In Southern Nigeria Loa loa Blood Microfilaria Density is Very Low Even in Areas with High Prevalence of Loiasis: Results of a Survey Using the New LoaScope Technology

The American Journal of Tropical Medicine and Hygiene
Emmanuel EmukahFrank O Richards

Abstract

Ivermectin treatment can cause central nervous system adverse events (CNS-AEs) in persons with very high-density Loa loa microfilaremia (≥ 30,000 mf/mL blood). Hypoendemic onchocerciasis areas where L. loa is endemic have been excluded from ivermectin mass drug administration programs (MDA) because of the concern for CNS AEs. The rapid assessment procedure for L. loa (RAPLOA) is a questionnaire survey to assess history of eye worm. If ≥ 40% of respondents report eye worm, this correlates with ≥ 2% prevalence of very high-density loiasis microfilaremia, posing an unacceptable risk of CNS-AEs after MDA. In 2016, we conducted a L. loa study in 110 ivermectin-naïve, suspected onchocerciasis hypoendemic villages in southern Nigeria. In previous RAPLOA surveys these villages had prevalences between 10% and 67%. We examined 10,605 residents using the LoaScope, a cell phone-based imaging device for rapidly determining the microfilaria (mf) density of L. loa infections. The mean L. loa village mf prevalence was 6.3% (range 0-29%) and the mean individual mf count among positives was 326 mf/mL. The maximum individual mf count was only 11,429 mf/mL, and among 2,748 persons sampled from the 28 villages with ≥ 40% RAPLOA, the ≥ 2% threshold ...Continue Reading

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Citations

May 27, 2020·PLoS Neglected Tropical Diseases·Federico GobbiZeno Bisoffi
Sep 23, 2020·The American Journal of Tropical Medicine and Hygiene·Lindsay J RakersFrank O Richards
Oct 30, 2020·Research and Reports in Tropical Medicine·Thomson LakwoDidier Bakajika
Oct 22, 2019·Diagnostic Microbiology and Infectious Disease·Oussama MouriRenaud Piarroux
Dec 10, 2020·EClinicalMedicine·Cédric B ChesnaisMichel Boussinesq
Aug 26, 2021·Revista Da Sociedade Brasileira De Medicina Tropical·Anil Kumar, Nandita Shashindran

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