Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection.
<h4>Background</h4>Our study in CDTI-naïve areas in Nord Kivu and Ituri (Democratic Republic of the Congo, DRC), Lofa County (Liberia) and Nkwanta district (Ghana) showed that a single 8 mg moxidectin dose reduced skin microfilariae density (microfilariae/mg skin, SmfD) better and for lo...
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| Language: | English |
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Public Library of Science (PLoS)
2022-04-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0010079 |
| _version_ | 1818478756941004800 |
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| author | Didier Bakajika Eric M Kanza Nicholas O Opoku Hayford M Howard Germain L Mambandu Amos Nyathirombo Maurice M Nigo Kambale Kasonia Kennedy Safari L Masembe Mupenzi Mumbere Kambale Kataliko Kpehe M Bolay Simon K Attah George Olipoh Sampson Asare Michel Vaillant Christine M Halleux Annette C Kuesel |
| author_facet | Didier Bakajika Eric M Kanza Nicholas O Opoku Hayford M Howard Germain L Mambandu Amos Nyathirombo Maurice M Nigo Kambale Kasonia Kennedy Safari L Masembe Mupenzi Mumbere Kambale Kataliko Kpehe M Bolay Simon K Attah George Olipoh Sampson Asare Michel Vaillant Christine M Halleux Annette C Kuesel |
| author_sort | Didier Bakajika |
| collection | DOAJ |
| description | <h4>Background</h4>Our study in CDTI-naïve areas in Nord Kivu and Ituri (Democratic Republic of the Congo, DRC), Lofa County (Liberia) and Nkwanta district (Ghana) showed that a single 8 mg moxidectin dose reduced skin microfilariae density (microfilariae/mg skin, SmfD) better and for longer than a single 150μg/kg ivermectin dose. We now analysed efficacy by study area and pre-treatment SmfD (intensity of infection, IoI).<h4>Methodology/principal findings</h4>Four and three IoI categories were defined for across-study and by-study area analyses, respectively. We used a general linear model to analyse SmfD 1, 6, 12 and 18 months post-treatment, a logistic model to determine the odds of undetectable SmfD from month 1 to month 6 (UD1-6), month 12 (UD1-12) and month 18 (UD1-18), and descriptive statistics to quantitate inter-interindividual response differences. Twelve months post-treatment, treatment differences (difference in adjusted geometric mean SmfD after moxidectin and ivermectin in percentage of the adjusted geometric mean SmfD after ivermectin treatment) were 92.9%, 90.1%, 86.8% and 84.5% in Nord Kivu, Ituri, Lofa and Nkwanta, and 74.1%, 84.2%, 90.0% and 95.4% for participants with SmfD 10-20, ≥20-<50, ≥50-<80, ≥80, respectively. Ivermectin's efficacy was lower in Ituri and Nkwanta than Nord Kivu and Lofa (p≤0.002) and moxidectin's efficacy lower in Nkwanta than Nord Kivu, Ituri and Lofa (p<0.006). Odds ratios for UD1-6, UD1-12 or UD1-18 after moxidectin versus ivermectin treatment exceeded 7.0. Suboptimal response (SmfD 12 months post-treatment >40% of pre-treatment SmfD) occurred in 0%, 0.3%, 1.6% and 3.9% of moxidectin and 12.1%, 23.7%, 10.8% and 28.0% of ivermectin treated participants in Nord Kivu, Ituri, Lofa and Nkwanta, respectively.<h4>Conclusions/significance</h4>The benefit of moxidectin vs ivermectin treatment increased with pre-treatment IoI. The possibility that parasite populations in different areas have different drug susceptibility without prior ivermectin selection pressure needs to be considered and further investigated.<h4>Clinical trial registration</h4>Registered on 14 November 2008 in Clinicaltrials.gov (ID: NCT00790998). |
| first_indexed | 2024-12-10T09:52:03Z |
| format | Article |
| id | doaj.art-1704f5ebb75340f7b6f1def82df12178 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-10T09:52:03Z |
| publishDate | 2022-04-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-1704f5ebb75340f7b6f1def82df121782022-12-22T01:53:38ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352022-04-01164e001007910.1371/journal.pntd.0010079Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection.Didier BakajikaEric M KanzaNicholas O OpokuHayford M HowardGermain L MambanduAmos NyathiromboMaurice M NigoKambale Kasonia KennedySafari L MasembeMupenzi MumbereKambale KatalikoKpehe M BolaySimon K AttahGeorge OlipohSampson AsareMichel VaillantChristine M HalleuxAnnette C Kuesel<h4>Background</h4>Our study in CDTI-naïve areas in Nord Kivu and Ituri (Democratic Republic of the Congo, DRC), Lofa County (Liberia) and Nkwanta district (Ghana) showed that a single 8 mg moxidectin dose reduced skin microfilariae density (microfilariae/mg skin, SmfD) better and for longer than a single 150μg/kg ivermectin dose. We now analysed efficacy by study area and pre-treatment SmfD (intensity of infection, IoI).<h4>Methodology/principal findings</h4>Four and three IoI categories were defined for across-study and by-study area analyses, respectively. We used a general linear model to analyse SmfD 1, 6, 12 and 18 months post-treatment, a logistic model to determine the odds of undetectable SmfD from month 1 to month 6 (UD1-6), month 12 (UD1-12) and month 18 (UD1-18), and descriptive statistics to quantitate inter-interindividual response differences. Twelve months post-treatment, treatment differences (difference in adjusted geometric mean SmfD after moxidectin and ivermectin in percentage of the adjusted geometric mean SmfD after ivermectin treatment) were 92.9%, 90.1%, 86.8% and 84.5% in Nord Kivu, Ituri, Lofa and Nkwanta, and 74.1%, 84.2%, 90.0% and 95.4% for participants with SmfD 10-20, ≥20-<50, ≥50-<80, ≥80, respectively. Ivermectin's efficacy was lower in Ituri and Nkwanta than Nord Kivu and Lofa (p≤0.002) and moxidectin's efficacy lower in Nkwanta than Nord Kivu, Ituri and Lofa (p<0.006). Odds ratios for UD1-6, UD1-12 or UD1-18 after moxidectin versus ivermectin treatment exceeded 7.0. Suboptimal response (SmfD 12 months post-treatment >40% of pre-treatment SmfD) occurred in 0%, 0.3%, 1.6% and 3.9% of moxidectin and 12.1%, 23.7%, 10.8% and 28.0% of ivermectin treated participants in Nord Kivu, Ituri, Lofa and Nkwanta, respectively.<h4>Conclusions/significance</h4>The benefit of moxidectin vs ivermectin treatment increased with pre-treatment IoI. The possibility that parasite populations in different areas have different drug susceptibility without prior ivermectin selection pressure needs to be considered and further investigated.<h4>Clinical trial registration</h4>Registered on 14 November 2008 in Clinicaltrials.gov (ID: NCT00790998).https://doi.org/10.1371/journal.pntd.0010079 |
| spellingShingle | Didier Bakajika Eric M Kanza Nicholas O Opoku Hayford M Howard Germain L Mambandu Amos Nyathirombo Maurice M Nigo Kambale Kasonia Kennedy Safari L Masembe Mupenzi Mumbere Kambale Kataliko Kpehe M Bolay Simon K Attah George Olipoh Sampson Asare Michel Vaillant Christine M Halleux Annette C Kuesel Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection. PLoS Neglected Tropical Diseases |
| title | Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection. |
| title_full | Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection. |
| title_fullStr | Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection. |
| title_full_unstemmed | Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection. |
| title_short | Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection. |
| title_sort | effect of a single dose of 8 mg moxidectin or 150 μg kg ivermectin on o volvulus skin microfilariae in a randomized trial differences between areas in the democratic republic of the congo liberia and ghana and impact of intensity of infection |
| url | https://doi.org/10.1371/journal.pntd.0010079 |
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