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A community trial of ivermectin for onchocerciasis in Sierra Leone: compliance and parasitological profiles after three and a half years of intervention
Author(s) -
Whitworth J. A. G.,
Downham M. D.,
Lahai G.,
Maude G. H.
Publication year - 1996
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1046/j.1365-3156.1996.d01-3.x
Subject(s) - ivermectin , onchocerciasis , sierra leone , medicine , confidence interval , randomized controlled trial , demography , veterinary medicine , immunology , socioeconomics , sociology
Summary We have studied the compliance patterns and the long‐term effects of repeated ivermectin at various dosing intervals in a randomized controlled trial. The setting for the trial was six neighbouring communities hyperendemic for onchocerciasis in southern Sierra Leone. A total of 335 subjects attended a survey 18 months after the fifth treatment round. Of those randomized to ivermectin, over 85 % had received at least three doses. There was no evidence that women of childbearing age were consistently under‐treated, despite the criteria for exclusion from treatment. An intention‐to‐treat analysis showed that a 6‐monthly ivermectin treatment regime satisfactorily suppressed microfilarial loads. Microfilarial repopulation was significantly slower over an 18‐month period after multiple doses compared to a single dose. Further analysis of microfilarial repopulation suggests that there is a cumulative suppressive effect after at least the first three doses of ivermectin, and that an annual treatment interval is as effective for short‐term microfilarial suppression as a 6‐monthly interval.