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Structure of the microfilarial reservoir of Loa loa in the human host and its implications for monitoring the programmes of Community-Directed Treatment with Ivermectin carried out in Africa

Published online by Cambridge University Press:  05 October 2004

S. D. S. PION ,
J. GARDON ,
J. KAMGNO ,
N. GARDON-WENDEL ,
J. P. CHIPPAUX  and
M. BOUSSINESQ
S. D. S. PION
Affiliation:
Laboratoire Mixte IRD–CPC (Institut de Recherche pour le Développement – Centre Pasteur du Cameroun) d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun Institut de Recherche pour le Développement, Unité de recherche 079-GEODES, 32 avenue Henri Varagnat, 93143 Bondy Cedex, France
J. GARDON
Affiliation:
Laboratoire Mixte IRD–CPC (Institut de Recherche pour le Développement – Centre Pasteur du Cameroun) d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun
J. KAMGNO
Affiliation:
Laboratoire Mixte IRD–CPC (Institut de Recherche pour le Développement – Centre Pasteur du Cameroun) d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun
N. GARDON-WENDEL
Affiliation:
Laboratoire Mixte IRD–CPC (Institut de Recherche pour le Développement – Centre Pasteur du Cameroun) d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun
J. P. CHIPPAUX
Affiliation:
Laboratoire Mixte IRD–CPC (Institut de Recherche pour le Développement – Centre Pasteur du Cameroun) d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun Institut de Recherche pour le Développement, B. P. 1 386, Dakar, Sénégal
M. BOUSSINESQ
Affiliation:
Laboratoire Mixte IRD–CPC (Institut de Recherche pour le Développement – Centre Pasteur du Cameroun) d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun Institut de Recherche pour le Développement, Département Sociétés et Santé, 213 rue La Fayette, 75480 Paris Cedex 10, France
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Abstract

This paper describes the structure of the microfilarial reservoir of Loa loa in an endemic population of central Cameroon. The possible effects of age and sex on the prevalence and intensity of microfilaraemia have been explored. Logistic analysis showed that the prevalence of microfilaraemia increased significantly with age, reaching 60% in the oldest males. This result suggests that the figure commonly reported, according to which only one third of the infected individuals were microfilaraemic, should be reconsidered; in addition, as part of surveys of loiasis, crude microfilaraemia prevalence values should be replaced by adjusted ones. The intensity of infection did not show any age-specific change. As a result, even if the oldest members of the male population are clearly the most at risk of developing post-ivermectin serious adverse reactions, especially Loa-encephalopathy, the other members of the population are not risk-free. Therefore, in those areas where the African Programme for Onchocerciasis Control is undertaking regular mass distributions of ivermectin for onchocerciasis control, and where loiasis is co-endemic, no subpopulation should be excluded from surveillance and monitoring during community directed treatments with ivermectin.

Keywords

Loa loamicrofilaraemiainfection age-profilesivermectinserious adverse reactionsindividuals at riskCameroon
Type
Research Article
Information
Parasitology , Volume 129 , Issue 5 , November 2004 , pp. 613 - 626
Copyright
© 2004 Cambridge University Press

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