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|Title: ||Comparison of Repeated Doses of Ivermectin Versus Ivermectin Plus Albendazole for the Treatment of Onchocerciasis: A Randomized, Open-label, Clinical Trial|
|Authors: ||Debrah, Linda Batsa|
Ayisi-Boateng, Nana Kwame
Kazura, James W.
King, Christopher L.
|Issue Date: ||Sep-2019|
|Publisher: ||Clinical Infectious Diseases|
|Citation: ||Clinical Infectious Diseases|
|Abstract: ||Background: Improved treatment for onchocerciasis is needed to accelerate onchocerciasis elimination in Africa. Aiming to better exploit registered drugs, this study was undertaken to determine whether annual or semiannual treatment with ivermectin (IVM; 200µg/kg) plus albendazole (ALB; 800mg single dose) is superior to IVM alone. Methods: This trial was performed in Ghana and included 272 microfilaria (MF) -positive participants randomized to 4 treatment arms: 1) IVM annual at 0, 12, and 24 months; 2) IVM semiannual at 0, 6, 12, 18 and 24 months; 3) IVM+ALB annual; 4) IVM+ALB semiannual. Microfiladermia was determined pre-treatment and at 6, 18 and 36 months. The primary outcome was the proportion of fertile and viable female worms in onchocercomata excised at 36 months. Results: Post-treatment nodule histology showed that 15/135 (11.1%), 22/155 (14.2%), 35/154 (22.7%) and 20/125 (16.0%) living female worms had normal embryogenesis in the IVM annual, IVM semiannual, IVM+ALB annual and IVM+ALB semiannual groups respectively (p=0.1229). Proportions of dead worms also did not differ between the 4 groups (p=0.9198). Proportions of patients without MF at 36 months (one year after the last treatment) were 35/56 (63%) after annual IVM, 42/59 (71%) after semiannual IVM, 39/64 (61%) after IVM+ALB annual, and 43/53 (81%) after semiannual IVM+ALB. Conclusions: The combination treatment with IVM plus ALB was no better than IVM alone for sterilizing, killing of adult worms or achieving sustained MF clearance. However, semiannual treatment was superior to annual treatment for achieving sustained clearance of O. volvulus MF from the skin (p=0.024).|
|Description: ||This article is published in Clinical Infectious Diseases and also available at DOI: 10.1093/cid/ciz889|
|Appears in Collections:||College of Health Sciences|
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