viral/efectos de los fármacos , Adulto , SARS-CoV-2/genética , SARS-CoV-2/efectos de los fármacos , Resultado del Tratamiento , COVID-19/virología , Anciano , Antivirales/administración & dosificación , Antivirales/uso terapéutico , Antivirales/efectos adversosRESUMEN
BACKGROUND: The World Health Organization's 2021-2030 Road Map for Neglected Tropical Diseases boosted global commitment towards the elimination of onchocerciasis, but the timeline to elimination will vary strongly between countries in Africa. To assess progress towards elimination in the Republic of Togo, we reviewed the history of control and time trends in infection. METHODOLOGY/PRINCIPAL FINDINGS: We collated all available programmatic, entomological, and epidemiological data since the initiation of the Onchocerciasis Control Programme (OCP) in Togo through different data sources. We then visualised data trends over time, to assess the impact of interventions on infection and transmission levels. Vector control was initiated by OCP from 1977 (northern and central parts of Togo) or 1988 (southern regions) up to 2002 (most areas) or 2007 ("special intervention zones" [SIZ], parts of Northern and Central Togo). Between 1988 and 1991, Togo initiated ivermectin mass drug administration (MDA) in eligible communities. The impact of vector control was high in most river basins, resulting in low annual biting rates and annual transmission potential declining to very low levels; the impact was lower in river basins designated as SIZ. Repeated, longitudinal ivermectin mass treatments have overall strongly reduced onchocerciasis transmission in Togo. Epidemiological surveys performed between 2014 and 2017 showed that the prevalence of skin microfilariae (mf) and anti-OV16 IgG4 antibodies had declined to low levels in several districts of the Centrale, Plateaux, and Maritime region. Yet, relatively high mf prevalences (between 5.0% and 32.7%) were still found in other districts during the same period, particularly along the Kéran, Mô and Ôti river basins (SIZ areas). CONCLUSIONS/SIGNIFICANCE: Trends in infection prevalence and intensity show that onchocerciasis levels have dropped greatly over time in most areas. This demonstrates the large impact of long-term and wide-scale interventions, and suggest that several districts of Togo are approaching elimination.
Asunto(s)
Ivermectina , Oncocercosis , Togo/epidemiología , Humanos , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Oncocercosis/epidemiología , Oncocercosis/transmisión , Oncocercosis/prevención & control , Animales , Administración Masiva de Medicamentos , Insectos Vectores/parasitología , Control de Insectos/métodos , Onchocerca volvulus , FemeninoRESUMEN
Pentylenetetrazole- (PTZ)-induced kindling is a broadly used experimental model to evaluate the impact of antiseizure drugs and their novel combination on seizure progression. The current study aimed to evaluate the anti-kindling effects of ivermectin (IVM) and rufinamide (RUFI) alone and their combination with vitamin E. The mice were administered 11 injections of PTZ (40 mg/kg) followed by assessment for anxiety-like behavior and cognitive abilities in a series of behavior tests with subsequent brain isolation for biochemical and histopathological evaluation. The outcomes showed a marked protection by IVM + RUFI (P<0.001) from kindling progression, anxiety-like behavior and cognitive deficit. However, additional supplementation with vitamin E worked superior to duo therapy as these mice were noted to be most fearless to visiting open, illuminated and elevated zones of open field, light/dark and elevated-plus maze (P<0.0001). Further, they showed marked remembrance of the familiar milieu in y-maze (P<0.01) and novel objection recognition (P<0.05) tests. Additionally, their recollection of aversive stimuli in passive avoidance and spatial memory in Morris water maze were evident (P<0.0001), in comparison to kindled mice. The IVM + RUFI duo therapy and its co-administration with vitamin E prevented kindling-triggered oxidative stress in brains and neuronal damage in hippocampus. We conclude that the benefits of the co-administration of vitamin E might be the results of antioxidant and anti-inflammatory effects of vitamin E which might be potentiating the antiseizure effects of RUFI and GABA-A modulating potential by ivermectin.
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Anticonvulsivantes , Conducta Animal , Ivermectina , Excitación Neurológica , Pentilenotetrazol , Convulsiones , Triazoles , Vitamina E , Animales , Excitación Neurológica/efectos de los fármacos , Vitamina E/farmacología , Vitamina E/administración & dosificación , Ratones , Ivermectina/farmacología , Ivermectina/administración & dosificación , Anticonvulsivantes/farmacología , Anticonvulsivantes/administración & dosificación , Masculino , Convulsiones/tratamiento farmacológico , Conducta Animal/efectos de los fármacos , Triazoles/farmacología , Triazoles/administración & dosificación , Quimioterapia Combinada , Ansiedad/tratamiento farmacológico , Aprendizaje por Laberinto/efectos de los fármacos , Encéfalo/efectos de los fármacos , Encéfalo/patología , Encéfalo/metabolismoRESUMEN
In Uganda, 15 of 17 foci have interrupted transmission of onchocerciasis (river blindness) and stopped mass drug administration (MDA) of ivermectin. This 2016 study describes the results of a knowledge, attitude, and practices survey regarding river blindness among participants (N = 1,577) 3-5 years after ivermectin MDA was halted in three foci: Imaramagambo halted in 2012, Kashoya-Kitomi in 2013, and Mt. Elgon in 2011. The study showed high levels of composite knowledge (focus-specific range: 66.8-81.2%) related to river blindness transmission, signs, symptoms, and treatment. However, 38.1% of respondents did not know that blackflies transmitted river blindness. Notably, 72.2% claimed they had not been informed why MDA was stopped, 56.3% did not believe river blindness had been eliminated, and 83.1% wanted ivermectin MDA to resume. During the 3-5 year post-treatment surveillance period, only 27.7% (438 of 1,577) reported being informed of what to do once treatments stopped, with the most knowledgeable hailing from the Mt. Elgon focus (47.9%). This study reinforces the need for programs to intensify health education and information dissemination when MDA is stopped. Programs must remind residents that although biting insects may persist, they no longer transmit river blindness. Incorporating messages about the elimination of river blindness into community health education campaigns can help improve the community's perceptions related to the disease's absence and the ending of a long-standing MDA intervention.
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Conocimientos, Actitudes y Práctica en Salud , Ivermectina , Humanos , Uganda/epidemiología , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Femenino , Masculino , Adulto , Persona de Mediana Edad , Oncocercosis Ocular/tratamiento farmacológico , Oncocercosis Ocular/transmisión , Oncocercosis Ocular/epidemiología , Animales , Encuestas y Cuestionarios , Adulto Joven , Administración Masiva de Medicamentos , Oncocercosis/transmisión , Oncocercosis/tratamiento farmacológico , Oncocercosis/epidemiología , Oncocercosis/prevención & control , AdolescenteRESUMEN
BACKGROUND & AIM: Rosacea is a chronic inflammatory, multifactorial disease for which combination therapy could be an effective treatment. In this study, we evaluate the effect of the combination therapy of brimonidine 0.33% and ivermectin 1% as a single cream for the treatment of papulopustular rosacea. METHOD: A stable and appropriate formulation was prepared by adding the aqueous phase to the lipid phase while being stirred. The stability and physicochemical properties of the formulation were evaluated under accelerated conditions. Twelve patients (36-60 years) with mild to moderate papulopustular rosacea and a Demodex count of five or more were treated with the combination of brimonidine 0.33% and ivermectin 1% cream. Clinician's Erythema Assessment (CEA), Patients Self-Assessment (PSA), skin erythema (ΔE) and lightness (ΔL), and skin biophysical parameters including transepidermal water loss (TEWL), skin hydration, pH, and sebum content, as well as erythema and melanin index and ultrasound parameters, were measured before treatment and 4 and 8 weeks after. Adverse drug reactions were also recorded. RESULTS: CEA and PSA decreased significantly from 3 to 2 after 8 weeks, respectively (p-value = 0.014 for CEA and 0.010 for PSA). ΔE and ΔL, as well as skin erythema index and TEWL improved after 8 weeks of treatment (p < 0.05). Two patients withdrew from the study in the first week because of local adverse effects; one developed flushing following treatment and left the investigation after 4 weeks and another patient withdrew from the study after 4 weeks due to deciding to become pregnant. CONCLUSION: Eight-week treatment with the combination of brimonidine 0.33% and ivermectin 1% was shown to be effective for improvement of erythema and inflammatory lesions in mild to moderate papulopustular rosacea.
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Tartrato de Brimonidina , Combinación de Medicamentos , Eritema , Ivermectina , Rosácea , Humanos , Rosácea/tratamiento farmacológico , Rosácea/diagnóstico , Tartrato de Brimonidina/administración & dosificación , Tartrato de Brimonidina/uso terapéutico , Adulto , Ivermectina/administración & dosificación , Ivermectina/uso terapéutico , Persona de Mediana Edad , Femenino , Masculino , Resultado del Tratamiento , Eritema/tratamiento farmacológico , Eritema/etiología , Crema para la Piel/administración & dosificación , Índice de Severidad de la Enfermedad , Administración Cutánea , Piel/efectos de los fármacos , Piel/patología , Pérdida Insensible de Agua/efectos de los fármacos , AnimalesRESUMEN
BACKGROUND: Preventive chemotherapy with ivermectin and albendazole (IA) in mass drug administration (MDA) programs for all at-risk populations is the core public health intervention to eliminate lymphatic filariasis (LF). Achieving this goal depends on drug effectiveness in reducing parasite reservoirs in the community to halt transmission. We assessed the efficacy of ivermectin and albendazole in clearing microfilariae and circulating filarial antigens (CFA) following MDA. METHODS: This community-based prospective study was conducted in Mkinga district, Tanga region, Tanzania, from November 2018 to June 2019. A total of 4115 MDA-eligible individuals were screened for CFA using Filarial test strips. CFA positives were re-examined for microfilariae by microscopy. CFA and microfilariae positive individuals were enrolled and received IA through MDA campaign. The status of microfilariae and CFA was monitored before MDA, and on day 7 and six-month following MDA. The primary efficacy outcomes were the clearance rates of microfilariae on day 7 and six-months, and CFA at 6 months of post-MDA. The McNemar test assessed the proportions of microfilariae positive pre- and post-MDA, while Chi-square tests were utilized to examine factors associated with CFA status six months post-MDA. RESULTS: Out of 4115 individuals screened, 239 (5.8%) tested positive for CFA, of whom 11 (4.6%) were also positive for microfilariae. Out of the ten microfilariae-positive individuals available for follow-up on day 7, nine tested negative, yielding a microfilariae clearance rate of 90% [95% confidence interval (CI): 59.6-98.2%]. Participants who tested negative for microfilariae on day 7 remained free of microfilariae six months after MDA. However, those who did not clear microfilariae on day-7 remained positive six-months post-MDA. The McNemar test revealed a significant improvement in microfilariae clearance on day 7 following MDA (P = 0.02). Out of 183 CFA-positive individuals who were available at 6-month follow-up, 160 (87.4%) remained CFA positive, while 23 became CFA negative. The CFA clearance rate at 6 months post-MDA was 12.6% (95% CI: 8.5-8.5%). There was no significant association of variability in ivermectin plasma exposure, measured by maximum concentration or area under the curve, and the clearance status of microfilariae or CFA post-MDA. CONCLUSIONS: Preventive chemotherapy with IA effectively clears microfilariae within a week. However, it is less effective in clearing CFA at six months of post-MDA. The low clearance rate for filarial antigenemia underscores the need for alternative drug combinations and additional preventive measures to achieve LF elimination by 2030.
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Albendazol , Filariasis Linfática , Filaricidas , Ivermectina , Administración Masiva de Medicamentos , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Albendazol/uso terapéutico , Albendazol/administración & dosificación , Tanzanía/epidemiología , Humanos , Filariasis Linfática/prevención & control , Filariasis Linfática/tratamiento farmacológico , Filariasis Linfática/transmisión , Estudios Prospectivos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adolescente , Adulto Joven , Animales , Niño , Filaricidas/uso terapéutico , Filaricidas/administración & dosificación , Quimioterapia Combinada , Microfilarias/efectos de los fármacos , Anciano , Preescolar , Antígenos Helmínticos/sangre , Resultado del TratamientoRESUMEN
Lymphatic filariasis is a neglected tropical disease that affects the lymphatic system of humans. The major etiologic agent is a nematode called Wuchereria bancrofti, but Brugia malayi and Brugia timoriare sometimes encountered as causative agents. Mosquitoes are the vectors while humans the definitive hosts respectively. The burden of the disease is heavier in Nigeria than in other endemic countries in Africa. This occurs with increasing morbidity and mortality at different locations within the country, the World Health Organization recommended treatments for lymphatic filariasis include the use of Albendazole (400mg) twice per year in co-endemic areas with loa loa, Ivermectin (200mcg/kg) in combination with Albendazole (400mg) in areas that are co-endemic with onchocerciasis, ivermectin (200mcg/kg) with diethylcarbamazine citrate (DEC) (6mg/kg) and albendazole (400mg) in areas without onchocerciasis. This paper covered a systematic review, meta-analysis, and scoping review on lymphatic filariasis in the respective geopolitical zones within the country. The literature used was obtained through online search engines including PubMed and Google Scholar with the heading "lymphatic filariasis in the name of the state", Nigeria. This review revealed an overall prevalence of 11.18% with regional spread of Northwest (1.59%), North Central and North East, (4.52%), South West (1.26%), and South-South with South East (3.81%) prevalence. The disease has been successfully eliminated in Argungu local government areas (LGAs) of Kebbi State, Plateau, and Nasarawa States respectively. Most clinical manifestations (31.12%) include hydrocele, lymphedema, elephantiasis, hernia, and dermatitis. Night blood samples are appropriate for microfilaria investigation. Sustained MDAs, the right testing methods, early treatment of infected cases, and vector control are useful for the elimination of lymphatic filariasis for morbidity management and disability prevention in the country. Regional control strategies, improved quality monitoring of surveys and intervention programs with proper records of morbidity and disability requiring intervention are important approaches for the timely elimination of the disease in Nigeria.
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Filariasis Linfática , Wuchereria bancrofti , Filariasis Linfática/epidemiología , Filariasis Linfática/tratamiento farmacológico , Humanos , Nigeria/epidemiología , Animales , Wuchereria bancrofti/aislamiento & purificación , Filaricidas/administración & dosificación , Filaricidas/uso terapéutico , Albendazol/administración & dosificación , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/parasitología , Ivermectina/administración & dosificación , Ivermectina/uso terapéutico , Brugia Malayi/aislamiento & purificaciónRESUMEN
Chronic myeloid leukemia is a hematological cancer, where disease relapse and drug resistance are caused by bone-hosted-residual leukemia cells. An innovative resolution is bone-homing and selective-active targeting of anticancer loaded-nanovectors. Herein, ivermectin (IVM) and methyl dihydrojasmonate (MDJ)-loaded nanostructured lipid carriers (IVM-NLC) were formulated then dually decorated by lactoferrin (Lf) and alendronate (Aln) to optimize (Aln/Lf/IVM-NLC) for active-targeting and bone-homing potential, respectively. Aln/Lf/IVM-NLC (1 mg) revealed nano-size (73.67 ± 0.06 nm), low-PDI (0.43 ± 0.06), sustained-release of IVM (62.75 % at 140-h) and MDJ (78.7 % at 48-h). Aln/Lf/IVM-NLC afforded substantial antileukemic-cytotoxicity on K562-cells (4.29-fold lower IC50), higher cellular uptake and nuclear fragmentation than IVM-NLC with acceptable cytocompatibility on oral-epithelial-cells (as normal cells). Aln/Lf/IVM-NLC effectively upregulated caspase-3 and BAX (4.53 and 15.9-fold higher than IVM-NLC, respectively). Bone homing studies verified higher hydroxyapatite affinity of Aln/Lf/IVM-NLC (1 mg; 22.88 ± 0.01 % at 3-h) and higher metaphyseal-binding (1.5-fold increase) than untargeted-NLC. Moreover, Aln/Lf/IVM-NLC-1 mg secured 1.35-fold higher in vivo bone localization than untargeted-NLC, with lower off-target distribution. Ex-vivo hemocompatibility and in-vivo biocompatibility of Aln/Lf/IVM-NLC (1 mg/mL) were established, with pronounced amelioration of hepatic and renal toxicity compared to higher Aln doses. The innovative Aln/Lf/IVM-NLC could serve as a promising nanovector for bone-homing, active-targeted leukemia therapy.
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Alendronato , Portadores de Fármacos , Ivermectina , Lactoferrina , Humanos , Animales , Portadores de Fármacos/química , Lactoferrina/química , Lactoferrina/farmacología , Lactoferrina/administración & dosificación , Alendronato/química , Alendronato/farmacología , Alendronato/administración & dosificación , Ivermectina/química , Ivermectina/análogos & derivados , Ivermectina/farmacología , Ivermectina/administración & dosificación , Ivermectina/farmacocinética , Células K562 , Nanopartículas/química , Ratones , Antineoplásicos/farmacología , Antineoplásicos/química , Antineoplásicos/administración & dosificación , Huesos/efectos de los fármacos , Huesos/metabolismo , Lípidos/química , Apoptosis/efectos de los fármacosRESUMEN
BACKGROUND: Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA. METHODOLOGY: In 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged ≥ 5 years invited to participate. Blood samples were tested for Ag and Mf. PRINCIPAL FINDINGS: Ag-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections. CONCLUSIONS/SIGNIFICANCE: This study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies.
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Albendazol , Dietilcarbamazina , Filariasis Linfática , Filaricidas , Ivermectina , Administración Masiva de Medicamentos , Filariasis Linfática/transmisión , Filariasis Linfática/epidemiología , Filariasis Linfática/tratamiento farmacológico , Filariasis Linfática/prevención & control , Humanos , Albendazol/administración & dosificación , Albendazol/uso terapéutico , Samoa/epidemiología , Dietilcarbamazina/administración & dosificación , Dietilcarbamazina/uso terapéutico , Ivermectina/administración & dosificación , Ivermectina/uso terapéutico , Masculino , Femenino , Adulto , Filaricidas/administración & dosificación , Filaricidas/uso terapéutico , Persona de Mediana Edad , Adolescente , Animales , Adulto Joven , Niño , Prevalencia , Antígenos Helmínticos/sangre , Quimioterapia Combinada , Preescolar , Wuchereria bancrofti/efectos de los fármacos , Wuchereria bancrofti/aislamiento & purificación , AncianoRESUMEN
In countries where soil-transmitted helminth (STH) infections are endemic, deworming programs are recommended to reduce morbidity; however, increasing levels of resistance to benzimidazoles are of concern. In an observational study in Peru, we studied the clinical efficacy of 400 mg of albendazole 20 days after treatment among children aged 2-11 years. Of 426 participants who provided samples, 52.3% were infected with a STH, 144 (33.8%) were positive for Ascaris (41.8% light, 50.8% moderate, and 7.4% heavy infections), 147 (34.5%) were positive for Trichuris (75.2% light, 22.5% moderate, and 2.3% heavy infections), and 1.1% were positive for hookworm species (100% light infections). Additional stool samples were examined at 20, 90, and 130 days after the initial treatment. At 20 days post-administration of albendazole, the cure rate (CR) of Ascaris infection was 80.1% (95% CI: 73.5-86.7), and the egg reduction rate (ERR) was 70.8% (95% CI: 57.8-88.7); the CR for Trichuris infection was 27.1% (95% CI: 20.0-34.3), and the ERR was 29.8% (95% CI: -1.40 to 57.5). Among participants with persistent or recurrent infections with Trichuris, the combined therapy of albendazole (400 mg) and ivermectin at 600 µg/dose increased overall CR for Trichuris infection to 75.2% (95% CI: 67.3-83.2%) with an ERR of 84.2% (95% CI: 61.3-93.8%). Albendazole administration alone for the control of STH was associated with high rates of treatment failure, especially for Trichuris. Combined single doses of albendazole and ivermectin was observed to have improved efficacy.
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Albendazol , Antihelmínticos , Helmintiasis , Ivermectina , Suelo , Humanos , Albendazol/uso terapéutico , Albendazol/administración & dosificación , Perú/epidemiología , Preescolar , Niño , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Masculino , Femenino , Suelo/parasitología , Helmintiasis/tratamiento farmacológico , Helmintiasis/epidemiología , Antihelmínticos/uso terapéutico , Antihelmínticos/administración & dosificación , Heces/parasitología , Quimioterapia Combinada , Animales , Resultado del Tratamiento , Tricuriasis/tratamiento farmacológico , Tricuriasis/epidemiología , Ascariasis/tratamiento farmacológico , Ascariasis/epidemiología , Trichuris/efectos de los fármacosAsunto(s)
Ivermectina , Rinofima , Ivermectina/administración & dosificación , Ivermectina/uso terapéutico , Humanos , Rinofima/tratamiento farmacológico , Rinofima/patología , Masculino , Femenino , Persona de Mediana Edad , Administración Tópica , Adulto , Antiparasitarios/administración & dosificación , Antiparasitarios/uso terapéutico , Resultado del Tratamiento , AncianoRESUMEN
BACKGROUND: The main vectors of onchocerciasis in Africa are Simulium damnosum sensu lato, which transmit the causative agent Onchocerca volvulus. The force of transmission is driven by the vector density, hence influencing the disease prevalence and intensity. Onchocerciasis is currently targeted for elimination using mass drug administration (MDA) of ivermectin, a potent microfilaricide. MDA in Cameroon began in 1987 in the Vina Valley, an endemic cross-border area with Chad, known for high vector densities and precontrol endemicity. Evaluations in 2008-2010 in this area showed ongoing transmission, while border areas in Chad were close to interrupting transmission. This study aimed to evaluate transmission in this area after several rounds of MDA since the last evaluation surveys. METHODS: Black flies were collected by human landing catches at seven border sites in Cameroon, twice a week, from August 2021 to March 2022. A fraction of the flies was dissected for parity assessment and identification of Onchocerca larval stages. The transmission indices were estimated. Black fly larvae were also collected from the breeding sites at the fly catching sites and identified to species level by cytotaxonomy. RESULTS: A total of 14,303 female flies were collected, and 6918 were dissected. Of these, 4421 (64.0%) were parous. The total biting rates were high, reaching up to 16,407 bites/person/study period, and transmission potential (third-stage larvae (L3) from head/all L3) were 367/702, 146/506, 51/55, 20/32, 0/3, 0/0, and 0/0 infective larvae/person, respectively, for Mbere-Tchad, Babidan, Hajam/V5, Gor, Djeing, Touboro, and Koinderi. Infectivity rates (L3 from head) were 16.00, 12.75, 5.15, and 4.07 infective females (L3H)/1000 parous flies for Haijam, Mbere-Tchad, Babidan, and Gor, respectively. These values exceed the World Health Organization (WHO) thresholds of ≤ 20 annual transmission potential (ATP) or < 1 infective female/1000 parous females. The major vectors identified were Simulium damnosum sensu stricto, S. squamosum, and for the first time in the area, S. yahense. CONCLUSIONS: More than 20 years of MDA has not eliminated onchocerciasis in the study area; hence, this area is a potential source of reintroduction of onchocerciasis in Chad and would require alternative treatment strategies. Many factors such as MDA efficiency, effectiveness of ivermectin, and cytospecies composition may be contributing to transmission persistence.
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Insectos Vectores , Ivermectina , Administración Masiva de Medicamentos , Onchocerca volvulus , Oncocercosis , Simuliidae , Oncocercosis/transmisión , Oncocercosis/epidemiología , Oncocercosis/tratamiento farmacológico , Animales , Camerún/epidemiología , Ivermectina/administración & dosificación , Simuliidae/parasitología , Humanos , Onchocerca volvulus/efectos de los fármacos , Onchocerca volvulus/fisiología , Insectos Vectores/parasitología , Insectos Vectores/efectos de los fármacos , Femenino , Chad/epidemiología , Larva , Filaricidas/administración & dosificación , Filaricidas/uso terapéutico , MasculinoRESUMEN
BACKGROUND: The health and productivity of dairy goats continue to be impacted by gastrointestinal nematodes (GIN) and lungworms (LW). Eprinomectin (EPN) is frequently selected for treatment because it is generally effective and does not require a milk withdrawal period. However, some factors, such as lactation, can have an impact on EPN pharmacokinetics and potentially its efficacy. To evaluate whether this can alter the efficacy of Eprecis® 2%, an eprinomectin injectable solution, a study was performed in lactating goats using the dose currently registered in cattle, sheep and goats (0.2 mg/kg). METHODS: This study was a blinded, randomized, controlled trial performed according to the VICH guidelines. Eighteen (18) worm-free lactating goats were included and experimentally challenged on day 28 with a mixed culture of infective gastrointestinal and lung nematode larvae (Haemonchus contortus, Trichostrongylus colubriformis, Teladorsagia circumcincta, Dictyocaulus filaria). At D-1, fecal samples were collected to confirm patent infection in all animals. On D0, the goats were randomly allocated into two groups of nine goats; group 1 was treated with Eprecis® 2% at 0.2 mg/kg BW by subcutaneous injection, while group 2 remained untreated. Fecal samples for egg counts were collected from all animals on days 3, 5, 7, 9, 11 and 14. On D14, all goats were killed, and the abomasum, small intestine and lungs were removed, processed and subsampled to record the number and species of worms. RESULTS: The treatment was well tolerated. After treatment, the arithmetic mean FEC decreased in the treated group and remained < 5 EPG until the end of the study, while the arithmetic mean FEC in the control group remained > 849.0 EPG. At D14, goats in the treated group had very limited or zero total worm counts, whereas all animals from the control group had a high worm burden. The measured efficacy was 100.0% against H. contortus and T. colubriformis, 99.9% against T. circumcincta and 98.0% against D. filaria. CONCLUSIONS: Eprinomectin (Eprecis®, 20 mg/ml), administered at the label dose (0.2 mg/kg), is highly effective against gastrointestinal nematodes and lungworms in lactating goats.