Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of Congo
Abstract Background The progress of mass, community-directed, treatment with ivermectin (CDTI) for onchocerciasis control was disrupted by severe adverse effects (SAE) in the Democratic Republic of Congo (DRC). The study aimed at determining the frequency of post-CDTI SAE as well as factors associat...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Pharmacology and Toxicology |
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| Online Access: | http://link.springer.com/article/10.1186/s40360-019-0327-5 |
| _version_ | 1818843336382873600 |
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| author | Jean-Claude Makenga Bof Daniel Muteba Paul Mansiangi Félicien Ilunga-Ilunga Yves Coppieters |
| author_facet | Jean-Claude Makenga Bof Daniel Muteba Paul Mansiangi Félicien Ilunga-Ilunga Yves Coppieters |
| author_sort | Jean-Claude Makenga Bof |
| collection | DOAJ |
| description | Abstract Background The progress of mass, community-directed, treatment with ivermectin (CDTI) for onchocerciasis control was disrupted by severe adverse effects (SAE) in the Democratic Republic of Congo (DRC). The study aimed at determining the frequency of post-CDTI SAE as well as factors associated with the occurrence of SAE. Methods Our retrospective study relied on SAE collection cards, as archived by the DRC Ministry of Health, and compiled for people who benefited from ivermectin treatment then further developed SAE. The study included 945 post-CDTI SAE recorded in DRC between 2003 and 2017. These cases occurred in 15 projects out of 22 projects implemented in the country. All cards were reviewed and analysed. Results Between the years 2003 and 2017, the total average population treated was around 15,552,588 among which 945 cases of SAE were registered in DR Congo, i.e. 6 cases of SAE for 100,000 persons treated per year. 55 deaths related to post-CDTI SAE were recorded, which represents 5.8% of all cases of SAE. Non-neurological SAE were dominated by severe headaches (74.8%), myalgia (64.0%) and arthralgia (62.7%). Neurological SAE were mainly coma (94.1%), motor deficit (75.4%) and palpebral subconjunctival haemorrhages (38.8%). Factors associated with the occurrence of SAE were: male, age over 18 years old, alcohol consumption, hemp intake and the presence of loiasis. The study also highlighted weaknesses of the National Program for Onchocerciasis Control (NPOC) in terms of awareness campaigns among the population. Conclusion Co-endemicity of loiasis and onchocerciasis is one of the key factors responsible for the occurrence of SAE following ivermectin treatment. Mobilization of resources necessary to the appropriate management of SAE and awareness of populations are essential to achieve onchocerciasis control in DRC. |
| first_indexed | 2024-12-19T04:56:15Z |
| format | Article |
| id | doaj.art-9b3646f88d074417a97e403262bd200c |
| institution | Directory Open Access Journal |
| issn | 2050-6511 |
| language | English |
| last_indexed | 2024-12-19T04:56:15Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pharmacology and Toxicology |
| spelling | doaj.art-9b3646f88d074417a97e403262bd200c2022-12-21T20:35:13ZengBMCBMC Pharmacology and Toxicology2050-65112019-08-0120111010.1186/s40360-019-0327-5Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of CongoJean-Claude Makenga Bof0Daniel Muteba1Paul Mansiangi2Félicien Ilunga-Ilunga3Yves Coppieters4School of Public Health, Université Libre de Bruxelles (ULB)National Program for Onchocerciasis Control (NPOC)School of Public Health, Faculty of Medicine, Université de Kinshasa (UNIKIN)School of Public Health, Université Libre de Bruxelles (ULB)School of Public Health, Université Libre de Bruxelles (ULB)Abstract Background The progress of mass, community-directed, treatment with ivermectin (CDTI) for onchocerciasis control was disrupted by severe adverse effects (SAE) in the Democratic Republic of Congo (DRC). The study aimed at determining the frequency of post-CDTI SAE as well as factors associated with the occurrence of SAE. Methods Our retrospective study relied on SAE collection cards, as archived by the DRC Ministry of Health, and compiled for people who benefited from ivermectin treatment then further developed SAE. The study included 945 post-CDTI SAE recorded in DRC between 2003 and 2017. These cases occurred in 15 projects out of 22 projects implemented in the country. All cards were reviewed and analysed. Results Between the years 2003 and 2017, the total average population treated was around 15,552,588 among which 945 cases of SAE were registered in DR Congo, i.e. 6 cases of SAE for 100,000 persons treated per year. 55 deaths related to post-CDTI SAE were recorded, which represents 5.8% of all cases of SAE. Non-neurological SAE were dominated by severe headaches (74.8%), myalgia (64.0%) and arthralgia (62.7%). Neurological SAE were mainly coma (94.1%), motor deficit (75.4%) and palpebral subconjunctival haemorrhages (38.8%). Factors associated with the occurrence of SAE were: male, age over 18 years old, alcohol consumption, hemp intake and the presence of loiasis. The study also highlighted weaknesses of the National Program for Onchocerciasis Control (NPOC) in terms of awareness campaigns among the population. Conclusion Co-endemicity of loiasis and onchocerciasis is one of the key factors responsible for the occurrence of SAE following ivermectin treatment. Mobilization of resources necessary to the appropriate management of SAE and awareness of populations are essential to achieve onchocerciasis control in DRC.http://link.springer.com/article/10.1186/s40360-019-0327-5OnchocerciasisIvermectinSevere adverse effectsCommunitiesCommunity-directed treatment with ivermectinDemocratic Republic of Congo |
| spellingShingle | Jean-Claude Makenga Bof Daniel Muteba Paul Mansiangi Félicien Ilunga-Ilunga Yves Coppieters Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of Congo BMC Pharmacology and Toxicology Onchocerciasis Ivermectin Severe adverse effects Communities Community-directed treatment with ivermectin Democratic Republic of Congo |
| title | Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of Congo |
| title_full | Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of Congo |
| title_fullStr | Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of Congo |
| title_full_unstemmed | Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of Congo |
| title_short | Analysis of severe adverse effects following community-based ivermectin treatment in the Democratic Republic of Congo |
| title_sort | analysis of severe adverse effects following community based ivermectin treatment in the democratic republic of congo |
| topic | Onchocerciasis Ivermectin Severe adverse effects Communities Community-directed treatment with ivermectin Democratic Republic of Congo |
| url | http://link.springer.com/article/10.1186/s40360-019-0327-5 |
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