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Sample records for ivermectin treatment conditioner

  1. Ivermectin treatment of onchocerciasis.

    PubMed

    Taylor, H R

    1989-11-01

    Ivermectin is a recently developed macrocyclic lactone that has widespread antiparasitic activity. A series of clinical trials has shown that ivermectin is safe and effective in the treatment of human infection with Onchocerca volvulus. Although it is rapidly microfilaricidal, it does not cause a severe reaction as is seen with diethylcarbamazine treatment. The drug also temporarily interrupts production of microfilaria but has no known long-lasting effects on the adult worms. In patients with onchocerciasis, a single oral dose of ivermectin (150 micrograms/kg) repeated once a year leads to a marked reduction in skin microfilaria counts and ocular involvement. At this dose, ivermectin causes minimal side effects and appears to be sufficiently free of severe adverse reactions to be used on a mass scale. Its use promises to revolutionise the treatment of onchocerciasis.

  2. Ivermectin treatment of ocular onchocerciasis.

    PubMed

    Taylor, H R

    1990-01-01

    Ivermectin, a recently developed macrocyclic lactone with broad antiparasitic activity, has been shown by a series of clinical trials to be safe and effective in the treatment of human infection with Onchocerca volvulus. Although it is rapidly microfilaricidal, it does not cause a severe reaction as is seen with diethylcarbamazine treatment. In patients with onchocerciasis, a single oral dose of ivermectin (150 micrograms/Kg) repeated once a year leads to a marked reduction in skin microfilaria counts and ocular involvement, although ivermectin has no known long-lasting effects on the adult worms. With treatment there is no significant exacerbation of either anterior or posterior segment eye disease even in those with severe ocular disease. Treatment leads to a marked and prolonged improvement in ocular status. Because of its safety and efficacy, ivermectin can be used on a mass scale and promises to revolutionize the treatment of onchocerciasis.

  3. The treatment of rosacea with topical ivermectin.

    PubMed

    Ali, S T; Alinia, H; Feldman, S R

    2015-04-01

    The treatment of rosacea is challenging because several pathophysiologic processes may be involved, including neurovascular dysregulation and alterations in innate immune status. Demodex mites may play a role in the latter mechanism. Topical ivermectin is a new therapeutic modality which demonstrates antiparasitic and anti-inflammatory properties. This article reviews published evidence related to the efficacy and safety of topical ivermectin. PubMed was utilized to search for key words "topical ivermectin", "ivermectin cream" and "rosacea". Three clinical trials were found that studied topical ivermectin as a treatment option for rosacea. Ivermectin was effective, safe and well tolerated.

  4. [Ivermectin].

    PubMed

    Develoux, M

    2004-01-01

    Ivermectin is a semi-synthetic derivative of a macrocyclic lactone. It causes paralysis in many nematodes and arthropodes because of its effect on ion-channels in cell membranes. Ivermectin was first used in veterinary medicine. In man, it was shown to be microfilaricid against Onchocerca volvulus. Most of the adverse reactions following treatment were mild, without the systemic and ocular side effects usually complicating diethylcarbamazine therapy. In endemic areas after repeated administration of ivermectin, a dramatic reduction in dermal microfilarial load was observed, resulting in a decrease in transmission. There was a significant decrease in the prevalence of anterior segment lesions in the eyes and acute onchocercal skin disease. Moreover, ivermectin also exhibited microfilaricidal activity against Wuchereria bancrofti and Brugia malayi. Annual mass treatment with a single dose of diethylcarbamazine alone, or associated with ivermectin, was initiated in endemic areas for lymphatic filariasis. The preliminary results showed a decrease in the reservoir of microfilariae and rate of transmission, a reduction in the frequency of clinical lymphatic abnormalities due to bancroftan filariasis. In Loa loa infections ivermectin decreases microfilaremia, but serious adverse events such as encephalopathy can be induced in patients with high rate of microfilaremia. Ivermectin appears to be the drug of choice in Strongyloides stercoralis infections, a single dose is highly effective with less frequent side effects than thiabendazole. Oral ivermectin is an alternative to topical scabicides, it appears as effective as local treatment for common scabies, but there are few comparative studies. The best indications for ivermectin in this ectoparasitic infection could be the outbreak in institutions and crusty scabies, but in association with topical treatment. The precise position of this agent in the treatment of scabies remains to be specified. Ivermectin is also affective

  5. Oral ivermectin for treatment of pediculosis capitis.

    PubMed

    Ameen, Mahreen; Arenas, Roberto; Villanueva-Reyes, Janeth; Ruiz-Esmenjaud, Julieta; Millar, Daniel; Domínguez-Dueñas, Francisca; Haddad-Angulo, Alexandra; Rodríguez-Alvarez, Mauricio

    2010-11-01

    Pediculosis capitis is a highly transmissible infestation prevalent worldwide. It is an important public health problem mainly affecting children. The emergence of drug resistance and high rates of treatment failure with several topical agents makes ivermectin, an antiparasitic drug, an attractive therapeutic option for lice control. To evaluate the efficacy and safety of oral ivermectin in the treatment of a pediatric population with pediculosis capitis. Children with pediculosis capitis from the ages of 6 to 15 years were recruited from an indigenous community in Mexico, and were treated with a single dose of oral ivermectin at 200 μg/kg. They were treated with a second dose of ivermectin 1 week later if there was evidence of persistent infestation. Forty-four children (mean age, 9.8 years) with active infestation were treated. A single approximately 200-μg/kg dose of ivermectin eradicated adult lice in all children. Forty-one percent (n = 18) required a second dose because of the presence of viable nits. At the third visit, 2 weeks after commencement of treatment there was no evidence of viable nits, and there was complete resolution of excoriations in all children and minimal or no symptoms of pruritus were reported in 93% (n = 41). There were no significant adverse effects due to ivermectin administration. Ivermectin demonstrates high efficacy and tolerability in the treatment of pediculosis capitis in children. A significant number of children required a second dose to ensure complete eradication.

  6. The treatment of scabies with ivermectin.

    PubMed

    Meinking, T L; Taplin, D; Hermida, J L; Pardo, R; Kerdel, F A

    1995-07-06

    Ivermectin is an anthelmintic agent that has been a safe, effective treatment for onchocerciasis (river blindness) when given in a single oral dose of 150 to 200 micrograms per kilogram of body weight. Anecdotal reports of improvement in patients who suffered from infestation with the mite Sarcoptes scabiei suggest that the ectoparasitic disease scabies might be treated with ivermectin. We conducted an open-label study in which ivermectin was administered in a single oral dose of 200 micrograms per kilogram to 11 otherwise healthy patients with scabies and to 11 patients with scabies who were also infected with the human immunodeficiency virus (HIV), 7 of whom had the acquired immunodeficiency syndrome. All patients received a full physical and dermatologic examination; scrapings from the skin of all patients tested positive for scabies. Patients were reexamined two and four weeks after treatment, when the scrapings for scabies were repeated. The patients used no other scabicides during the 30 days before ivermectin treatment or during the 4-week study period. None of the 11 otherwise healthy patients had evidence of scabies four weeks after a single dose of ivermectin. Of the 11 HIV-infected patients, 2 had < or = 10 scabies lesions before treatment, 3 had 11 to 49 lesions, 4 had > or = 50 lesions, and 2 had heavily crusted skin lesions. In eight of the patients the scabies was cured after a single dose of ivermectin. Two patients received a second dose two weeks after the first. Ten of the 11 patients with HIV infection (91 percent) had no evidence of scabies four weeks after their first treatment with ivermectin. The anthelmintic agent ivermectin, given in a single oral dose, is an effective treatment for scabies in otherwise healthy patients and in many patients with HIV infection.

  7. Treatment of equine onchocerciasis with ivermectin paste.

    PubMed

    Pollitt, C C; Holdsworth, P A; Kelly, W R; Meacham, C S; Sheahan, B

    1986-05-01

    A single oral dose of ivermectin paste was administered to 12 horses with dermatitis and clinical signs typical of onchocerciasis. Two of the horses also had lesions of Queensland itch. Microfilarias of Onchocerca cervicalis were identified in fresh, macerated, skin biopsies from the neck, brisket or umbilical regions of all horses and microfilarias of O. gutturosa from the neck of 2. Eight of the horses developed skin reactions 4 to 24 h after the administration of the ivermectin, notably weals over the neck, shoulders and flanks and pitting oedema of the ventral midline and intermandibular space. Regression of the onchocerciasis lesions was evident within 7 days of treatment and affected skin had returned to normal within 3 months. The lesions of Queensland itch were not affected by the ivermectin treatment. Microfilarias were present in biopsies of skin, particularly in the superficial dermis, before treatment, but were absent from all skin biopsies taken one week after treatment. In some horses transient skin sensitivity reactions developed. Microfilarias began to reappear in the biopsies of some of the horses 2 months after treatment. It is concluded that the oral paste formulation of ivermectin, although not effective against adult onchocerca, is useful for the therapeutic control of microfilarias in the skin lesions of equine onchocerciasis.

  8. Ivermectin: new indication. Oral treatment of scabies: simple and effective.

    PubMed

    2002-10-01

    (1) Ivermectin is the first oral drug to be licensed in France for the treatment of scabies. (2) In common scabies, three small trials suggest that ivermectin is about as effective as topical preparations. (3) Several cohort studies have shown that ivermectin can control outbreaks of scabies (especially in institutions) and also in endemic areas. (4) There are no clinical trial data on ivermectin in crusted scabies. Case series suggest that combining ivermectin with topical treatments may increase efficacy. (5) Ivermectin seems to have few, mostly mild short-term side effects in adults. There are no reports of ivermectin treatment in infants weighing less than 15 kg or in breast-feeding infants. Data on about 400 pregnant women treated with ivermectin are reassuring. (6) In a small cohort of elderly patients, ivermectin used after topical preparations coincided with excess mortality 6 months later. Subsequent studies were reassuring, but all adverse events (including death) in elderly patients treated with ivermectin must none the less be notified. (7) In practice, oral ivermectin is effective against scabies and is thus an alternative to topical treatments. Its single-dose administration facilitates treatment, especially during outbreaks.

  9. Ivermectin treatment of demodicosis in 56 hamsters.

    PubMed

    Tani, K; Iwanaga, T; Sonoda, K; Hayashiya, S; Hayashiya, M; Taura, Y

    2001-11-01

    Fifty-six hamsters with demodicosis were treated with daily oral administration of ivermectin (0.3 mg/kg). Thirty-three cases (58.9%) were cured and 6 cases (10.7%) had improved clinically but needed to continue treatment. Of 5 cases (8.9%) who relapsed within 3 months and were retreated with ivermectin, 4 were cured and 1 needed further treatment. Five cases (8.9%) had improved clinically but died within 3 months. Seven cases (12.5%) had not improved and died within 3 months. Overall 49 (87.5%) hamsters had improved clinically. No significant differences in prognosis of demodicosis were detected according to sex, breed, age and clinical features, but the prognosis of demodicosis in hamsters with concurrent disease was poor.

  10. Non-Oral Treatment with Ivermectin for Disseminated Strongyloidiasis

    PubMed Central

    Fusco, Dahlene N.; Downs, Jennifer A.; Satlin, Michael J.; Pahuja, Meera; Ramos, Liz; Barie, Philip S.; Fleckenstein, Lawrence; Murray, Henry W.

    2010-01-01

    Critically ill patients with disseminated strongyloidiasis may not be candidates for oral treatment. We report four patients with disseminated strongyloidiasis, believed to be unable to absorb oral therapy, who were treated with ivermectin by rectal and/or subcutaneous administration. Obtaining subcutaneous ivermectin and dosing it appropriately is a challenge. These cases underscore the need for improved access to subcutaneous ivermectin and more pharmacological data to guide use of this treatment approach. PMID:20889884

  11. Ivermectin

    MedlinePlus

    ... moves through the airways and lives in the intestines). Ivermectin is also used to control onchocerciasis (river ... treats strongyloidosis by killing the worms in the intestines. It treats onchocerciasis by killing the developing worms. ...

  12. Treatment of onchocerciasis. The ocular effects of ivermectin and diethylcarbamazine.

    PubMed

    Taylor, H R; Murphy, R P; Newland, H S; White, A T; D'Anna, S A; Keyvan-Larijani, E; Aziz, M A; Cupp, E W; Greene, B M

    1986-06-01

    The ocular changes that occur with diethylcarbamazine treatment of onchocerciasis seriously restrict its usefulness. Ivermectin, a newly developed antifilarial drug, was compared with diethylcarbamazine for treatment of onchocerciasis in a double-masked, placebo-controlled trial. Thirty men with moderate to severe infection and ocular involvement were randomly assigned to receive ivermectin as a single oral dose (200 micrograms/kg), diethylcarbamazine (administered for eight days), or placebo. Detailed ocular examinations were performed serially over a 12-month period. Diethylcarbamazine treatment caused a marked increase in living and dead microfilariae in the cornea, punctate opacities, and limbitis during the first week of therapy. Ivermectin had no such effect. However, ivermectin therapy resulted in a long-term reduction in intraocular microfilariae comparable to that seen with diethylcarbamazine. Ivermectin appears to have few ocular complications and be a better-tolerated and more effective microfilaricidal agent than diethylcarbamazine for the treatment of onchocerciasis.

  13. [Systemic adverse reactions with ivermectin treatment of scabies].

    PubMed

    Sparsa, A; Bonnetblanc, J-M; Peyrot, I; Loustaud-Ratti, V; Vidal, E; Bédane, C

    2006-10-01

    Scabies is a common parasitic infestation and is very difficult to eradicate from institutions. Ivermectin is used extensively thanks to its efficacy and ease of use through oral administration; it was approved for the treatment of scabies in humans in 2001 in France. Most of the adverse effects noted with this drug have been seen during treatment of onchocerciasis and other filarial disease, but they are rare in the treatment of scabies. We report side effects with ivermectin in two elderly patients with scabies. A 72-year-old man was referred for scabies and was treated with benzyl benzoate (Ascabiol) and ivermectin (200 microg/kg) in a single dose. Two days later, the patient presented abdominal pain and nausea. Laboratory tests revealed cytolysis tests for other causes of hepatitis were negative. Within two weeks, liver function had returned to normal. Hepatitis due to ivermectin was diagnosed. An 86-year-old woman hospitalised for scabies was treated with benzyl benzoate and a single dose of ivermectin (200 microg/kg). She developed sinus tachycardia and asthma 3 days later. Screening for embolic, cardiac and infectious origins was found. Toxicity of ivermectin was suspected. Since the introduction of ivermectin for the treatment of scabies, reports of adverse events are rare although this drug can cause cardiac dysfunction and liver disease in other indications. In our cases, the causal relationship with ivermectin is probable and care must be taken, particularly in the elderly, the population in which this drug is probably most widely prescribed.

  14. Comparison of ivermectin and diethylcarbamazine in the treatment of onchocerciasis.

    PubMed

    Greene, B M; Taylor, H R; Cupp, E W; Murphy, R P; White, A T; Aziz, M A; Schulz-Key, H; D'Anna, S A; Newland, H S; Goldschmidt, L P

    1985-07-18

    We compared ivermectin with diethylcarbamazine for the treatment of onchocerciasis in a double-blind, placebo-controlled trial. Thirty men with moderate to heavy infection and ocular involvement were randomly assigned to receive ivermectin in a single oral dose (200 micrograms per kilogram of body weight), diethylcarbamazine daily for eight days, or placebo. Diethylcarbamazine caused a significantly more severe systemic reaction than ivermectin (P less than 0.001), whereas the reaction to ivermectin did not differ from the reaction to placebo. Diethylcarbamazine markedly increased the number of punctate opacities in the eye (P less than 0.001), as well as the number of dead and living microfilariae in the cornea over the first week of therapy. Ivermectin had no such effect. Both ivermectin and diethylcarbamazine promptly reduced skin microfilaria counts, but only in the ivermectin group did counts remain significantly lower (P less than 0.005) than in the placebo group at the end of six months of observation. Analysis of adult worms isolated from nodules obtained two months after the start of therapy showed no effect of either drug on viability. Ivermectin appears to be a better tolerated, safer, and more effective microfilaricidal agent than diethylcarbamazine for the treatment of onchocerciasis.

  15. [Treatment of human onchocerciasis with ivermectin].

    PubMed

    Coulaud, J P; Larivière, M; Gervais, M C; Gaxotte, P; Aziz, A; Deluol, A M; Cenac, J

    1983-11-01

    Twenty immigrants from Mali and West Senegal were treated in Paris. Onchocerciasis was diagnosed by six skin snips using a Holth punch. Ivermectine was given in a single oral dose: ten patients were given 50 mcg/kg, three were given 75 mcg/kg and seven received 100 mcg/kg. No patients had ocular symptoms. The results were as follows: Pruritus disappeared rapidly in 9 out of 11 patients who itched before treatment. The microfilarial load decreased rapidly, especially in cases treated with 75 mcg/kg and 100 mcg/kg as all patients tested on day 60 were negative. Clinical signs of the Mazzotti reaction and ocular reactions were not observed following the treatment. Pruritus was briefly aggravated in only two patients. No cardiovascular, hematological, hepatic or renal toxicity was noted.

  16. Effects of repeated ivermectin treatment in onchocerciasis.

    PubMed

    Njoo, F L; Stilma, J S; van der Lelij, A

    1992-01-01

    A group of 87 onchocerciasis patients from a hyperendemic area without vector control was treated with a single dose of 150 micrograms/kg ivermectin. A second, third and fourth dose was administered 5, 12 and 17 months later to 44, 35 and 25 patients. Skin snip loads reduced substantially following each consecutive dose. However, after three doses 44% of the patients remained skin snip positive. Side-effects decreased from 32.2% requiring medical treatment at the first dose to none after the fourth dose. From this study it was concluded that a complete eradication of microfilariae in skin snips in severely infected persons living in a hyperendemic area without vector control is probably not feasible. Medical supervision for the observation of side-effects after the third dose can be limited.

  17. Doxycycline plus ivermectin versus ivermectin alone for treatment of patients with onchocerciasis.

    PubMed

    Abegunde, Ayokunle T; Ahuja, Richard M; Okafor, Nkem J

    2016-01-15

    Onchocerciasis, also known as "river blindness," is a parasitic disease that is caused by infection from the filarial nematode (roundworm), Onchocerca volvulus. Nematodes are transmitted from person to person by blackflies of the Simulium genus, which usually breed in fast flowing streams and rivers. The disease is the second leading infectious cause of blindness in endemic areas.Ivermectin (a microfilaricide) is widely distributed to endemic populations for prevention and treatment of onchocerciasis. Doxycycline, an antibiotic, targets Wolbachia organisms that are crucial to the survival of adult onchocerca (macrofilaricide). Combined treatment with both drugs is believed to cause direct microfilarial death by ivermectin and indirect macrofilarial death by doxycycline. Long-term reduction in the numbers of microfilaria in the skin and eyes and in the numbers of adult worms in the body has the potential to reduce the transmission and occurrence of onchocercal eye disease. The primary aim of this review was to assess the effectiveness of doxycycline plus ivermectin versus ivermectin alone for prevention and treatment of onchocerciasis. The secondary aim was to assess the effectiveness of doxycycline plus ivermectin versus ivermectin alone for prevention and treatment of onchocercal ocular lesions in communities co-endemic for onchocerciasis and Loa loa (loiasis) infection. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 7, 2015), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to July 2015), EMBASE (January 1980 to July 2015), PubMed (1948 to July 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to July 2015), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 1 July 2014), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical

  18. Doxycycline plus ivermectin versus ivermectin alone for treatment of patients with onchocerciasis

    PubMed Central

    Abegunde, Ayokunle T; Ahuja, Richard M; Okafor, Nkem J

    2016-01-01

    Background Onchocerciasis, also known as “river blindness,” is a parasitic disease that is caused by infection from the filarial nematode (roundworm), Onchocerca volvulus. Nematodes are transmitted from person to person by blackflies of the Simulium genus, which usually breed in fast flowing streams and rivers. The disease is the second leading infectious cause of blindness in endemic areas. Ivermectin (a microfilaricide) is widely distributed to endemic populations for prevention and treatment of onchocerciasis. Doxycycline, an antibiotic, targets Wolbachia organisms that are crucial to the survival of adult onchocerca (macrofilaricide). Combined treatment with both drugs is believed to cause direct microfilarial death by ivermectin and indirect macrofilarial death by doxycycline. Long-term reduction in the numbers of microfilaria in the skin and eyes and in the numbers of adult worms in the body has the potential to reduce the transmission and occurrence of onchocercal eye disease. Objectives The primary aim of this review was to assess the effectiveness of doxycycline plus ivermectin versus ivermectin alone for prevention and treatment of onchocerciasis. The secondary aim was to assess the effectiveness of doxycycline plus ivermectin versus ivermectin alone for prevention and treatment of onchocercal ocular lesions in communities co-endemic for onchocerciasis and Loa loa (loiasis) infection. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 7, 2015), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to July 2015), EMBASE (January 1980 to July 2015), PubMed (1948 to July 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to July 2015), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 1 July 2014), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health

  19. Treatment of scabies: Comparison of permethrin 5% versus ivermectin.

    PubMed

    Goldust, Mohamad; Rezaee, Elham; Hemayat, Sevil

    2012-06-01

    Scabies is an ectoparasitic, highly contagious skin disease caused by a mite called Sarcoptes scabiei. The insecticides ivermectin and permethrin are commonly used for treatment of scabies. This study aimed at comparing the efficacy of oral ivermectin with topical permethrin in treating scabies. Two hundred and forty-two patients with scabies attending the dermatology outpatient department of Sina Hospital, Tabriz University of Medical Sciences were admitted. Patients were divided into two groups randomly. The first group and their family contacts received 5% permethrin cream and the other received oral ivermectin. Treatment was evaluated at intervals of 2 and 4 weeks. A single dose of ivermectin provided a cure rate of 85.9% at a 2-week interval, which increased to 100% after crossing over to the permethrin group at a 4-week interval. Twice application of permethrin with a 1-week interval was effective in 92.5% of patients, which increased to 94.2% after crossing over to the ivermectin group at a 4-week interval. Permethrin-treated patients recovered earlier. Twice application of permethrin with a 1-week interval is superior to a single dose of ivermectin. The temporal dissociation in clinical response suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite.

  20. Genetic Selection of Low Fertile Onchocerca volvulus by Ivermectin Treatment

    PubMed Central

    Bourguinat, Catherine; Pion, Sébastien D. S.; Kamgno, Joseph; Gardon, Jacques

    2007-01-01

    Background Onchocerca volvulus is the causative agent of onchocerciasis, or “river blindness”. Ivermectin has been used for mass treatment of onchocerciasis for up to 18 years, and recently there have been reports of poor parasitological responses to the drug. Should ivermectin resistance be developing, it would have a genetic basis. We monitored genetic changes in parasites obtained from the same patients before use of ivermectin and following different levels of ivermectin exposure. Methods and Findings O. volvulus adult worms were obtained from 73 patients before exposure to ivermectin and in the same patients following three years of annual or three-monthly treatment at 150 µg/kg or 800 µg/kg. Genotype frequencies were determined in β-tubulin, a gene previously found to be linked to ivermectin selection and resistance in parasitic nematodes. Such frequencies were also determined in two other genes, heat shock protein 60 and acidic ribosomal protein, not known to be linked to ivermectin effects. In addition, we investigated the relationship between β-tubulin genotype and female parasite fertility. We found a significant selection for β-tubulin heterozygotes in female worms. There was no significant selection for the two other genes. Quarterly ivermectin treatment over three years reduced the frequency of the β-tubulin “aa” homozygotes from 68.6% to 25.6%, while the “ab” heterozygotes increased from 20.9% to 69.2% in the female parasites. The female worms that were homozygous at the β-tubulin locus were more fertile than the heterozygous female worms before treatment (67% versus 37%; p = 0.003) and twelve months after the last dose of ivermectin in the groups treated annually (60% versus 17%; p<0.001). Differences in fertility between heterozygous and homozygous worms were less apparent three months after the last treatment in the groups treated three-monthly. Conclusions The results indicate that ivermectin is causing genetic selection on

  1. The status of ivermectin in the treatment of human onchocerciasis.

    PubMed

    Taylor, H R; Greene, B M

    1989-10-01

    Ivermectin is a macrocyclic lactone that has widespread antiparasitic activity. Numerous clinical trials have shown that ivermectin is safe and effective in the treatment of human infection with Onchocerca volvulus. Although it is rapidly microfilaricidal, it does not cause a severe reaction, as is seen with diethylcarbamazine treatment. The drug temporarily interrupts production of microfilaria but has not known long-lasting effects on the adult worms. In patients with onchocerciasis, a single oral dose of ivermectin (150 micrograms/kg) repeated once a year leads to a marked reduction in skin microfilaria counts and ocular involvement. At this dose, ivermectin causes minimal side effects and is sufficiently free of severe reactions to be used on a mass scale. It promises to revolutionize the treatment of onchocerciasis.

  2. Decrease in adverse reactions after repeated ivermectin treatment in onchocerciasis.

    PubMed

    Van der Lelij, A; Rothova, A; Klaassen-Broekema, N; Wilson, W R; Barbe, R F; Stilma, J S

    1990-10-01

    We assessed the side-effects after multiple single-dose treatment with ivermectin (150 micrograms/kg) in onchocerciasis patients form a hyperendemic area in Sierra Leone, in order to investigate whether medical surveillance was always necessary. After initial treatment 87 onchocerciasis patients were examined for adverse reactions. Fourty-four of these 87 patients (51%) received a second dose of ivermectin 5 months later and thirty-five (40%) received a third dose one year later. The side-effects after the second and third doses were significantly diminished, when compared with the initial dose of ivermectin in the treatment of onchocerciasis (chi2 test p less than 0.005, resp. p less than 0.008). Side-effects requiring therapy were observed in 32% of patients after the first dose, in 18% after the second dose and in 11% after the third dose of ivermectin. Severe side-effects (9%) were only seen after the initial ivermectin dose. All the severe adverse reactions appeared within 48 hours. In view of our findings, it seems necessary that the first treatment with ivermectin should take place under strict medical supervision during at least two days. Five months after treatment with a single dose of ivermectin 29 out of 44 patients (66%) still had a positive skin-snip test. Seven months after the second dose 15 of 35 patients (43%) had a positive skin-snip count. Since almost half of the patients had a positive skin-snip test despite two treatments with ivermectin, it could be argued that in hyperendemic areas treatment should consist of at least two doses in the first year.

  3. Clinical treatment of ocular Demodex folliculorum by systemic ivermectin.

    PubMed

    Holzchuh, Flávio Gaieta; Hida, Richard Yudi; Moscovici, Bernardo Kaplan; Villa Albers, Marcos Bottene; Santo, Ruth Miyuki; Kara-José, Newton; Holzchuh, Ricardo

    2011-06-01

    To report clinical outcomes of the treatment of ocular Demodex folliculorum with oral ivermectin. Noncomparative, interventional case series. Setting. Institutional. Study Population. Twenty-four eyes of 12 patients (3 male and 9 female; mean age ± standard deviation, 50.4 ± 21.0 years) with refractory posterior blepharitis with the presence of D. folliculorum in lash samples were enrolled in this study. Intervention. Patients were instructed to take 1 dose of oral ivermectin (200 μg/kg). All patients were instructed to repeat the treatment after 7 days. Main outcome measures. Tear meniscus height, Schirmer I test results, noninvasive tear film break-up time (BUT), quantification of the absolute number of D. folliculorum found in the lashes, and corneal fluorescein and rose bengal staining scores were obtained from all patients 1 day before and 28 days after treatment. Statistical improvement was observed in the absolute number of D. folliculorum found in the lashes after the treatment with oral ivermectin. Average values of Schirmer I test results and tear film break-up time improved statistically after the treatment of oral ivermectin. No statistical improvement was observed in average lacrimal meniscus height or value of corneal fluorescein and rose bengal staining after treatment with oral ivermectin. Ivermectin successfully reduced the number of D. folliculorum found in the lashes of patients with refractory blepharitis. Oral ivermectin may be very useful as a complement in the treatment of D. folliculorum infestation with ocular manifestation, especially in cases of unsuccessful treatment related to patient compliance. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Ivermectin vs. lindane in the treatment of scabies.

    PubMed

    Goldust, Mohamad; Rezaee, Elham; Raghifar, Ramin; Naghavi-Behzad, Mohammad

    2013-01-01

    Scabies is commonly treated with acaricides but the treatment of choice is still controversial. This study aimed at comparing the efficacy of oral ivermectin vs. lindane lotion 1% for the treatment of scabies. Four hundred fourty patients with scabies were enrolled, and randomized into two groups: the first group received a single dose of oral ivermectin 200 microg/kg body weight, and the second group were treated with two applications of topical lindane lotion 1%, with a 1-week interval. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Single dose of oral ivermectin provided a cure rate of 63.6% at the 2-week follow-up, which increased to 81.8% at the 4-week follow-up after repeating the treatment. Treatment with two applications of lindane lotion 1%, with a 1-week interval between them, was effective in 45.4% of patients at the 2-week follow-up, which increased to 63.6% at the 4-week follow-up after this treatment was repeated. Single dose ivermectin was as effective as two applications of lindane lotion 1% at the 2-week follow-up. After repeating the treatment, ivermectin was superior to lindane lotion 1% at the 4-week follow up.

  5. Treatment of scabies: comparison of ivermectin vs. lindane lotion 1%.

    PubMed

    Mohebbipour, Alireza; Saleh, Parviz; Goldust, Mohamad; Amirnia, Mehdi; Zadeh, Yousef Javad; Mohamadi, Ramin Mir; Rezaee, Elham

    2012-01-01

    Topical antiscabietics have poor compliance. This study aimed at comparing the efficacy and safety of oral ivermectin with topical lindane in treating scabies. In this clinical trial, 248 patients from 2 to 86 years of age were divided into two groups. Oral ivermectin was given to group A in a single dose of 200 μg/kg body weight. Group B received application of lindane lotion 1% twice at one-week interval. When there was no cure in two weeks, 2nd treatment was given with either drug in the respective group. A single dose of ivermectin provided a cure rate of 58.6% at two-week follow up, which increased to 92.7% with 2 doses at the end of 4-week interval. The application of lindane lotion 1% twice at one-week interval was effective in 44.3% of patients at two-week follow up, which increased to 71.7% after repeating the treatment for another two weeks. Single dose application of oral ivermectin was as effective as twice application of lindane lotion 1% at one-week interval. Two doses of ivermectin proved superior to lindane lotion 1% after repeating the treatment at 4-week follow up.

  6. Ivermectin treatment of patients with severe ocular onchocerciasis.

    PubMed

    Taylor, H R; Semba, R D; Newland, H S; Keyvan-Larijani, E; White, A; Dukuly, Z; Greene, B M

    1989-05-01

    The treatment of onchocerciasis with diethylcarbamazine and suramin is associated with an exacerbation of ocular disease. This occurs more frequently in patients with severe onchocercal ocular disease. We assessed ocular changes following ivermectin treatment in 39 patients with severe ocular onchocerciasis. Patients were treated with 100, 150, or 200 micrograms/kg of ivermectin at either 1 or 2 year intervals and followed for 3 years. There was no evidence for an acute exacerbation of either anterior or posterior segment eye disease, and there was a marked improvement in ocular status in the group as a whole. There was a significant decrease in onchocercal involvement which was maintained for at least 3 years. Annual treatment with ivermectin can be used safely in patients with severe ocular disease and is beneficial over a prolonged period of time.

  7. Ivermectin treatment of hyperreactive onchodermatitis (sowda) in Liberia.

    PubMed

    Darge, K; Büttner, D W

    1995-12-01

    Seventeen male and 39 female Liberian patients, one third of them children, were diagnosed as having hyperreactive onchodermatitis (sowda). They presented with itching (98%), asymmetric (98%), chronic onchodermatitis (median 5 years), and swelling of femoral lymph nodes (89%). The geometric means of the microfilaria (mf) densities were 1.0 mf/mg in children and 0.7 mf/mg in adults. These patients not only suffered from their skin lesions, and severe itching resulting in disturbance of sleep but also from social stigmata. They urgently needed treatment. Ivermectin was administered as a single oral dose of 150 micrograms/kg body weight. The following adverse effects were observed in 30 patients within the first 72 hours after ivermectin treatment: increase of pruritus (93%), aggravation of dermatitis (73%), fever (25%), headache (20%), myalgia (20%), painful swelling of lymph nodes (13%) and severe swelling of arm or leg (10%). Symptomatic therapy was sufficient. No dangerous or life-threatening side effects were observed. At follow-up examinations 1-2 months after ivermectin treatment, the prevalence of mf carriers had decreased from 100% to 19%. Seventeen out of 18 patients felt their dermatitis had improved. Evaluation of the dermatitis by a physician using a score from 0 (no dermatitis) to 9 (severe dermatitis) revealed a reduction of the score from 4.3 before treatment to 0.7 (84%) after ivermectin. In contrary, at the follow-up examination of 16 patients 6-12 months after ivermectin some recrudescences were observed. In this group the prevalence of mf carriers was 47%, 13 out of the 16 patients felt their skin lesions had improved and the score had decreased from 2.2 to 0.5 (77%). Consequently, it is recommended to administer ivermectin to patients with hyperreactive onchodermatitis every 3-4 months.

  8. [Place of ivermectin in the treatment of scabies].

    PubMed

    Henno, A; Leys, C; Detry, M P; de la Brassinne, M

    2005-04-01

    Ivermectin is the first oral treatment available for scabies. It is however not licensed for use in Belgium. In this article, we review its mechanism of action, its preferential indications among which crusted scabies and institutional outbreaks, its contra-indications and its advantages in comparison with topical treatments.

  9. Ivermectin treatment in severe asymmetric reactive onchodermatitis (sowda) in Sudan.

    PubMed

    Baraka, O Z; Mahmoud, B M; Ali, M M; Ali, M H; el Sheikh, E A; Homeida, M M; Mackenzie, C D; Williams, J F

    1995-01-01

    Ivermectin efficacy and post-treatment reactions in asymmetric severe reactive ochodermatitis (sowda) were studied in 8 patients with sowda syndrome and 6 with mild generalized onchodermatitis in Sudan. Initial skin snips from 12 patients contained microfilariae (1-9 per mg skin). Patients were treated in hospital with a single oral dose of c. 150 micrograms/kg ivermectin (103-200 micrograms/kg) and monitored for frequency and severity of post-treatment reactions for 4 weeks. Serial samples of heparinized blood were collected over the first 24 h after treatment for determination of ivermectin pharmacokinetics. Skin snips from all patients on days 3 and 28 revealed no microfilariae. Post-treatment reactions were more common and severe in individuals with sowda; they consisted mainly of musculoskeletal pain, local swellings with pitting oedema, and lymph gland tenderness and enlargement. No relation was established between these reactions, the microfilarial infection intensity, or the plasma pharmacokinetic profiles. A single oral dose of ivermectin cleared the skin of microfilariae and led to improvement of symptoms and dermatological signs of sowda, but resulted in more marked reactions than in cases of generalized onchodermatitis.

  10. Assessment of topical versus oral ivermectin as a treatment for head lice.

    PubMed

    Ahmad, Hesham M; Abdel-Azim, Eman S; Abdel-Aziz, Rasha T

    2014-01-01

    Many medications are available for treatment of pediculosis capitis including ivermectin. Our aim is to compare the efficacy and safety of topical versus oral ivermectin in treatment of pediculosis capitis. Sixty-two patients with proved head lice infestation were included and divided into group I (31 patients; received single topical application of 1% ivermectin) and group II (31 patients; received single dose of oral ivermectin). Treatment was repeated after 1 week for nonresponders. At 1 week after treatment, the eradication rates and improvement of pruritus were significantly higher among patients who received topical than oral ivermectin. When a second treatment, topical or oral, was given to nonresponders, the cure rates of infestation and pruritus was 100% and 97% among patients treated with topical and oral ivermectin, respectively with no significant difference between the two groups. This study suggests that both topical and oral ivermectin demonstrate high efficacy and tolerability in treatment of pediculosis capitis. However, a single treatment with topical ivermectin provides significantly higher cure of infestation and faster relief of pruritus than oral ivermectin. In addition, whether topical or oral ivermectin is used to treat head lice, a second dose is required in some cases to ensure complete eradication. © 2014 Wiley Periodicals, Inc.

  11. Oral ivermectin in the treatment of body lice.

    PubMed

    Foucault, Cedric; Ranque, Stephane; Badiaga, Sekene; Rovery, Clarisse; Raoult, Didier; Brouqui, Philippe

    2006-02-01

    The mainstays of treatment of body-louse infestation in humans in a community setting are insecticides and the removal of infested clothing. We report here the dramatic effect that 3 doses of oral ivermectin (12 mg each), administered at 7-day intervals, have in reducing the total number of body lice in a cohort of homeless men from a shelter in Marseilles, France. We identified a baseline total of 1898 lice in the cohort. Over a 14-day period, this number fell to 6 lice; the prevalence of infested individuals fell from 84.9% to 18.5%. Although this effect was not sustained at day 45, it establishes that ivermectin plays a novel role in the control of body-louse infestation in humans.

  12. Adverse reactions to ivermectin treatment in Simulium neavei-transmitted onchocerciasis.

    PubMed

    Kipp, Walter; Bamhuhiiga, Jotham; Rubaale, Tom; Büttner, Dietrich W

    2003-12-01

    To assess adverse effects of ivermectin treatment in a Simulium neavei-transmitted focus of onchocerciasis, a study was conducted with 1,246 patients infected with Onchocerca volvulus in eight villages in western Uganda. Study participants were treated the first time with a single dose of 150 microg/kg of ivermectin. Adverse reactions to ivermectin were determined through questioning and clinical examination during house-to-house visits to the participants within 48 hours after ivermectin treatment. Overall adverse reactions were observed in 737 (59.1%) patients. Severe reactions were rare (10 patients, 1.4%). Our data show that adverse reactions to ivermectin in an S. neavei-transmitted onchocerciasis focus in western Uganda occur frequently. In spite of the fact that many patients showed adverse reactions to ivermectin, the drug was well accepted and appreciated by the population.

  13. Adherence to ivermectin is more associated with perceptions of community directed treatment with ivermectin organization than with onchocerciasis beliefs

    PubMed Central

    Kamga, Guy-Roger; Humblet, Perrine Claire; Robert, Annie; Souopgui, Jacob; Kamgno, Joseph; Essi, Marie José; Ghogomu, Stephen Mbigha; Godin, Isabelle

    2017-01-01

    Background The fight against onchocerciasis in Africa has boomed thanks to the Community Directed Treatment with Ivermectin (CDTI) program. However, in Cameroon, after more than 15 years of mass treatment, onchocerciasis prevalence is still above the non-transmission threshold. This study aimed to explore a possible association between people’s beliefs/perceptions of onchocerciasis and of CDTI program, and their adherence to ivermectin in three regions of Cameroon. Methodology/Principal findings A cross sectional survey was carried out in three health districts with persistent high onchocerciasis prevalence. Participants were randomly selected in 30 clusters per district. Adherence to ivermectin was comparable between Bafang and Bafia (55.0% and 48.8%, respectively, p>0.05) and lower in Yabassi (40.7%). Among all factors related to program perceptions and disease representations that were studied, perceptions of the program are the ones that were most determinant in adherence to ivermectin. People who had a “not positive” opinion of ivermectin distribution campaigns were less compliant than those who had a positive opinion about the campaigns (40% vs 55% in Bafang, and 48% vs 62% in Bafia, p<0.01), as well as those who had a negative appreciation of community drug distributors’ commitment (22% vs 53% in Bafang, 33% vs 59% in Bafia, 27% vs 47% in Yabassi; p<0.01). The most common misconception about onchocerciasis transmission was the lack of hygiene, especially in Bafia and Yabassi. In Bafang, high proportions of people believed that onchocerciasis was due to high consumption of sugar (31% vs less than 5% in Bafia and Yabassi, p<0.001). Conclusion/Significance There are still frequent misconceptions about onchocerciasis transmission in Cameroon. Perceptions of ivermectin distribution campaigns are more strongly associated to adherence. In addition to education/sensitisation on onchocerciasis during the implementation of the CDTI program, local health

  14. Adherence to ivermectin is more associated with perceptions of community directed treatment with ivermectin organization than with onchocerciasis beliefs.

    PubMed

    Dissak-Delon, Fanny Nadia; Kamga, Guy-Roger; Humblet, Perrine Claire; Robert, Annie; Souopgui, Jacob; Kamgno, Joseph; Essi, Marie José; Ghogomu, Stephen Mbigha; Godin, Isabelle

    2017-08-01

    The fight against onchocerciasis in Africa has boomed thanks to the Community Directed Treatment with Ivermectin (CDTI) program. However, in Cameroon, after more than 15 years of mass treatment, onchocerciasis prevalence is still above the non-transmission threshold. This study aimed to explore a possible association between people's beliefs/perceptions of onchocerciasis and of CDTI program, and their adherence to ivermectin in three regions of Cameroon. A cross sectional survey was carried out in three health districts with persistent high onchocerciasis prevalence. Participants were randomly selected in 30 clusters per district. Adherence to ivermectin was comparable between Bafang and Bafia (55.0% and 48.8%, respectively, p>0.05) and lower in Yabassi (40.7%). Among all factors related to program perceptions and disease representations that were studied, perceptions of the program are the ones that were most determinant in adherence to ivermectin. People who had a "not positive" opinion of ivermectin distribution campaigns were less compliant than those who had a positive opinion about the campaigns (40% vs 55% in Bafang, and 48% vs 62% in Bafia, p<0.01), as well as those who had a negative appreciation of community drug distributors' commitment (22% vs 53% in Bafang, 33% vs 59% in Bafia, 27% vs 47% in Yabassi; p<0.01). The most common misconception about onchocerciasis transmission was the lack of hygiene, especially in Bafia and Yabassi. In Bafang, high proportions of people believed that onchocerciasis was due to high consumption of sugar (31% vs less than 5% in Bafia and Yabassi, p<0.001). There are still frequent misconceptions about onchocerciasis transmission in Cameroon. Perceptions of ivermectin distribution campaigns are more strongly associated to adherence. In addition to education/sensitisation on onchocerciasis during the implementation of the CDTI program, local health authorities should strive to better involve communities and more encourage

  15. Treatment of scabies with oral ivermectin in 15 infants: a retrospective study on tolerance and efficacy.

    PubMed

    Bécourt, C; Marguet, C; Balguerie, X; Joly, P

    2013-10-01

    The incidence of scabies is increasing in Europe, and it often affects children and infants. Although numerous topical treatments have been approved for treatment of scabies in adults, they are often poorly tolerated in infants. One treatment, ivermectin, remains off label for infants weighing < 15 kg. To report our experience on the safety and efficacy of oral ivermectin in refractory scabies in infants. A retrospective study was performed in the dermatology and paediatrics departments of Rouen University Hospital between January 2009 and October 2012. Infants diagnosed with scabies were identified, and the data for those fulfilling the inclusion criteria were analysed. Of 219 infants identified, 15 had received oral ivermectin and had been followed up for at least 3 months. All 15 patients were given two doses of ivermectin, 200 μg kg(-1), at baseline and 14 days later. Of 14 patients contacted 1 month after treatment, 12 had achieved healing. The other two were treated with ivermectin or benzyl benzoate; both healed. Overall, 3 months after the first ivermectin treatment, 13/14 patients had healed and only one had active disease. Ivermectin is generally well tolerated in infants. The 80% rate of healing observed in infants who had failed to respond to at least two other topical treatments suggests that ivermectin could be considered for treatment of infants with recalcitrant or relapsing scabies. © 2013 British Association of Dermatologists.

  16. [Secondary effects of the treatment of hypermicrofilaremic loiasis using ivermectin].

    PubMed

    Ducorps, M; Gardon-Wendel, N; Ranque, S; Ndong, W; Boussinesq, M; Gardon, J; Schneider, D; Chippaux, J P

    1995-01-01

    In the last ten years ivermectin appeared an efficient and safe alternative to diethylcarbamazine which is known to induce severe adverse reactions in loiasis, including encephalitis. After these results, large scale ivermectin treatments against onchocerciasis were carried out in Central Africa where loiasis is also endemic; and seven cases of severe reaction were reported in Cameroon since 1991, during these mass ivermectin treatments. In order to study adverse reactions in patients harbouring high load of Loa loa microfilariae (mf), we realized careful hospital based treatment in 112 patients with more than 3,000 mf/ml (ml) blood. Patients received once 200 micrograms ivermectin per kilogram at day 0 (D0). Clinical examination was made daily during the four following days (D1 to D4). Blood and urine samples were analysed before treatment and at D1 and D3. Lumbar puncture was made at D1 for 39 patients with more than 10,000 mf/ml; at D3 for the 49 following patients without consideration for the level of parasitaemia, and at D0 and D3 for ten voluntary patients. For analysis the patients were distributed in 3 groups according to initial parasitaemia: the first group included 50% out of the patients, those whose parasitaemia was fewer than 15,000 mf/ml blood; the second group included 25% patients whose parasitaemia was between 15,000 and 30,000 mf/ml; the third group included the last 25% patients whose parasitaemia was higher than 30,000 mf per ml blood. Adverse reactions were observed in 71% out of the patients. Symptoms described were fever, pruritus, headache, arthralgia. Most symptoms appeared 24 to 36 hours after treatment. Temperature increased significantly in group 3. Microfilaraemia decreased by 85% in the 3 groups during the 4 days following treatment. C-reactive-protein increased dramatically after treatment in all patients (p < 10(-4)). Some patients presented blood in urine in three groups but haematuria reached 35% of patients in group 3

  17. Ivermectin Topical

    MedlinePlus

    ... a lotion to apply to the scalp and hair. It is usually applied to the scalp and hair in one treatment. Follow the directions on your ... Ivermectin lotion should only be used on the hair and scalp. Avoid getting ivermectin lotion in your ...

  18. Uncertainty Surrounding Projections of the Long-Term Impact of Ivermectin Treatment on Human Onchocerciasis

    PubMed Central

    Turner, Hugo C.; Churcher, Thomas S.; Walker, Martin; Osei-Atweneboana, Mike Y.; Prichard, Roger K.; Basáñez, María-Gloria

    2013-01-01

    Background Recent studies in Mali, Nigeria, and Senegal have indicated that annual (or biannual) ivermectin distribution may lead to local elimination of human onchocerciasis in certain African foci. Modelling-based projections have been used to estimate the required duration of ivermectin distribution to reach elimination. A crucial assumption has been that microfilarial production by Onchocerca volvulus is reduced irreversibly by 30–35% with each (annual) ivermectin round. However, other modelling-based analyses suggest that ivermectin may not have such a cumulative effect. Uncertainty in this (biological) and other (programmatic) assumptions would affect projected outcomes of long-term ivermectin treatment. Methodology/Principal Findings We modify a deterministic age- and sex-structured onchocerciasis transmission model, parameterised for savannah O. volvulus–Simulium damnosum, to explore the impact of assumptions regarding the effect of ivermectin on worm fertility and the patterns of treatment coverage compliance, and frequency on projections of parasitological outcomes due to long-term, mass ivermectin administration in hyperendemic areas. The projected impact of ivermectin distribution on onchocerciasis and the benefits of switching from annual to biannual distribution are strongly dependent on assumptions regarding the drug's effect on worm fertility and on treatment compliance. If ivermectin does not have a cumulative impact on microfilarial production, elimination of onchocerciasis in hyperendemic areas may not be feasible with annual ivermectin distribution. Conclusions/Significance There is substantial (biological and programmatic) uncertainty surrounding modelling projections of onchocerciasis elimination. These uncertainties need to be acknowledged for mathematical models to inform control policy reliably. Further research is needed to elucidate the effect of ivermectin on O. volvulus reproductive biology and quantify the patterns of coverage and

  19. Treatment of human Mansonella streptocerca infection with ivermectin.

    PubMed

    Fischer, P; Bamuhiiga, J; Büttner, D W

    1997-02-01

    We studied the short-term effects of a single dose of 150 micrograms/kg body weight ivermectin on Mansonella streptocerca in an area endemic for streptocerciasis, but not for onchocerciasis, in western Uganda. Six and 12 days after treatment no microfilaria (mf) were found in the skin of 53 out of 96 mf carriers living in 3 villages, and the geometric means of the mf densities of remaining mf carriers were only 33-40% of pretreatment levels. This reduction of mf density was highly significant (P < 0.0001). Immunohistological examination of skin biopsies showed degenerated and disintegrating mf surrounded by activated eosinophils (positive for activated cationic protein), macrophages, and neutrophils (positive for myeloperoxidase and defensin) on day 6 after treatment. Remarkable was the invasion of young, L1 protein-positive macrophages and the release of neutrophil defensin as signs of acute inflammation. We conclude that ivermectin has a strong microfilaricidal activity against M. streptocerca. Common adverse effects were increased pruritus and acute papular dermatitis in 45% of 86 mf carriers on day 6 after treatment. No serious adverse side-effects were noticed in about 700 treated persons.

  20. Ivermectin in the treatment of onchocerciasis in Britain.

    PubMed

    Godfrey-Faussett, P; Dow, C; Black, M E; Bryceson, A D

    1991-06-01

    Thirty-one patients with onchocerciasis were treated with a single dose of 150-200 micrograms/kg ivermectin. They were observed for three days to detect acute reactions and were reassessed clinically and parasitologically three, six and twelve months after treatment. 22 patients were expatriates. All had early, light and often localised infections and were not reexposed to infection during the course of the study. 25 patients completed follow-up. Patients who relapsed were retreated with the same dose after an interval of not less than five months. Adverse reactions were less severe than those experienced by similar patients treated with diethylcarbamazine and only one patient was given corticosteroids. 17 patients (68%) relapsed within one year and two thirds of these had done so within 6 months. A similar pattern was seen after the second dose. A single dose of ivermectin, repeated every three to six months as necessary, is likely to be the treatment of choice for patients in non-endemic areas, lightly infected with Onchocerca volvulus, until a safe macrofilaricidal drug emerges. One third of such patients may be cured with each treatment.

  1. New developments in the treatment of rosacea – role of once-daily ivermectin cream

    PubMed Central

    Cardwell, Leah A; Alinia, Hossein; Moradi Tuchayi, Sara; Feldman, Steven R

    2016-01-01

    Rosacea is a chronic dermatological disorder with a variety of clinical manifestations localized largely to the central face. The unclear etiology of rosacea fosters therapeutic difficulty; however, subtle clinical improvement with pharmacologic treatments of various drug categories suggests a multifactorial etiology of the disease. Factors that may contribute to disease pathogenesis include immune abnormality, vascular abnormality, neurogenic dysregulation, presence of cutaneous microorganisms, UV damage, and skin barrier dysfunction. The role of ivermectin in the treatment of rosacea may be as an anti-inflammatory and anti-parasitic agent targeting Demodex mites. In comparing topical ivermectin and metronidazole, ivermectin was more effective; this treatment modality boasted more improved quality of life, reduced lesion counts, and more favorable participant and physician assessment of disease severity. Patients who received ivermectin 1% cream had an acceptable safety profile. Ivermectin is efficacious in decreasing inflammatory lesion counts and erythema. PMID:27051311

  2. Topical ivermectin 0.5% lotion for treatment of head lice.

    PubMed

    Deeks, Louise S; Naunton, Mark; Currie, Marian J; Bowden, Francis J

    2013-09-01

    To investigate the pharmacology, pharmacokinetics, efficacy, adverse effects, and place in therapy of a single application of topical ivermectin 0.5% lotion for head lice treatment. Literature was obtained by searching MEDLINE, PubMed, CINAHL, and Scopus (January 1980 to January 2013). Abstracts were searched for the terms ivermectin AND (head lice or pediculus or pediculosis), topical ivermectin, ivermectin lotion, ivermectin AND (pharmacology OR pharmacokinetics). The New Drug Application filed with the Food and Drug Administration and the product data sheets for ivermectin were obtained. All English-language articles retrieved from the search were evaluated for relevance to the objective. The recommended first-line head lice treatments in the United States are permethrin 1% or pyrethrins, with malathion 0.5% lotion used as a second-line treatment. Significantly more of the 289 head lice-infested participants using topical ivermectin 0.5% lotion were lice-free at day 15 when compared with vehicle control (73.8% vs 17.6%; P < .001) in 2 studies. Although this rate is lower than other third-line treatments (eg, spinosad 0.9% or benzyl alcohol 5%), topical ivermectin 0.5% lotion is well tolerated (pruritus, the most common adverse event, 0.9%) and requires only a single application. Topical ivermectin 0.5% lotion kills head lice by increasing chloride in muscle cells, causing hyperpolarization and paralysis. Only 1 application is required; when the treated eggs hatch, the lice are not viable because they cannot feed as a result of pharyngeal muscle paralysis. Minimal systemic absorption occurs following topical application. Studies have demonstrated that topical ivermectin 0.5% is a safe and efficacious treatment for head lice. Although it has no documented resistance, there is limited clinical experience, it requires a prescription, and it is expensive. Therefore it should be reserved as a third-line treatment for head lice in the United States.

  3. Dynamics of Onchocerca volvulus microfilarial densities after ivermectin treatment in an ivermectin-naïve and a multiply treated population from Cameroon.

    PubMed

    Pion, Sébastien D S; Nana-Djeunga, Hugues C; Kamgno, Joseph; Tendongfor, Nicholas; Wanji, Samuel; Njiokou, Flobert; Prichard, Roger K; Boussinesq, Michel

    2013-01-01

    Ivermectin has been the keystone of onchocerciasis control for the last 25 years. Sub-optimal responses to the drug have been reported in Ghanaian communities under long-term treatment. We assessed, in two Cameroonian foci, whether the microfilaricidal and/or embryostatic effects of ivermectin on Onchocerca volvulus have been altered after several years of drug pressure. We compared the dynamics of O. volvulus skin microfilarial densities after ivermectin treatment in two cohorts with contrasting exposure to this drug: one received repeated treatment for 13 years whereas the other had no history of large-scale treatments (referred to as controls). Microfilarial densities were assessed 15, 80 and 180 days after ivermectin in 122 multiply treated and 127 ivermectin-naïve individuals. Comparisons were adjusted for individual factors related to microfilarial density: age and number of nodules. Two weeks post ivermectin, microfilarial density dropped equally (98% reduction) in the ivermectin-naïve and multiply treated groups. Between 15 and 180 days post ivermectin, the proportion of individuals with skin microfilariae doubled (from 30.8% to 67.8%) in controls and quadrupled (from 19.8% to 76.9%) in multiply treated individuals but the mean densities remained low in both sites. In fact, between 15 and 80 days, the repopulation rate was significantly higher in the multiply treated individuals than in the controls but no such difference was demonstrated when extending the follow-up to 180 days. The repopulation rate by microfilariae was associated with host factors: negatively with age and positively with the number of nodules. These observations may indicate that the worms from the multi-treated area recover mf productivity earlier but would be less productive than the worms from the ivermectin-naïve area between 80 and 180 days after ivermectin. Moreover, they do not support the operation of a strong cumulative effect of repeated treatments on the fecundity of female

  4. An emerging treatment: Topical ivermectin for papulopustular rosacea.

    PubMed

    Abokwidir, Manal; Fleischer, Alan B

    2015-01-01

    Ivermectin shows broad-spectrum anti-parasitic activity. It kills the Demodex mites that reside in the pilosebaceous units of patients with papulopustular rosacea. Ivermectin also has anti-inflammatory effects, it decreases cellular and humoral immune responses. Inflammatory mechanisms appear to play a dominant role in the development of rosacea inflammatory lesions. Additionally, there is some evidence that it shows antimicrobial activity against Myobacterium tuberculosis and Chlamydia trachomatis. The recent clinical studies of ivermectin on rosacea show that it was superior to vehicle in reducing inflammatory lesion counts, and its tolerability was excellent. Ivermectin displays antimicrobial, antiparasitic, antibacterial, and anti-inflammatory activities.

  5. Differential effect of human ivermectin treatment on blood feeding Anopheles gambiae and Culex quinquefasciatus.

    PubMed

    Derua, Yahya A; Kisinza, William N; Simonsen, Paul E

    2015-02-27

    Widespread and large scale use of ivermectin in humans and domestic animals can have unexpected effects on non-target organisms. As a search for a possible explanation for an observed longitudinal decline in density of anopheline vector mosquitoes, but not in Culex quinquefasciatus, in an area of north-eastern Tanzania which has been exposed to ivermectin mass drug administration, this study assessed and compared the effect of human ivermectin treatment on blood feeding Anopheles gambiae and Cx. quinquefasciatus. Consenting adult volunteers were randomized into two groups to receive either ivermectin or placebo. Twenty four hours after treatment, one volunteer from each group was concurrently exposed to 50 laboratory reared An. gambiae on one arm and 50 laboratory reared Cx. quinquefasciatus on the other arm for 15-30 minutes. Engorged mosquitoes were maintained on 10% glucose solution for 12 days and observed for survival and fecundity. The experiment was repeated 15 times. Two days after the blood meals, nearly half (average 47.7% for the 15 experiments) of the blood fed An. gambiae in the ivermectin group had died while almost all in the placebo group were alive (97.2%), and the difference in survival between these two groups continued to widen on the following days. There was no clear effect of ivermectin on Cx. quinquefasciatus, which had high survival in both ivermectin and placebo group on day 2 (95.7% and 98.4%, respectively) as well as on the following days. Ivermectin completely inhibited egg laying in An. gambiae, while egg laying and subsequent development of immature stages appeared normal in the other three groups. Blood meals taken on ivermectin treated volunteers significantly reduced survival and halted fecundity of An. gambiae but had only limited or no effect on Cx. quinquefasciatus. The result suggests that widespread use of ivermectin may have contributed to the observed decline in density of An. gambiae, without similar decrease in Cx

  6. The treatment of microfilaremia due to Wuchereria bancrofti var. pacifica: ivermectin versus diethylcarbamazine.

    PubMed

    Cartel, J L; Spiegel, A; Nguyen, L; Plichart, R; Martin, P M; Roux, J F

    1991-09-01

    In October 1989, a controlled, double-blind parallel group trial was implemented to compare both efficacy and tolerability of single doses of ivermectin and diethylcarbamazine (DEC). Fifty eight apparently healthy Wuchereria bancrofti carriers were hospitalized and randomly allocated to treatment with ivermectin 100 mcg/kg, DEC 3 or 6 mg/kg. Six months later, half of those initially treated with ivermectin 100 mcg/kg and DEC 3 mg/kg were given a second similar dose while the rest were given a placebo. After initial treatment, clearance of microfilaremia was complete in 22 of the 23 carriers treated with ivermectin and in one only of the 35 treated with DEC. Adjusted geometric mean microfilaremia was significantly lower (p less than 0.01) in carriers treated with ivermectin than in those treated with DEC at one, but neither at 3 (p = 0.26) nor at 6 months (p = 0.63). The comparison of adjusted geometric mean microfilaremia per group indicated that (i) regarding either ivermectin 100 mcg/kg or DEC 3 mg/kg, 2 successive doses resulted in higher efficacy than one annual dose and (ii) efficacy of 2 successive doses of ivermectin 100 mcg/kg or DEC 3 mg/kg were not significantly different. During the 3 days following initial treatment, adverse reactions were observed in 80% of the treated carriers of whom 14% suffered a grade 3 reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Efficacy of ivermectin in the treatment of concomitant Mansonella perstans infections in onchocerciasis patients.

    PubMed

    Schulz-Key, H; Albrecht, W; Heuschkel, C; Soboslay, P T; Banla, M; Görgen, H

    1993-01-01

    As part of an ivermectin dose-ranging study of onchocerciasis patients in Togo, 55 onchocerciasis patients with concomitant mansonelliasis received single oral doses either of ivermectin (100 to 200 micrograms/kg body weight) or placebo. As expected, Onchocerca volvulus microfilariae in the skin were greatly reduced in number soon after drug treatment, but microfilariae of Mansonella perstans reacted differently. Microfilarial densities of M. perstans were assessed with a filtration technique both before, and 4 times after, treatment. In untreated patients microfilarial densities were stable until the end of the study at 6 months. In patients receiving ivermectin, microfilarial densities dropped on average to less than 60% of the pre-treatment level and remained there until the final post-treatment examination. This partial reduction was probably not caused by a microfilaricidal effect of ivermectin, but rather by an altered distribution of microfilariae in the peripheral blood and in a suspected microfilarial reservoir.

  8. Efficacy of permethrin cream and oral ivermectin in treatment of scabies.

    PubMed

    Abedin, Sarfrazul; Narang, Manish; Gandhi, Vijay; Narang, Shiva

    2007-10-01

    To compare the efficacy of mass treatment of scabies with permethrin cream and oral ivermectin in a closed urban pediatric population. A comparative trial of topical permethrin and oral ivermectin was conducted in a closed population of 84 children living in a urban hostel of Delhi. After mass treatment with 2 doses of oral ivermectin, one case was recorded in following 6 months, as compared to 22 cases in preceding 6 months when children were treated with a single application of 5% permethrin. Mass treatment of scabies with ivermectin in an endemic population is more efficacious as compared to topical permethrin application in reducing the baseline prevalence, decreasing the chain of transmission and chances of reinfection.

  9. Identifying sub-optimal responses to ivermectin in the treatment of River Blindness

    PubMed Central

    Churcher, Thomas S.; Pion, Sébastien D. S.; Osei-Atweneboana, Mike Y.; Prichard, Roger K.; Awadzi, Kwablah; Boussinesq, Michel; Collins, Richard C.; Whitworth, James A.; Basáñez, María-Gloria

    2009-01-01

    Identification of drug resistance before it becomes a public health concern requires a clear distinction between what constitutes a normal and a suboptimal treatment response. A novel method of analyzing drug efficacy studies in human helminthiases is proposed and used to investigate recent claims of atypical responses to ivermectin in the treatment of River Blindness. The variability in the rate at which Onchocerca volvulus microfilariae repopulate host's skin following ivermectin treatment is quantified using an individual-based onchocerciasis mathematical model. The model estimates a single skin repopulation rate for every host sampled, allowing reports of suboptimal responses to be statistically compared with responses from populations with no prior exposure to ivermectin. Statistically faster rates of skin repopulation were observed in 3 Ghanaian villages (treated 12–17 times), despite the wide variability in repopulation rates observed in ivermectin-naïve populations. Another village previously thought to have high rates of skin repopulation was shown to be indistinguishable from the normal treatment response. The model is used to generate testable hypotheses to identify whether atypical rates of skin repopulation by microfilariae could result from low treatment coverage alone or provide evidence of decreased ivermectin efficacy. Further work linking phenotypic poor responses to treatment with parasite molecular genetics markers will be required to confirm drug resistance. Limitations of the skin-snipping method for estimating parasite load indicates that changes in the distribution of microfilarial repopulation rates, rather than their absolute values, maybe a more sensitive indicator of emerging ivermectin resistance. PMID:19805362

  10. Identifying sub-optimal responses to ivermectin in the treatment of River Blindness.

    PubMed

    Churcher, Thomas S; Pion, Sébastien D S; Osei-Atweneboana, Mike Y; Prichard, Roger K; Awadzi, Kwablah; Boussinesq, Michel; Collins, Richard C; Whitworth, James A; Basáñez, María-Gloria

    2009-09-29

    Identification of drug resistance before it becomes a public health concern requires a clear distinction between what constitutes a normal and a suboptimal treatment response. A novel method of analyzing drug efficacy studies in human helminthiases is proposed and used to investigate recent claims of atypical responses to ivermectin in the treatment of River Blindness. The variability in the rate at which Onchocerca volvulus microfilariae repopulate host's skin following ivermectin treatment is quantified using an individual-based onchocerciasis mathematical model. The model estimates a single skin repopulation rate for every host sampled, allowing reports of suboptimal responses to be statistically compared with responses from populations with no prior exposure to ivermectin. Statistically faster rates of skin repopulation were observed in 3 Ghanaian villages (treated 12-17 times), despite the wide variability in repopulation rates observed in ivermectin-naïve populations. Another village previously thought to have high rates of skin repopulation was shown to be indistinguishable from the normal treatment response. The model is used to generate testable hypotheses to identify whether atypical rates of skin repopulation by microfilariae could result from low treatment coverage alone or provide evidence of decreased ivermectin efficacy. Further work linking phenotypic poor responses to treatment with parasite molecular genetics markers will be required to confirm drug resistance. Limitations of the skin-snipping method for estimating parasite load indicates that changes in the distribution of microfilarial repopulation rates, rather than their absolute values, maybe a more sensitive indicator of emerging ivermectin resistance.

  11. Concurrent parasitic infections in onchocerciasis and the occurrence of adverse reactions after ivermectin treatment.

    PubMed

    Njoo, F L; Belling, G A; Oosting, J; Vetter, J C; Stilma, J S; Kijlstra, A

    1993-05-01

    Ivermectin is a safe, effective, and relatively well-tolerated drug for the treatment of human onchocerciasis. However, due to side effects of the drug, large-scale ivermectin distribution without medical supervision is not recommended. The mechanisms involved in the pathogenesis of ivermectin-induced adverse reactions are not yet known. Since onchocerciasis patients are likely to have concurrent parasitic infections, we investigated whether side effects that occur after ivermectin treatment could be related to the presence of parasite eggs and cysts in stool samples prior to treatment. One hundred twenty-nine onchocerciasis patients were treated with a single dose of ivermectin (150 micrograms/kg) and side effects were graded according to the classification of Greene and others. Stool samples were collected before and three days after treatment. A high percentage (80.5%) of the patients reported adverse effects (57% mild, 14.1% moderate, and 9.4% severe reactions). Most (95.1%) of the patients had one or more concurrent parasitic infections. No relationship could be found between the occurrence and extent of side effects and the severity of concurrent intestinal parasitic infections. However, side effects were significantly correlated with pretreatment microfilarial counts. Ivermectin treatment did not induce significant short-term changes in Trichuris trichiura or Schistosoma mansoni egg counts. However, a significant reduction in Ascaris lumbricoides egg counts and Entamoeba coli cyst loads was observed; a cure rate of 46% for cysts was reached. In contrast, hookworm egg production increased after ivermectin treatment. Further studies are required to verify ivermectin-induced changes in cyst and hookworm loads as well as the significance of these findings.

  12. Treatment of 18 children with scabies or cutaneous larva migrans using ivermectin.

    PubMed

    del Mar Sáez-De-Ocariz, M; McKinster, C Durán; Orozco-Covarrubias, L; Tamayo-Sánchez, L; Ruiz-Maldonado, R

    2002-06-01

    In addition to onchocerciasis and other filarial diseases, ivermectin has been used for the treatment of scabies, head lice, larva migrans and gnathostomiasis. However, there is concern regarding the safety of its use in children under 5 years of age or weighing less than 15 kg. We present our experience in 18 children (aged 14 months to 17 years), with scabies or cutaneous larva migrans successfully treated with ivermectin. They included four cases of crusted scabies associated with immunosuppression and seven cases of common scabies four of whom had associated clinical mental retardation, immunosuppression or hypomobility. A further seven patients had cutaneous larva migrans. Fifteen patients were cured with a single dose of ivermectin, and three patients with crusted scabies required a second dose. None of our patients suffered significant adverse effects. We believe that ivermectin is a safe and effective alternative treatment of cutaneous parasitosis in children.

  13. Ivermectin for the treatment of Wuchereria bancrofti filariasis. Efficacy and adverse reactions.

    PubMed

    Kumaraswami, V; Ottesen, E A; Vijayasekaran, V; Devi, U; Swaminathan, M; Aziz, M A; Sarma, G R; Prabhakar, R; Tripathy, S P

    1988-06-03

    Ivermectin treatment was evaluated for efficacy and side effects in 40 patients in South India who had microfilaremia and bancroftian filariasis. Ivermectin was administered once orally at four dose levels (range, 25 to 200 micrograms/kg), and at each it was found to be completely effective in clearing blood microfilariae within five to 12 days. In most patients, microfilariae reappeared by three months; by six months the levels averaged 14% to 32% of pretreatment values in the four study groups, and all groups showed equivalent efficacy. Detailed monitoring identified some side effects in almost all patients: usually fever, headache, light-headedness, myalgia, sore throat, or cough that occurred most prominently 18 to 36 hours after treatment. These were most frequent and severe in patients with the greatest microfilaremia, but only when treated with the two higher doses of ivermectin (100 and 200 micrograms/kg). The low-dose (25 micrograms/kg) ivermectin group, despite equivalent efficacy in parasite killing, had clinical reaction scores that were minimal and that were not correlated with parasitemia. Since efficacy and side effects of ivermectin therapy compare favorably with those reported for treatment with the standard antifilarial drug diethylcarbamazine citrate, the major advantage of single-oral-dose administration makes ivermectin the best candidate to replace diethylcarbamazine as the treatment of choice for bancroftian filariasis.

  14. Clinical efficacy and safety of topical versus oral ivermectin in treatment of uncomplicated scabies.

    PubMed

    Ahmad, Hesham M; Abdel-Azim, Eman S; Abdel-Aziz, Rasha T

    2016-01-01

    Many medications are available for scabies treatment including oral and topical ivermectin. However, studies comparing these two forms as a scabies treatment are few. This study compares efficacy and safety of topical versus oral ivermectin as scabies treatment. The study included 62 confirmed uncomplicated scabies patients, divided into: Group I (32 patients, received topical ivermectin) and Group II (30 patients, received oral ivermectin). Patients were assessed, clinically and by KOH smear at 1, 2 and 4 weeks. Treatment was repeated after one week in patients with persistent infection. Adverse events were recorded. Most patients (87.5% and 73.5% in group I and group II respectively) were symptom free after a single treatment. A second treatment was required in 4 patients of group I and 8 patients of group II. However, 2 weeks after treatment symptoms and signs completely resolved in all cases with no recurrence at 4 weeks. This study suggests that both topical and oral ivermectin are safe and equally effective in treatment of uncomplicated scabies. Single treatment, whether topical or oral, is associated with high cure rate in a week post treatment. However, repeating treatment after one week may be required to achieve 100% cure.

  15. The efficacy of topical ivermectin versus malation 0.5% lotion for the treatment of scabies.

    PubMed

    Goldust, Mohamad; Rezaee, Elham

    2013-05-06

    Objective: There are different medications for the treatment of scabies but the treatment of choice is still controversial. This study aimed at comparing the efficacy of topical ivermectin versus malation 0.5% lotion for the treatment of scabies. Methods: In total, 340 patients with scabies were enrolled, and randomized into two groups: the first group received 1% ivermectin applied topically to the affected skin and the second group received topical malation 0.5% lotion and were told to apply this twice with 1 week interval. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Results: Two application of topical ivermectin provided a cure rate of 67.6% at the 2-week follow-up, which increased to 85.2% at the 4-week follow-up after repeating the treatment. Treatment with two applications of malation 0.5% lotion was effective in 44.1% of patients at the 2-week follow-up, which increased to 67.6% at the 4-week follow-up after this treatment was repeated. Conclusion:Two application of ivermectin was as effective as single applications of malation 0.5% lotion at the 2-week follow-up. After repeating the treatment, ivermectin was superior to malation 0.5% lotion at the 4-week follow up.

  16. Comparison of oral ivermectin vs. lindane lotion 1% for the treatment of scabies.

    PubMed

    Mohebbipour, A; Saleh, P; Goldust, M; Amirnia, M; Zadeh, Y J; Mohamad, R M; Rezaee, E

    2013-10-01

    Scabies is a common parasitic infestation that is an important public-health problem in many resource-poor regions. It is commonly treated with the insecticides ivermectin and permethrin. To compare the efficacy and safety of oral ivermectin vs. lindane lotion 1% for the treatment of scabies. In total, 148 patients with scabies were enrolled, and were randomized into two groups: the first group received a single dose of oral ivermectin 200 μg/kg body weight, and the second group were treated with two applications of topical lindane lotion 1%, with a 1-week interval between applications. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. A single dose of ivermectin provided a cure rate of 60.8% at the 2-week follow-up, which increased to 89.1% at the 4-week follow-up. after crossing over to the lindane lotion 1% group. Treatment with two applications of lindane lotion 1%, with a 1-week interval between them, was effective in 47.2% of patients at the 2-week follow-up, which increased to 72.9% at the 4-week follow-up after this treatment was repeated. A single dose of ivermectin was as effective as two applications of lindane lotion 1% at the 2-week follow-up. After repeat treatment, ivermectin was superior to lindane lotion 1% at the 4-week follow up. The delay in clinical response with ivermectin suggests that it may not be effective against all the stages in the life cycle of the parasite. © 2013 British Association of Dermatologists.

  17. Dynamics of Onchocerca volvulus Microfilarial Densities after Ivermectin Treatment in an Ivermectin-naïve and a Multiply Treated Population from Cameroon

    PubMed Central

    Pion, Sébastien D. S.; Nana-Djeunga, Hugues C.; Kamgno, Joseph; Tendongfor, Nicholas; Wanji, Samuel; Njiokou, Flobert; Prichard, Roger K.; Boussinesq, Michel

    2013-01-01

    Background/Objective Ivermectin has been the keystone of onchocerciasis control for the last 25 years. Sub-optimal responses to the drug have been reported in Ghanaian communities under long-term treatment. We assessed, in two Cameroonian foci, whether the microfilaricidal and/or embryostatic effects of ivermectin on Onchocerca volvulus have been altered after several years of drug pressure. Methods We compared the dynamics of O. volvulus skin microfilarial densities after ivermectin treatment in two cohorts with contrasting exposure to this drug: one received repeated treatment for 13 years whereas the other had no history of large-scale treatments (referred to as controls). Microfilarial densities were assessed 15, 80 and 180 days after ivermectin in 122 multiply treated and 127 ivermectin-naïve individuals. Comparisons were adjusted for individual factors related to microfilarial density: age and number of nodules. Findings Two weeks post ivermectin, microfilarial density dropped equally (98% reduction) in the ivermectin-naïve and multiply treated groups. Between 15 and 180 days post ivermectin, the proportion of individuals with skin microfilariae doubled (from 30.8% to 67.8%) in controls and quadrupled (from 19.8% to 76.9%) in multiply treated individuals but the mean densities remained low in both sites. In fact, between 15 and 80 days, the repopulation rate was significantly higher in the multiply treated individuals than in the controls but no such difference was demonstrated when extending the follow-up to 180 days. The repopulation rate by microfilariae was associated with host factors: negatively with age and positively with the number of nodules. Conclusion These observations may indicate that the worms from the multi-treated area recover mf productivity earlier but would be less productive than the worms from the ivermectin-naïve area between 80 and 180 days after ivermectin. Moreover, they do not support the operation of a strong cumulative effect

  18. The efficacy of topical and oral ivermectin in the treatment of human scabies.

    PubMed

    Panahi, Yunes; Poursaleh, Zohreh; Goldust, Mohamad

    2015-01-01

    Scabies is an itchy skin condition caused by the microscopic mite Sarcoptes scabei. The itching is caused by an allergic reaction to the mites. The treatment of choice is still controversial. It is commonly treated with topical insecticides. The aim of this study was to assess the efficacy of topical and oral ivermectin in the treatment of human scabies. We searched electronic databases (Cochrane Occupational Safety and Health Review Group Specialised Register, CENTRAL (The Cochrane Library), MEDLINE (Ovid), Pubmed, EMBASE, LILACS, CINAHL, Open Grey and WHO ICTRP) up to September 2014. Randomized controlled trials (RCTs) or cluster RCTs which compared the efficacy of ivermectin with other medications in the treatment of scabies. Interventions could be compared to each other, or to placebo or to no treatment. The author intended to extract dichotomous data (developed infection or did not develop infection) for the effects of interventions. We intended to report any adverse outcomes similarly. It has been sated that ivermectin was as effective as permethrin in the treatment of scabies. In comparison to other medications such as lindane, benzyl benzoate, crotamiton and malathion, ivermectin was more effective in the treatment of scabies. Ivermectin is an effective and cost-comparable alternative to topical agents in the treatment of scabies infection.

  19. Short communication: impact of long-term (14 years) bi-annual ivermectin treatment on Wuchereria bancrofti microfilaraemia.

    PubMed

    Kyelem, D; Medlock, J; Sanou, S; Bonkoungou, M; Boatin, B; Molyneux, D H

    2005-10-01

    Ivermectin has been and continues to be extensively used to control onchocerciasis in areas of hyper and mesoendemicity within the African Programme of Onchocerciasis Control. As programmes to eliminate lymphatic filariasis (LF) caused by Wuchereria bancrofti expand, areas of coendemicity with onchocerciasis will be incorporated into LF programmes. This study reports that in villages which were hyperendemic for onchocerciasis after some 14 years of treatment with ivermectin, no W. bancrofti could be detected in a population of 1210 individuals whilst in adjacent villages a prevalence of around 3% was found. Despite the long period of ivermectin treatment Mansonella perstans did not appear to respond to ivermectin in this setting.

  20. Evaluating the Effects of Ivermectin Treatment on Communities of Gastrointestinal Parasites in Translocated Woylies (Bettongia penicillata).

    PubMed

    Northover, Amy S; Godfrey, Stephanie S; Lymbery, Alan J; Morris, Keith; Wayne, Adrian F; Thompson, R C Andrew

    2017-03-01

    Wildlife species are often treated with anti-parasitic drugs prior to translocation, despite the effects of this treatment being relatively unknown. Disruption of normal host-parasite relationships is inevitable during translocation, and targeted anti-parasitic drug treatment may exacerbate this phenomenon with inadvertent impacts on both target and non-target parasite species. Here, we investigate the effects of ivermectin treatment on communities of gastrointestinal parasites in translocated woylies (Bettongia penicillata). Faecal samples were collected at three time points (at the time of translocation, and 1 and 3 months post-translocation) and examined for nematode eggs and coccidian oocysts. Parasite prevalence and (for nematodes) abundance were estimated in both treated and untreated hosts. In our study, a single subcutaneous injection of ivermectin significantly reduced Strongyloides-like egg counts 1 month post-translocation. Strongyle egg counts and coccidia prevalence were not reduced by ivermectin treatment, but were strongly influenced by site. Likewise, month of sampling rather than ivermectin treatment positively influenced body condition in woylies post-translocation. Our results demonstrate the efficacy of ivermectin in temporarily reducing Strongyloides-like nematode abundance in woylies. We also highlight the possibility that translocation-induced changes to host density may influence coinfecting parasite abundance and host body condition post-translocation.

  1. Ivermectin Treatment in Patients With Onchocerciasis-Associated Epilepsy: Protocol of a Randomized Clinical Trial

    PubMed Central

    Mandro, Michel; Mukendi, Deby; Dolo, Housseini; Suykerbuyk, Patrick; Van Oijen, Marieke

    2017-01-01

    Background Many studies have reported an association between epilepsy, nodding syndrome (NS), and onchocerciasis (river blindness). A high prevalence of epilepsy has been noted particularly in onchocerciasis hyperendemic areas where onchocerciasis is not or insufficiently controlled with mass ivermectin distribution. There is evidence that increasing the coverage of ivermectin reduces the incidence of epilepsy, and anecdotal evidence suggests a reduction in seizure frequency in onchocerciasis-associated epilepsy (OAE) patients who receive ivermectin. Finding an alternative treatment for epilepsy in these patients will have major consequences. Objective The goal of the study is to assess whether ivermectin treatment decreases the frequency of seizures and leads to seizure freedom in OAE patients, including patients with NS. If we are able to demonstrate such an effect, this would strengthen the argument that onchocerciasis is causing epilepsy and therefore we should increase our efforts to eliminate onchocerciasis. Methods We will conduct a randomized clinical trial in the Democratic Republic of Congo to compare seizure freedom in onchocerciasis-infested epilepsy patients who receive immediate ivermectin treatment with delayed (after 4 months) ivermectin treatment. All participants will simultaneously receive antiepilepsy drugs (AEDs) according to local guidelines for epilepsy treatment. The primary endpoint is seizure freedom defined as no seizures during the 4 month of follow-up. Secondary endpoint is significant (>50%) seizure reduction compared to baseline seizure frequency. Reduction of seizures will be compared between ivermectin and nonivermectin arms. Results Start of enrollment is planned for August 2017, and we expect to have enrolled all 110 participants by December 2017. Results are expected in June 2018. Conclusions If ivermectin treatment in addition to AEDs is able to lead to seizure freedom or significantly reduces seizure frequency in OAE patients

  2. Impact of ivermectin on onchocerciasis transmission: assessing the empirical evidence that repeated ivermectin mass treatments may lead to elimination/eradication in West-Africa

    PubMed Central

    Borsboom, Gerard JJM; Boatin, Boakye A; Nagelkerke, Nico JD; Agoua, Hyacinthe; Akpoboua, Komlan LB; Alley, E William Soumbey; Bissan, Yeriba; Renz, Alfons; Yameogo, Laurent; Remme, Jan HF; Habbema, J Dik F

    2003-01-01

    Background The Onchocerciasis Control Program (OCP) in West Africa has been closed down at the end of 2002. All subsequent control will be transferred to the participating countries and will almost entirely be based on periodic mass treatment with ivermectin. This makes the question whether elimination of infection or eradication of onchocerciasis can be achieved using this strategy of critical importance. This study was undertaken to explore this issue. Methods An empirical approach was adopted in which a comprehensive analysis was undertaken of available data on the impact of more than a decade of ivermectin treatment on onchocerciasis infection and transmission. Relevant entomological and epidemiological data from 14 river basins in the OCP and one basin in Cameroon were reviewed. Areas were distinguished by frequency of treatment (6-monthly or annually), endemicity level and additional control measures such as vector control. Assessment of results were in terms of epidemiological and entomological parameters, and as a measure of inputs, therapeutic and geographical coverage rates were used. Results In all of the river basins studied, ivermectin treatment sharply reduced prevalence and intensity of infection. Significant transmission, however, is still ongoing in some basins after 10–12 years of ivermectin treatment. In other basins, transmission may have been interrupted, but this needs to be confirmed by in-depth evaluations. In one mesoendemic basin, where 20 rounds of four-monthly treatment reduced prevalence of infection to levels as low as 2–3%, there was significant recrudescence of infection within a few years after interruption of treatment. Conclusions Ivermectin treatment has been very successful in eliminating onchocerciasis as a public health problem. However, the results presented in this paper make it almost certain that repeated ivermectin mass treatment will not lead to the elimination of transmission of onchocerciasis from West Africa. Data

  3. Topical ivermectin versus crotamiton cream 10% for the treatment of scabies.

    PubMed

    Goldust, Mohamad; Rezaee, Elham; Raghiafar, Ramin

    2014-07-01

    Scabies, known colloquially as the 7-year itch, is a contagious skin infection that occurs among humans and other animals. The treatment of choice is still controversial. The aim of this study was to compare the efficacy and safety of topical ivermectin vs. crotamiton cream 10% for the treatment of scabies. In total, 340 patients with scabies were enrolled, and randomized into two groups. The first group received 1% ivermectin applied topically to the affected skin. The dose employed was 400 μg/kg, repeated once the following week, and the second group received crotamiton 10% cream and were told to apply this twice daily for five consecutive days. Treatment was evaluated at intervals of two and four weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Two applications of topical ivermectin provided a cure rate of 64.7% at the 2-week follow-up, which increased to 82.3% at the 4-week follow-up after repeating the treatment. Treatment with single applications of crotamiton cream 10% was effective in 41.2% of patients at the 2-week follow-up, which increased to 64.7% at the 4-week follow-up after this treatment was repeated. Ivermectin was quite safe in our cases. Two applications of ivermectin were as effective as single applications of crotamiton 10% cream at the 2-week follow-up. After repeating the treatment, ivermectin was superior to crotamiton cream 10% at the 4-week follow-up.

  4. The efficacy of oral ivermectin vs. sulfur 10% ointment for the treatment of scabies.

    PubMed

    Alipour, Human; Goldust, Mohamad

    2015-01-01

    Human scabies is caused by an infection of the skin by the human itch mite (Sarcoptes scabiei var. hominis). There are different medications for the treatment of scabies. This study aimed at comparing the efficacy and safety of oral ivermectin vs. sulfur 10% ointment for the treatment of scabies. In total, 420 patients with scabies were enrolled, and randomized into two groups: the first group received a single dose of oral ivermectin 200 μg/kg body weight, and the second group received sulfur 10% ointment and were told to apply this for three successive days. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. A single dose of ivermectin provided a cure rate of 61.9% at the 2-week follow-up, which increased to 78.5% at the 4-week follow-up after repeating the treatment. Treatment with single applications of sulfur 10% ointment was effective in 45.2% of patients at the 2-week follow-up, which increased to 59.5% at the 4-week follow-up after this treatment was repeated. A single dose of ivermectin was as effective as single applications of sulfur 10% ointment at the 2-week follow-up. After repeating the treatment, ivermectin was superior to sulfur 10% ointment at the 4-week follow up. The delay in clinical response with ivermectin suggests that it may not be effective against all the stages in the life cycle of the parasite. .

  5. Comparison of oral ivermectin versus crotamiton 10% cream in the treatment of scabies.

    PubMed

    Goldust, Mohamad; Rezaee, Elham; Raghifar, Ramin

    2014-12-01

    Scabies is a relatively contagious infection caused by a tiny mite (Sarcoptes scabiei). Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. The aim of this study was to compare the efficacy and safety of oral ivermectin versus crotamiton 10% cream for the treatment of scabies. In total, 320 patients with scabies were enrolled, and were randomized into two groups: the first group received a single dose of oral ivermectin 200 µg/kg body weight, and the second group were treated with crotamiton 10% cream and were told to apply this twice daily for five consecutive days. Treatment was evaluated at intervals of two and four weeks, and if there was treatment failure at the two-week follow-up, the treatment was repeated. A single dose of ivermectin provided a cure rate of 62.5% at the two-week follow-up, which increased to 87.5% at the four-week follow-up after repeating the treatment. Treatment with crotamiton 10% cream was effective in 46.8% of patients at the two-week follow-up, which increased to 62.5% at the four-week follow-up after this treatment was repeated. A single dose of ivermectin was as effective as one application of crotamiton 10% cream at the two-week follow-up. After repeat treatment, ivermectin was superior to crotamiton 10% cream at the four-week follow up. The delay in clinical response with ivermectin suggests that it may not be effective against all the stages in the life cycle of the parasite.

  6. The efficacy of permethrin 5% vs. oral ivermectin for the treatment of scabies.

    PubMed

    Ranjkesh, Mohammad Reza; Naghili, Behrouz; Goldust, Mohamad; Rezaee, Elham

    2013-01-01

    Human scabies is caused by an infestation of the skin by the human itch mite (Sarcoptes scabiei var. hominis). The aim of this study is to compare the efficacy and safety of permethrin 5% lotion with oral ivermectin for the treatment of scabies. In total, 60 patients with scabies were enrolled, and randomized into two groups: The first group and their family contacts received 5% permethrin cream twice with a one week interval, and the other received a single dose of oral ivermectin. Treatment was evaluated at intervals of 2 and 4 weeks. A single dose of ivermectin provided a cure rate of 62.4%, which increased to 92.8% with 2 doses at a 2-week interval. Treatment with two applications of permethrin with a one week interval was effective in 96.9% of patients. Permethrin-treated patients recovered earlier. Two applications of permethrin with a one week interval is more effective than a single dose of ivermectin. Two doses of ivermectin is as effective as a single application of permethrin.

  7. Ivermectin in the treatment of Physaloptera preputialis in two cats.

    PubMed

    Gustafson, B W

    1995-01-01

    Two mixed-breed cats were examined for intermittent vomiting of several months' duration. Adult Physaloptera preputialis nematodes were detected in the vomitus and melena was observed in both cases. Clinicopathological abnormalities including anemia and eosinophilia were found in one case. Clinical signs resolved following anthelmintic therapy with ivermectin (200 micrograms/kg body weight) administered subcutaneously.

  8. Ivermectin--clinical trials and treatment schedules in onchocerciasis.

    PubMed

    Brown, K R; Neu, D C

    1990-01-01

    Initial clinical trials with ivermectin were performed in patients with both roundworm infestation and onchocerciasis. Obvious clinical safety allowed for rapid progression through 5-30-50-100-150-200 mcg/kg in infected patients. Initial studies showed some effect at 50 mcg/kg; subsequent double-blind controlled studies, either with placebo or diethylcarbamazine (DEC), confirmed the efficacy of ivermectin as well as further defining its safety profile. Absence of adverse eye findings or serious systemic reactions justified the further open trials. Studies of patients treated at 6, 12, or 18 month intervals showed a long lasting effect of ivermectin in reducing skin microfilaria counts. Phase III studies confirmed safety and efficacy and further refined the dose to 150 mcg/kg every 12 months. Large trials in Liberia and other countries in West Africa, and subsequently under Onchocerciasis Control Program (OCP), included approximately 120,000 persons carefully followed during which few patients with serious adverse experiences were reported. These extensive field trials confirmed the relative safety allowing for broad distribution of ivermectin in programs not able to provide physician monitoring.

  9. Controlled trial and dose-finding study of ivermectin for treatment of onchocerciasis.

    PubMed

    White, A T; Newland, H S; Taylor, H R; Erttmann, K D; Keyvan-Larijani, E; Nara, A; Aziz, M A; D'Anna, S A; Williams, P N; Greene, B M

    1987-09-01

    Ivermectin, given as a single oral dose, has shown considerable promise as a new treatment for onchocerciasis. We assessed the safety and efficacy of ivermectin and tried to determine the optimal dose. Two hundred Liberians received 100, 150, or 200 micrograms of ivermectin/kg or placebo and were followed up for 12 months. Therapy was associated with only minimal systemic and ocular side effects. A 200-micrograms/kg dose was associated with greater systemic reaction than was a 100-micrograms/kg dose. Each treatment group had significant reduction in skin microfilaria counts by day 3 and a decrease of approximately 95% at three months. At three months the proportion of persons with no microfilariae in a specimen of skin was significantly less in the 100-micrograms/kg group than in the 150-micrograms/kg or 200-micrograms/kg groups. At 12 months, the level of microfilariae in skin was still reduced approximately 80%. Significant reduction in ocular involvement was seen in all groups. These results confirm that single-dose ivermectin is effective and well-tolerated and suggest that 150 micrograms of ivermectin/kg may be the optimal dose for initial therapy.

  10. Required duration of combined annual ivermectin treatment and vector control in the Onchocerciasis Control Programme in west Africa.

    PubMed Central

    Plaisier, A. P.; Alley, E. S.; van Oortmarssen, G. J.; Boatin, B. A.; Habbema, J. D.

    1997-01-01

    In the extension areas of the Onchocerciasis Control Programme in West Africa, aerial larviciding is supplemented with annual ivermectin treatment, mainly to achieve better control of morbidity. The purpose of this study is to determine whether and to what extent the addition of annual ivermectin treatment permits earlier cessation of vector control than originally recommended. The effectiveness of combined ivermectin distribution and vector control was assessed using an epidemiological model. Model predictions suggest that, dependent on the pre-control endemicity of the area and the proportion of persons treated during each ivermectin round, large-scale annual treatment permits a considerable reduction in the duration of vector control. Taking into account uncertainty about the efficacy of ivermectin, our results indicate that, provided treatment coverage is at least 65% and there is no importation of infection from elsewhere, 12 years of combined control will be sufficient to reduce the risk of recrudescence to below 1% in even the most afflicted areas. PMID:9277011

  11. Oral ivermectin treatment in two cases of scabies: effective in crusted scabies induced by corticosteroid but ineffective in nail scabies.

    PubMed

    Ohtaki, Noriko; Taniguchi, Hiroko; Ohtomo, Hiroshi

    2003-05-01

    We report two cases of scabies treated with oral ivermectin (200 micro g/kg). Case 1, a 72-year-old man, developed crusted scabies with the use of oral corticosteroids due to a misdiagnosis by an earlier physician. The patient was successfully treated with two doses of oral ivermectin at a 7 day interval with concomitant topical use of crotamiton and keratolytic agents. However, the nail scabies in this patient failed to respond to these treatments. Live mites were detected from all his toenails two weeks after the second dose of ivermectin. A complete cure of the nail scabies was achieved by occlusive dressing of 1% gamma-BHC on all toenails for one month. Case 2, a 52-year-old woman, had been treated with oral corticosteroid for mesangial nephritis. She developed common scabies, but a topical scabicide, crotamiton, was not effective. Two weeks after treatment with a single dose of oral ivermectin, eggs were still detected from a burrow on her trunk. Her treatment was completed after a further two doses of oral ivermectin were administered at 7 day intervals. In both patients, the administration of oral ivermectin did not induce any clinical or laboratory side effects. Oral ivermectin is effective for crusted scabies, but not effective for nail scabies. Two doses of oral ivermectin, administered with a one-week interval, is an appropriate treatment regimen.

  12. Treatment of rabbit cheyletiellosis with selamectin or ivermectin: a retrospective case study

    PubMed Central

    Mellgren, Marianne; Bergvall, Kerstin

    2008-01-01

    Background A retrospective study of rabbits treated against cheyletiellosis was performed to evaluate the efficacy and safety of selamectin or ivermectin in clinical practice. Methods Medical records from 53 rabbits with microscopically confirmed Cheyletiella infestation were collected from two small animal clinics. The rabbits were divided into three groups, based on treatment protocols. Group 1 included 11 rabbits treated with ivermectin injections at 200–476 μg kg-1 subcutaneously 2–3 times, with a mean interval of 11 days. In Group 2, 27 rabbits were treated with a combination of subcutaneous ivermectin injections (range 618–2185 μgkg-1) and oral ivermectin (range 616–2732 μgkg-1) administered by the owners, 3–6 times at 10 days interval. The last group (Group 3) included 15 rabbits treated with selamectin spot-on applications of 6.2–20,0 mgkg-1, 1–3 times with an interval of 2–4 weeks. Follow-up time was 4 months–4.5 years. Results Rabbits in remission were 9/11 (81,8%), 14/27 (51,9%) and 12/15 (80,8%) in groups 1, 2 and 3, respectively. Conclusion All treatment protocols seemed to be sufficiently effective and safe for practice use. Though very high doses were used in Group 2 (ivermectin injections followed by oral administration), the protocol seemed less efficacious compared to ivermectin injections (Group 1) and selamectin spot on (Group 3), respectively, although not statistically significant. Controlled prospective studies including larger groups are needed to further evaluate efficacy of the treatment protocols. PMID:18171479

  13. Mass treatment with ivermectin for filariasis control in Papua New Guinea: impact on mosquito survival.

    PubMed

    Bockarie, M J; Hii, J L; Alexander, N D; Bockarie, F; Dagoro, H; Kazura, J W; Alpers, M P

    1999-05-01

    Field studies were carried out to determine the impact of mass human treatment with ivermectin on the survival of anthropophagic mosquitoes of the Anopheles punctulatus complex (Diptera: Culicidae), the vectors of lymphatic filariasis and malaria in Papua New Guinea. In a village where mass treatment had been given, using 400 microg/kg ivermectin plus 6 mg/kg diethylcarbamazine citrate (DEC), we performed pre- and post-treatment collections of freshly blood-engorged mosquitoes from the same nine bedrooms. All blood-fed mosquitoes collected less than 4 days after mass treatment died within 9 days, whereas 67% of those collected before treatment survived for >9 days. Comparison (using the log-rank test) of the survival curves for mosquitoes collected (i) before treatment, (ii)<4 days after treatment, and (iii) 28 days after treatment, showed the survival rate of group (ii) to be significantly lower than the other two (chi2=176, df=2, P<0.0001). Pre- and post-treatment all-night landing catches showed no reduction in human biting rates in the experimental village. In another village, where people were mass treated with ivermectin (400 microg/kg) only, the survival rates of freshly blood-engorged An. punctulatus collected from bedroom resting-sites less than 1 day after treatment, were compared to similar collections carried out at the same time in a nearby village where people were not treated with ivermectin. The 48-h survival rate for the ivermectin-treated village was 31% compared to 94% for the other; this difference was highly significant (chi2=32.42, df=1, P<0.0001). Mosquitoes fed 2 months post-treatment with DEC or collected 38 days post-treatment with ivermectin had normal survival rates. We conclude that the duration of the systemic lethal effect of ivermectin on mosquitoes is insufficient to be of epidemiological significance in filariasis control programmes that are based on biannual and annual single-dose treatments, but might reduce vectorial capacity

  14. Sustained Clearance of Mansonella ozzardi Infection after Treatment with Ivermectin in the Brazilian Amazon

    PubMed Central

    Basano, Sergio de Almeida; Fontes, Gilberto; Medeiros, Jansen Fernandes; Aranha Camargo, Juliana Souza de Almeida; Souza Vera, Luana Janaína; Parente Araújo, Marcos Paulo; Pires Parente, Maira Santiago; Mattos Ferreira, Ricardo de Godoi; Barreto Crispim, Pedro di Tárique; Aranha Camargo, Luís Marcelo

    2014-01-01

    Abstract. Therapy for mansonelliasis is challenging because there is no standard drug recommended for its treatment. This non-randomized study was conducted to evaluate the effectiveness of a single dose of 0.15 mg/kg of ivermectin to reduce Mansonella ozzardi microfilaraemia in infected persons. A total of 74 patients were studied within the municipality of Lábrea, which is located in Amazonas State, Brazil. The patients were treated with ivermectin after detection of the parasite by blood examination. Significant microfilaraemia reduction was observed and its residual effect was maintained for at least 12 months. There was no significant change in the laboratory blood count, hepatic metabolites, and nitrogen-bounding compound excreta dosage values that could compromise the use of this drug, demonstrating that ivermectin has a low toxicity level. PMID:24710613

  15. Successful Treatment of Brugia pahangi in Naturally Infected Cats with Ivermectin

    PubMed Central

    Chungpivat, Sudchit

    2013-01-01

    Lymphatic filariasis is a common parasitic disease of cats in tropical regions including Thailand. The objective of this study was to determine the efficacy of ivermectin against microfilariae of Brugia pahangi in naturally infected cats. Eight cats naturally infected with B. pahangi were divided into control (untreated) and treated groups. Cats in the latter group were given ivermectin injection at 400 µg/kg weekly for 2 months. Microfilariae were counted every week until 48 weeks. Microfilaremia was significantly decreased in the treated group 4 weeks after starting the treatment and become zero at week 9 and afterwards. On the other hand, cats in the control group had high microfilaremia throughout the study. It was successful to treat and control B. pahangi infection in naturally infected cats using ivermectin. PMID:24516287

  16. Sarcoptes scabiei var. canis refractory to ivermectin treatment in two dogs.

    PubMed

    Terada, Yuri; Murayama, Nobuo; Ikemura, Hiroshi; Morita, Tatsushi; Nagata, Masahiko

    2010-12-01

    A 10-year-old castrated male Shih Tzu presented with severe generalized pruritus. Skin scrapings revealed the presence of Sarcoptes scabiei var. canis. A Yorkshire terrier in the same household simultaneously developed pruritus due to scabies. Both dogs were treated with 300 μg/kg ivermectin, at first orally and then subcutaneously at 14 day intervals. However, live mites were still found on day 35, and the skin condition deteriorated in both dogs. These findings suggested that the S. scabiei in these dogs was clinically refractory to ivermectin. The pruritus in both dogs rapidly and completely disappeared following topical fipronil administration. This appears to be the first report of canine scabies refractory to ivermectin treatment. © 2010 The Authors. Journal compilation © 2010 ESVD and ACVD.

  17. Community-based treatment of onchocerciasis with ivermectin: acceptability and early adverse reactions.

    PubMed Central

    Pacque, M. C.; Dukuly, Z.; Greene, B. M.; Munoz, B.; Keyvan-Larijani, E.; Williams, P. N.; Taylor, H. R.

    1989-01-01

    A study of community-based treatment of onchocerciasis with ivermectin was undertaken in a rain forest area of Liberia to investigate the possible occurrence of serious adverse effects. The total population was 13,704, the microfilarial load was 5.35 mf/mg skin, and the prevalence of Onchocerca volvulus infection was 50% at 9 years of age and over 80% among those aged 15 years and older. Certain groups (like pregnant women and young children) were excluded from treatment. Out of the 7956 people eligible for treatment, 7699 (97%) accepted the ivermectin. Data on possible adverse reactions were collected by four different methods, including systematic house-by-house follow-up visits three days after treatment, biweekly population surveillance, and monitoring of both mobile clinic records and hospital records. No severe adverse reactions were noted, and no deaths could be related to ivermectin treatment; only 1.3% of the persons treated had a moderate adverse reaction of the Mazzotti type, presumably related to the killing of microfilariae. The study showed good acceptance by the population, and that mass treatment campaigns with ivermectin are feasible. PMID:2633887

  18. [Ivermectin in the treatment and prevention of human onchocerciasis].

    PubMed

    Larivière, M; Beauvais, B; Derouin, F; Basset, D; Basset, A; Sarfati, C

    1987-01-01

    Ivermectin is a synthetic derivative of a macrocyclic lactone produced by an actinomycete Streptomyces avermitilis. It has a broad spectrum antiparasitic activity against nematodes and certain acarians in animals. The microfilaricide action of this product against horse and cattle onchocercosis led to the study of its effects in human onchocercosis against O. volvulus. Several trials performed mainly in endemic zones of Africa showed that this drug was more effective than the reference microfilaricide, diethylcarbamazine. A single oral dose of 200 micrograms/kg of Ivermectin reduces the dermal microfilaria population to nearly zero within a few days and the effect is maintained for at least 6 months. Secondary ocular or systemic effects are rare, negligible and transitory. The prolonged elimination of dermal microfilariasis caused by sequestration followed by degeneration of the microfilaria in the uterus of females raises the hope that Ivermectin used in a single annual or bi-annual dose will contribute to the interruption of the transmission of this serious parasitic disease.

  19. Eimeria stiedae: experimental infection in rabbits and the effect of treatment with toltrazuril and ivermectin.

    PubMed

    Cam, Yücel; Atasever, Ayhan; Eraslan, Gökhan; Kibar, Murat; Atalay, Oznur; Beyaz, Latife; Inci, Abdullah; Liman, Bilal Cem

    2008-05-01

    The aim of this study was to investigate the clinical, haematological, biochemical, lipid peroxidation, ultrasonographic and pathologic findings in hepatic coccidiosis induced by Eimeria stiedae in rabbits, and also to compare the treatment effects of both toltrazuril and ivermectin separately and in combination. In this study, 56 rabbits were divided into eight groups. The first group was designated as healthy control group. Rabbits were infected with 40.000 sporulated oocysts of E. stiedae. Groups 2, 3, 4, 5, 6, 7 and 8 were allocated as the infected control group, infected+toltrazuril-treated group, infected+ivermectin-treated group, infected+toltrazuril+ivermectin-treated group, non-infected+toltrazuril-treated group, non-infected+ivermectin-treated group, non-infected+toltrazuril+ivermectin-treated group, respectively. Haematocrit, Haemoglobin and MCV values as well as percentage of lymphocyte decreased in Groups 2 and 4 whereas leucocyte counts and percentage of granulocyte leucocyte increased. Serum GGT, ALT and AST activities increased but albumin value decreased. Plasma MDA concentrations increased whereas erythrocyte CAT, GSH-Px, and SOD activities decreased. Mean oocyst numbers in per gram faeces (epg values) increased in both groups during the study. Ultrasonographic examination revealed that the liver was enlarged and had hyperechogenic parenchyma. Bile ducts were dilated and hyperechogenic and the gall bladder was dilated. The livers of these animals were enlarged and typical macroscopic and microscopic findings of coccidiosis were present. Treatment with toltrazuril and toltrazuril+ivermectin combination were highly effective in reducing faecal oocyst output in infected rabbits. Haematological, biochemical and lipid peroxidation parameters and, ultrasonographic findings of the liver were close to control values for Groups 3 and 5. Necropsy of these animals showed no visible lesions related to hepatic coccidiosis although a few oocysts were detected

  20. Treatment of scabies: the topical ivermectin vs. permethrin 2.5% cream.

    PubMed

    Goldust, Mohamad; Rezaee, Elham; Raghifar, Ramin; Hemayat, Sevil

    2013-01-01

    Human scabies is caused by an infestation of the skin by the human itch mite (Sarcoptes scabiei va. hominis). It is commonly treated with topical insecticides, but the treatment of choice is still controversial. The aim of this study is to compare the efficacy of topical ivermectin vs. permethrin 2.5% cream for the treatment of scabies. In total, 380 patients with scabies were enrolled, and randomized into two groups: the first group received 1% ivermectin applied topically to the affected skin at a dose of 400 microg/kg, repeated once the following week, while the second group received permethrin 2.5% cream and were told to apply this twice at one week intervals. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Two applications of topical ivermectin provided a cure rate of 63.1% at the 2-week follow-up, which increased to 84.2% at the 4-week follow-up after repeating the treatment. Treatment with two applications of permethrin 2.5% cream with a 1-week interval between them was effective in 65.8% of patients at the 2-week follow-up, which increased to 89.5% at the 4-week follow-up after this treatment was repeated. Two application of ivermectin was as effective as two applications of permethrin 2.5% cream at the 2-week follow-up. After repeating the treatment, ivermectin was as effective as permethrin 2.5% cream at the 4-week follow up.

  1. Compliance with eight years of annual ivermectin treatment of onchocerciasis in Cameroon and Nigeria

    PubMed Central

    2011-01-01

    Background As the African Programme for Onchocerciasis Control (APOC) matured into its 10th year of ensuring community involvement in mass annual treatment of onchocerciasis with ivermectin, there was recognition of a need to study not only annual coverage of ivermectin in villages but also the compliance of individual villagers with these annual treatments. This was based on the concern that while population coverage goals may be achieved each year, there might be segments of the population who systematically are not complying with the annual regimen, thus creating a reservoir of infection and threatening program gains. Methods A multi-site study in five APOC sponsored projects in Nigeria and Cameroon was undertaken to identify the socio-demographic correlates of compliance with ivermectin treatment. A total of 8,480 villagers above 9 years of age selected through a systematic random sampling from 101 communities were surveyed to ascertain their levels of compliance, by adapting APOC's standard household ivermectin survey form. Community leaders, community directed distributors (CDDs) of ivermectin and health workers were interviewed with in-depth interview guides, while focus group discussions were held with community members to help explain how socio-demographic factors might affect compliance. Results Eight-year compliance ranged from 0 to 8 times with 42.9% taking ivermectin between 6-8 times annually (high compliance). In bivariate analysis high compliance was positively associated with being male, over 24 years of age, having been married, not being Christian, having little or no formal education and being in the ethnic majority. These variables were also confirmed through regression analysis based on total times ivermectin was taken over the period. While these factors explained only 8% of the overall variation in compliance, ethnic status and education appeared to be the strongest factors. Those with higher education may be more mobile and harder to reach

  2. Neoplastic change in Onchocerca volvulus and its relation to ivermectin treatment.

    PubMed

    Duke, B O L; Marty, A M; Peett, D L; Gardo, J; Pion, S D S; Kamgno, J; Boussinesq, M

    2002-11-01

    A pleomorphic neoplasm (PN) is described from sections of Onchocerca volvulus worms in nodules excised from Cameroonian patients. PN is confined to older, non-fecund, female worms, and those classed as moribund/dead. It is mainly composed of small, roundish, basophilic cells of diverse sizes, often forming a 'rosette' pattern around amorphous eosinophilic centres. The cells have a high nuclear/cytoplasmic ratio and up to 2-3 mitoses/high-power field; some become grossly enlarged, highly polymorphic and contain large, irregular blocks of chromatin. The eukaryotic PN cells first appear posteriorly in the pseudocoelom, probably from ovarian cells; they spread anteriorly, invading or compressing the uteri. Ivermectin treatment increased the prevalence PN from 3.7% of 1422 female worms in 637 patients before treatment to 17.5% of 1134 worms in 511 patients after 3 years treatment. Ivermectin at 400-800 microg/kg annually, or at 150 microg/kg or 400-800 microg/kg 3-monthly, over 3 years, did not increase the PN prevalence significantly, as compared with standard doses of 150 microg/kg annually. In other small series of African patients, PN prevalence increased in worms 2, 4, 6 and 10 months after ivermectin treatment; but there was no increase after treatment with amocarzine, albendazole or diethylcarbamazine and suramin. PN may partly account for the increased macrofilaricidal action of ivermectin on female O. volvulus in patients treated for 3 years at 3-monthly intervals.

  3. Treatment failure of a single high dose of ivermectin for Mansonella perstans filariasis.

    PubMed

    Van den Enden, E; Van Gompel, A; Van der Stuyft, P; Vervoort, T; Van den Ende, J

    1993-01-01

    Infections with Mansonella perstans are common in certain parts of Africa and South America. There is no standard treatment at present. We evaluated the effect of a single high dose of ivermectin (600 micrograms/kg) on microfilaraemia in 7 consecutive patients. No decrease in microfilarial counts could be demonstrated after a follow-up period of 7-56 d.

  4. Onchocerciasis and human immunodeficiency virus in western Uganda: prevalences and treatment with ivermectin.

    PubMed

    Fischer, P; Kipp, W; Kabwa, P; Buttner, D W

    1995-08-01

    Epidemiologic investigations were made to assess the interaction between onchocerciasis and human immunodeficiency (HIV) type 1 infection and the efficacy of ivermectin treatment. Among 1,910 Onchocerca volvulus carriers in a hyperendemic focus, 73 (3.8%) were concurrently infected with HIV and 20 (7.2%) of 276 persons without microfilariae (mf) were HIV-seropositive. A stratified analysis showed no epidemiologic association between onchocerciasis and HIV infection. Consistently, a microfilaria density of 11.9 mf/mg of skin in HIV-positive subjects and 17.7 mf/mg in HIV-negatives ones was observed. During mass treatment of onchocerciasis with a single dose of 150 micrograms/kg of ivermectin, no difference of the efficacy was detected between persons with or without HIV and side effects in the two groups were similar. Even in HIV-positive persons with a reduced ratio of CD4+:CD8+ cells and reduced numbers of CD4+ cells, a significant reduction of their microfilaria density was observed after treatment with ivermectin. Thus, in HIV-endemic areas, the usual dose of ivermectin can be administered during mass treatment.

  5. Community based distribution of ivermectin in eastern Sudan: acceptability and early post-treatment reactions.

    PubMed

    Baraka, O Z; Khier, M M; Ahmed, K M; Ali, M M; el Mardi, A E; Mahmoud, B M; Ali, M H; Homeida, M M; Williams, J F

    1995-01-01

    A study to monitor ivermectin acceptability and post-treatment reactions during mass community distribution was carried out in eastern Sudan, where severe reactive onchodermatitis is prevalent. Of 1081 individuals eligible for treatment, 1076 (99.5%) accepted the ivermectin. Post-treatment reactions were monitored by self reporting, 5 d after a single dose of about 150 micrograms/kg (range 103-200 micrograms/kg); 230 persons reported adverse events (21.4%). No reaction was rated as severe. The most common problem was itching with cutaneous papular eruptions (16.2%). Local oedematous swelling was the second most common and the most slowly resolving complaint (5.4%), followed by musculoskeletal pain. There was a high acceptance rate of the treatment and remarkable tolerance of the post-treatment effects, probably due to efforts made to prepare the community to expect reactions to ivermectin, widespread awareness of the beneficial effects of treatment by villagers who had participated in clinical trials previously, and the encouragement we gave to the population to become involved in improvement of their health care services. Single doses of ivermectin resulted in good clinical responses and created much goodwill among villagers. Improvements in physical fitness, ability to work, and freedom from musculoskeletal pain were reported at the 3 months' follow-up. We recommend that, during mass distribution of ivermectin, community involvement in planning overall health improvement should be included, since the treatment initiates the process well. In areas where sowda syndrome is prevalent, medical surveillance for 3 d or more should be considered.

  6. Impact of long-term treatment of onchocerciasis with ivermectin in Ecuador: potential for elimination of infection.

    PubMed

    Vieira, Juan Carlos; Cooper, Philip J; Lovato, Raquel; Mancero, Tamara; Rivera, Jorge; Proaño, Roberto; López, Andrea A; Guderian, Ronald H; Guzmán, José Rumbea

    2007-05-23

    Onchocerciasis is a leading cause of blindness worldwide, hence elimination of the infection is an important health priority. Community-based treatment programs with ivermectin form the basis of control programs for the disease in Latin America. The long-term administration of ivermectin could eliminate Onchocerca volvulus infection from endemic areas in Latin America. A strategy of annual to twice-annual treatments with ivermectin has been used for onchocerciasis in endemic communities in Ecuador for up to 14 years. The impact of ivermectin treatment on ocular morbidity, and O. volvulus infection and transmission was monitored in seven sentinel communities. Over the period 1990-2003, high rates of treatment coverage of the eligible population were maintained in endemic communities (mean 85.2% per treatment round). Ivermectin reduced the prevalence of anterior segment disease of the eye to 0% in sentinel communities and had a major impact on the prevalence and transmission of infection, with possible elimination of infection in some foci. The distribution of ivermectin in endemic communities in Ecuador might have eliminated ocular morbidity and significant progress has been made towards elimination of the infection. A strategy of more frequent treatments with ivermectin may be required in communities where the infection persists to achieve the objective of elimination of the infection from Ecuador. The elimination of the infection from an endemic country in Latin America would be a major public health achievement and could stimulate the implementation of elimination strategies in other endemic countries.

  7. Impact of long-term treatment of onchocerciasis with ivermectin in Ecuador: potential for elimination of infection

    PubMed Central

    Vieira, Juan Carlos; Cooper, Philip J; Lovato, Raquel; Mancero, Tamara; Rivera, Jorge; Proaño, Roberto; López, Andrea A; Guderian, Ronald H; Guzmán, José Rumbea

    2007-01-01

    Background Onchocerciasis is a leading cause of blindness worldwide, hence elimination of the infection is an important health priority. Community-based treatment programs with ivermectin form the basis of control programs for the disease in Latin America. The long-term administration of ivermectin could eliminate Onchocerca volvulus infection from endemic areas in Latin America. Methods A strategy of annual to twice-annual treatments with ivermectin has been used for onchocerciasis in endemic communities in Ecuador for up to 14 years. The impact of ivermectin treatment on ocular morbidity, and O. volvulus infection and transmission was monitored in seven sentinel communities. Results Over the period 1990–2003, high rates of treatment coverage of the eligible population were maintained in endemic communities (mean 85.2% per treatment round). Ivermectin reduced the prevalence of anterior segment disease of the eye to 0% in sentinel communities and had a major impact on the prevalence and transmission of infection, with possible elimination of infection in some foci. Conclusion The distribution of ivermectin in endemic communities in Ecuador might have eliminated ocular morbidity and significant progress has been made towards elimination of the infection. A strategy of more frequent treatments with ivermectin may be required in communities where the infection persists to achieve the objective of elimination of the infection from Ecuador. The elimination of the infection from an endemic country in Latin America would be a major public health achievement and could stimulate the implementation of elimination strategies in other endemic countries. PMID:17521449

  8. Serious adverse events following treatment with ivermectin for onchocerciasis control: a review of reported cases

    PubMed Central

    Twum-Danso, Nana AY

    2003-01-01

    This paper presents a summary of reported cases of Serious Adverse Events (SAEs) following treatment with Mectizan® (ivermectin, Merck, Sharpe & Dohme) in onchocerciasis mass treatment programs from January 1, 1989 to December 31, 2001 through a passive surveillance system. A total of 207 SAE cases were reported out of approximately 165 million reported treatments delivered during the period under review, giving rise to a cumulative incidence of 1 reported SAE per 800,000 reported treatments. The mean age was 40 years and 70% of the cases were males. The mean time between ivermectin intake and onset of illness was 1 day. For 57% of the cases (n = 118), that was their first exposure to ivermectin. The majority of cases were reported from Cameroon (n = 176; 85%) with peaks in the incidence of SAE reporting in 1989–1991 and 1994–1995 when the program expanded to ivermectin-naïve populations. Fifty-five percent of the cases from Cameroon (i.e. 97 out of 176 cases) were encephalopathic and were reported from the central-southern region of the country; two-thirds of these cases were 'probable' or 'possible' cases of Loa loa encephalopathy temporally related to ivermectin treatment. Reporting bias may explain some but not all of the differences in SAE reporting between the 34 onchocerciasis-endemic countries that have, or have had, mass treatment programs. Further research is needed to understand the apparent clustering of encephalopathy cases in central-southern Cameroon since L. loa infection alone probably does not explain the increased incidence of this type of SAE from this region. PMID:14975060

  9. Oral ivermectin for the treatment and prophylaxis of scabies in prison.

    PubMed

    Ribeiro, Fernando de Andrade Quintanilha; Taciro, Edson; Guerra, Marília Ribeiro M; Eckley, Claudia A

    2005-08-01

    Oral ivermectin has been widely used to treat various human diseases, such as filariasis, myiasis, larva migrans, strongyloidiasis and scabies (both the common and crusted forms). However, there are only a small number of papers on the effects of this drug for the control of scabies in infested environments. The current study shows the results obtained with the collective treatment of inmates of a public jail. A total of 123 inmates living in a restricted and contaminated environment were evaluated clinically by experienced dermatologists for the assessment of the degree of infestation by Sarcoptes scabiei, and were then treated with oral ivermectin (200-300 micorg/kg single dose repeated after 7 days). Both clothing and environment were disinfected. Patients were re-evaluated after 15 days. In all, 78% of the inmates were infected upon initial evaluation. Re-evaluation 15 days after repeat treatment revealed a cure rate of 91.05%. Prophylaxis was also highly effective, where 93.2% of the non-infected inmates and virtually all the house staff remained disease-free throughout the study period. Two of the 29 inmates (6.8%) who showed no apparent lesions upon initial examination were found to be infected upon re-evaluation. These patients responded well to a third dose of ivermectin. Oral ivermectin at a dose of 300 microg/kg single dose repeated after 7 days proved effective for the treatment and prophylaxis of scabies in an infected institutional environment.

  10. Ophthalmological results from a placebo controlled comparative 3-dose ivermectin study in the treatment of onchocerciasis.

    PubMed

    Dadzie, K Y; Awadzi, K; Bird, A C; Schulz-Key, H

    1989-09-01

    One hundred and ninety eight patients with moderate to heavy infection with Onchocerca volvulus and with eye involvement in most, were allocated randomly to treatment with 100, 150 or 200 mcg/kg body weight of ivermectin or placebo given as a single oral dose in a double-blind dose finding study. The patients were drawn from an area under over ten years of vector control in Northern Ghana by the Onchocerciasis Control Programme, OCP. They underwent detailed clinical, laboratory and ophthalmological examination before treatment and in the review period of one year in hospital. Ivermectin given in a dose of 100, 150 or 200 mcg/kg eliminated microfilariae similarly slowly over 3-6 months and was associated with inflammatory reaction in the anterior segment which resolved without treatment. No changes in the fundus of the eye was detected by fluorescein angiography and no no-table other adverse eye reaction was observed. The ceiling of therapeutic activity of ivermectin in the eye is therefore put at 100 mcg/kg which is lower than the level fo 150 mcg/kg found in the skin. The apparent discrepancy may be due to different dose requirements on account of different mechanisms of action of ivermectin at the two sites. In the skin there is active killing while in the eye it is presumed there is a passive elimination of microfilariae.

  11. Effect of treatment with an ivermectin sustained-release bolus on productivity of stocker beef calves.

    PubMed

    Williams, J C; Loyacano, A F; Broussard, S D; Coombs, D F

    1995-05-01

    Three groups of 30 crossbred beef steers, 8-10 months of age and ranging in weight from 158 to 320 kg, were used to compare effects of treatment with an ivermectin sustained-release bolus or two ivermectin injectable treatments on parasite control and productivity in relation to untreated controls during a 168 day winter-spring grazing period. Each group of 30 consisted of five cattle on each of six separate 1.6 ha pastures. Treatments on Day 0 (12 December) were: Group 1: untreated controls; Group 2: ivermectin injectable at 200 micrograms kg-1 bodyweight, s.c., on Day 0 and Day 56; Group 3: ivermectin sustained-release bolus to deliver ivermectin at 12 mg day-1 over approximately 135 days. All cattle were weighed at 28 day intervals and fecal samples were collected for egg per gram counts (EPG). Geometric mean EPG for Group 3 remained consistently less than 1.0 after Day 0 and were highest (2.4) on Day 168. All group EPG were significantly different (P < 0.01) by Day 56, and EPG of Group 2 had increased to 10.5 following initial treatment and to 42.8 on Day 112. With the exception of a low mean EPG of 6.8 for Group 1 on Day 112, EPG of the group were consistently highest (range 24.9-36.0) to the end of the experiment. Ostertagia ostertagi was predominant, along with smaller proportions of Haemonchus placei and Cooperia spp. Throughout the experiment Group 3 had highest liveweights and gains that were most often different from those of Group 1 at P < 0.01 or greater.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Interferences on microbial inhibitor tests related to ivermectin treatment in lactating dairy goats.

    PubMed

    Romero, Tamara; Moya, Vicente Javier; Fernández, Nemesio; Althaus, Rafael; Reybroeck, Wim; Molina, María Pilar

    2016-08-01

    This Research Communication reports interferences related to the administration of ivermectin in lactating dairy goats on the response of microbial tests for screening antibiotics in milk. Twenty-eight Murciano-Granadina goats, naturally infested with Sarcoptes scabiei var. caprae, were treated with a subcutaneous injection of ivermectin (200 µg/kg b.w.). To prevent re-infestation, a second dose was applied 7 d later. Individual milk samples were collected, daily, up to 15 d post-treatment. Milk samples were analysed by microbial inhibitor tests (BRT MRL, Delvotest SP-NT MCS and Eclipse 100) and ivermectin residues were quantified by HPLC. A large number of positive results were obtained for all microbial tests, especially on the first day after treatment (BRT MRL = 46·4%; Delvotest SP-NT MCS = 14·3%; and Eclipse 100 = 17·8%). However, the highest concentration of drug residues in milk (24·3 ng/ml) was detected on the tenth day after treatment, when positive outcomes were relatively lower (BRT MRL = 17·8%; Delvotest SP-NT MCS = 10·7%; and Eclipse 100 = 7·4%). Results herein suggest that factors related to the ivermectin treatment other than drug residues in milk, or alterations produced by the parasitic disease itself affecting the immune response of animals, could be the cause of false-positive results in microbial tests. It can be concluded that the application of ivermectin in dairy goats infested with sarcoptes mange during lactation produces persistent drug residues in milk, and could also cause false-positive results in microbial inhibitor tests for screening antibiotics.

  13. Topical 0.5% ivermectin lotion for treatment of head lice.

    PubMed

    Pariser, David M; Meinking, Terri Lynn; Bell, Margie; Ryan, William G

    2012-11-01

    The emergence of resistance to treatment complicates the public health problem of head-louse infestations and drives the need for continuing development of new treatments. There are limited data on the activity of ivermectin as a topical lousicide. In two multisite, randomized, double-blind studies, we compared a single application of 0.5% ivermectin lotion with vehicle control for the elimination of infestations without nit combing in patients 6 months of age or older. A tube of topical ivermectin or vehicle control was dispensed on day 1, to be applied to dry hair, left for 10 minutes, then rinsed with water. The primary end point was the percentage of index patients (youngest household member with ≥3 live lice) in the intention-to-treat population who were louse-free 1 day after treatment (day 2) and remained so through days 8 and 15. A total of 765 patients completed the studies. In the intention-to-treat population, significantly more patients receiving ivermectin than patients receiving vehicle control were louse-free on day 2 (94.9% vs. 31.3%), day 8 (85.2% vs. 20.8%), and day 15 (73.8% vs. 17.6%) (P<0.001 for each comparison). The frequency and severity of adverse events were similar in the two groups. A single, 10-minute, at-home application of ivermectin was more effective than vehicle control in eliminating head-louse infestations at 1, 7, and 14 days after treatment. (Funded by Topaz Pharmaceuticals [now Sanofi Pasteur]; ClinicalTrials.gov numbers, NCT01066585 and NCT01068158.).

  14. Control, Elimination, and Eradication of River Blindness: Scenarios, Timelines, and Ivermectin Treatment Needs in Africa

    PubMed Central

    Kim, Young Eun; Remme, Jan H. F.; Steinmann, Peter; Stolk, Wilma A.; Roungou, Jean-Baptiste; Tediosi, Fabrizio

    2015-01-01

    River blindness (onchocerciasis) causes severe itching, skin lesions, and vision impairment including blindness. More than 99% of all current cases are found in sub-Saharan Africa. Fortunately, vector control and community-directed treatment with ivermectin have significantly reduced morbidity. Studies in Mali and Senegal proved the feasibility of elimination with ivermectin administration. The treatment goal is shifting from control to elimination in endemic African regions. Given limited resources, national and global policymakers need a rigorous analysis comparing investment options. For this, we developed scenarios for alternative treatment goals and compared treatment timelines and drug needs between the scenarios. Control, elimination, and eradication scenarios were developed with reference to current standard practices, large-scale studies, and historical data. For each scenario, the timeline when treatment is expected to stop at country level was predicted using a dynamical transmission model, and ivermectin treatment needs were predicted based on population in endemic areas, treatment coverage data, and the frequency of community-directed treatment. The control scenario requires community-directed treatment with ivermectin beyond 2045 with around 2.63 billion treatments over 2013–2045; the elimination scenario, until 2028 in areas where feasible, but beyond 2045 in countries with operational challenges, around 1.15 billion treatments; and the eradication scenario, lasting until 2040, around 1.30 billion treatments. The eradication scenario is the most favorable in terms of the timeline of the intervention phase and treatment needs. For its realization, strong health systems and political will are required to overcome epidemiological and political challenges. PMID:25860569

  15. Treatment and Eradication of Murine Fur Mites: I. Toxicologic Evaluation of Ivermectin-Compounded Feed

    PubMed Central

    Arbona, Rodolfo J Ricart; Lipman, Neil S; Riedel, Elyn R; Wolf, Felix R

    2010-01-01

    Fur mite outbreaks remain a persistent problem in laboratory mouse colonies. All currently published treatment methods are labor-intensive, expensive, or unreliable. During a recent outbreak with Myobia musculi and Myocoptes musculinus in a large colony (approximately 30,000 cages), we developed a feed-based treatment regime in which ivermectin was the active ingredient. Rodent feed was compounded with 3 different concentrations of ivermectin (12, 24, and 48 ppm) and γ-irradiated. Postcompounding analysis revealed loss of ivermectin during manufacturing, but the remaining drug was stable for at least 6 mo. In an 8-wk toxicity study in a C57BL/6NTac mouse breeding colony, ad-libitum feeding of the 3 diets yielded estimated doses of 1.3, 2.7, and 5.4 mg/kg. Adult mice lacked adverse clinical effects, except that 1 of the 144 mice in the 48-ppm group developed tremors and ataxia and was euthanized. No significant differences between doses were revealed by CBC, serum chemistry, body weight, or gross necropsy. Plasma drug concentrations plateaued at a dose-dependent level 7 to 10 d after initiation of treatment and decreased to undetectable levels 6 to 9 d after its discontinuation. Fertility of the P0 generation was unaffected. Pup mortality was higher in the 24- and 48-ppm groups, reaching 100% at the higher dose. Animals exposed to ivermectin as neonates had normal weaning weights, but mice receiving 24-ppm feed had lower adult weights. Our results indicate that using feed containing 12 ppm ivermectin (estimated ingested dose, 1.3 mg/kg) was safe in a C57BL/6NTac breeding colony. PMID:20858356

  16. Tolerance and efficacy of emamectin benzoate and ivermectin for the treatment of Pseudocapillaria tomentosa in laboratory zebrafish (Danio rerio).

    PubMed

    Collymore, Chereen; Watral, Virginia; White, Julie R; Colvin, Michael E; Rasmussen, Skye; Tolwani, Ravi J; Kent, Michael L

    2014-10-01

    Tolerance of adult zebrafish and efficacy of emamectin benzoate and ivermectin in eliminating Pseudocapillaria tomentosa infection were evaluated. In the tolerance study, behavioral changes, fecundity, histopathology, and mortality were evaluated for in-feed administration of emamectin (0.05, 0.10, and 0.25 mg/kg) and ivermectin (0.05 and 0.10 mg/kg). All doses of emamectin were well tolerated. Ivermectin 0.05 mg/kg administration resulted in mild behavioral changes and a transient decrease in fecundity. Ivermectin 0.10 mg/kg administration resulted in severe behavioral changes and some mortality. In the efficacy study, emamectin (0.05 and 0.25 mg/kg) and ivermectin (0.05 mg/kg) were evaluated for their efficacy in eliminating P. tomentosa infection. Emamectin reduced parasite burden in infected zebrafish, and ivermectin eliminated intestinal nematode infections. Despite a small margin of safety, ivermectin 0.05 mg/kg was effective at eliminating P. tomentosa infection in adult zebrafish. Higher doses or a longer course of treatment may be needed for complete elimination of P. tomentosa infection using emamectin. In this study, we propose two possible treatments for intestinal nematode infections in zebrafish.

  17. Tolerance and Efficacy of Emamectin Benzoate and Ivermectin for the Treatment of Pseudocapillaria tomentosa in Laboratory Zebrafish (Danio rerio)

    PubMed Central

    Collymore, Chereen; Watral, Virginia; White, Julie R.; Colvin, Michael E.; Rasmussen, Skye; Tolwani, Ravi J.

    2014-01-01

    Abstract Tolerance of adult zebrafish and efficacy of emamectin benzoate and ivermectin in eliminating Pseudocapillaria tomentosa infection were evaluated. In the tolerance study, behavioral changes, fecundity, histopathology, and mortality were evaluated for in-feed administration of emamectin (0.05, 0.10, and 0.25 mg/kg) and ivermectin (0.05 and 0.10 mg/kg). All doses of emamectin were well tolerated. Ivermectin 0.05 mg/kg administration resulted in mild behavioral changes and a transient decrease in fecundity. Ivermectin 0.10 mg/kg administration resulted in severe behavioral changes and some mortality. In the efficacy study, emamectin (0.05 and 0.25 mg/kg) and ivermectin (0.05 mg/kg) were evaluated for their efficacy in eliminating P. tomentosa infection. Emamectin reduced parasite burden in infected zebrafish, and ivermectin eliminated intestinal nematode infections. Despite a small margin of safety, ivermectin 0.05 mg/kg was effective at eliminating P. tomentosa infection in adult zebrafish. Higher doses or a longer course of treatment may be needed for complete elimination of P. tomentosa infection using emamectin. In this study, we propose two possible treatments for intestinal nematode infections in zebrafish. PMID:25237985

  18. Adverse reactions after community treatment of onchocerciasis with ivermectin in Guatemala.

    PubMed

    Zea-Flores, R; Richards, F O; González-Peralta, C; Castro Ramirez, J; Zea-Flores, G; Collins, R C; Cupp, E

    1992-01-01

    Male and female residents on a Guatemalan coffee plantation where Onchocerca volvulus infections were hyperendemic were offered oral ivermectin (100-200 micrograms/kg) as part of a community-wide treatment programme for onchocerciasis. Forty-five persons were treated and then questioned daily for 28 d about changes in their health. Those with complaints were monitored until all signs and symptoms had resolved. Sixty-seven percent complained of some adverse event after treatment; 60% developed observable adverse reactions attributed clinically to ivermectin. No reaction was life-threatening; the most common were oedema (53%) and fever (47%). Expulsion of intestinal helminths was reported by 38%. Almost all reactions began 24-48 h after treatment; their mean duration was 5 d, despite treatment with acetaminophen and antihistamines. Three patients had oedematous changes lasting over 2 weeks. Incidence, but not severity, of reactions was related to the pretreatment density of microfilariae in skin.

  19. [Ivermectin and the treatment of outbreaks of scabies in medical facilities].

    PubMed

    Meltzer, Eyal

    2002-11-01

    In cramped facilities, including hospital wards and nursing homes, secondary spread of scabies to staff and patients can be widespread. This is frequently facilitated by a delay in diagnosis, which is not infrequent in elderly and immune compromised patients. A particular problem is presented in cases of crusted scabies--a form of hyperinfection. The common topical treatments for scabies share several drawbacks including compliance, slow regression of symptoms and failure with non-meticulous application. In crusted scabies treatment failure is not infrequent. Ivermectin is a drug effective against various ecto and endo-parasites. We describe 2 typical cases of crusted scabies, one leading to an outbreak of scabies in a medical ward and another that was treated with Ivermectin. An evidence-based review of the literature shows Ivermectin to be at least as effective as topical treatment, with the advantages of the ease in treating large populations, good compliance and safety. Approval of this drug for this indication should be considered.

  20. Assessment of oral ivermectin versus shampoo in the treatment of pediculosis (head lice infestation) in rural areas of Sine-Saloum, Senegal.

    PubMed

    Leulmi, Hamza; Diatta, Georges; Sokhna, Cheikh; Rolain, Jean-Marc; Raoult, Didier

    2016-12-01

    Reports of treatment failure and the emergence of resistance to topical head lice treatments have become increasingly common, driving the need for continued development of new therapeutic options for pediculosis. Ivermectin has been proposed as a potential alternative for the treatment of pediculosis but has not been sufficiently evaluated. In this study, the effectiveness of oral ivermectin versus shampoo in the treatment of pediculosis in Senegal was compared. The study was conducted in two neighbouring villages of Sine-Saloum, Senegal: Dielmo (ivermectin trial group; 201 female participants) and Ndiop (shampoo trial group; 239 female participants). In the ivermectin group, patients received two doses of oral ivermectin (400 µg/kg body weight; Mectizan(®)) 7 days apart. In contrast, the shampoo group received a shampoo treatment based on d-phenothrin (0.23%; Hégor(®)). At the beginning of the study, 70 (34.8%) of 201 participants in the ivermectin group were infested by head lice versus 145 (60.7%) of 239 participants in the shampoo group. At Day 15 post-treatment, the efficacy of the treatment against head lice reached 41/53 (77.4%) in the ivermectin group (53 patients were tested in this group) versus 42/130 (32.3%) in the shampoo group (130 patients were tested in this group) (P <10(-7)). However, 4 (7.5%) of the 53 females in the ivermectin group exhibited probable ivermectin treatment failure, suggesting the emergence of ivermectin-resistant lice. This study demonstrates that oral ivermectin is highly effective for the treatment of pediculosis compared with shampoo, but also suggests that ivermectin resistance may emerge during treatment. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  1. Comparative study of efficacy of oral ivermectin versus some topical antiscabies drugs in the treatment of scabies.

    PubMed

    Manjhi, Pramod Kumar; Sinha, Rani Indira; Kumar, Manish; Sinha, Kumari Indu

    2014-09-01

    The conventionally used topical antiscabetics have poor compliance. Ivermectin, an oral antiparasitic drug, has been shown to be an effective scabicide and could be a useful substitute. This study was designed to compare efficacy of oral ivermectin with commonly used topical antiscabies drugs. This study was conducted on four groups including 60 patients in each group by simple random sampling. Treatment given in each group was: Group 1: Ivermectin (200 μg/kg body weight) oral in a single dose, Group 2: Topical Permethrin 5% cream single application, Group 3: Topical gamma benzene hexachloride (GBHC) lotion 1% single application and Group 4: Topical Benzyl benzoate (BB) lotion 25% single application. All of the patients were followed for improvement in terms of severity of disease and severity of pruritus at the end of 1(st) wk and 6(th) wk. Efficacy of ivermectin, permethrin, GBHC and BB lotion considering improvement in severity of pruritus as parameter were 85%, 90%, 75% and 68.33% respectively at 2(nd) follow-up. Similarly considering improvement in severity of lesion as parameter, results were 80%, 88.33%, 71.66% and 65% respectively at 2(nd) follow up. Topical Permethrin (5%) was more effective as compared to topical BB lotion and topical GBHC lotion (p<0.05, significant) but statistical difference between efficacy of topical Permethrin and oral Ivermectin was non-significant (p>0.05). The results suggested that oral Ivermectin and topical Permethrin (5%) were equally efficacious. Oral Ivermectin is well tolerated, non irritant to skin, does not show central nervous system side effects because it does not cross blood brain barrier. So, the good therapeutic response with few side effects seen with oral Ivermectin can be useful in those patients for whom topical treatment is potentially irritant and less well-tolerated.

  2. Elimination of African Onchocerciasis: Modeling the Impact of Increasing the Frequency of Ivermectin Mass Treatment

    PubMed Central

    Coffeng, Luc E.; Stolk, Wilma A.; Hoerauf, Achim; Habbema, Dik; Bakker, Roel; Hopkins, Adrian D.; de Vlas, Sake J.

    2014-01-01

    The African Programme for Onchocerciasis Control (APOC) is currently shifting its focus from morbidity control to elimination of infection. To enhance the likelihood of elimination and speed up its achievement, programs may consider to increase the frequency of ivermectin mass treatment from annual to 6-monthly or even higher. In a computer simulation study, we examined the potential impact of increasing the mass treatment frequency for different settings. With the ONCHOSIM model, we simulated 92,610 scenarios pertaining to different assumptions about transmission conditions, history of mass treatment, the future mass treatment strategy, and ivermectin efficacy. Simulation results were used to determine the minimum remaining program duration and number of treatment rounds required to achieve 99% probability of elimination. Doubling the frequency of treatment from yearly to 6-monthly or 3-monthly was predicted to reduce remaining program duration by about 40% or 60%, respectively. These reductions come at a cost of additional treatment rounds, especially in case of 3-monthly mass treatment. Also, aforementioned reductions are highly dependent on maintained coverage, and could be completely nullified if coverage of mass treatment were to fall in the future. In low coverage settings, increasing treatment coverage is almost just as effective as increasing treatment frequency. We conclude that 6-monthly mass treatment may only be worth the effort in situations where annual treatment is expected to take a long time to achieve elimination in spite of good treatment coverage, e.g. because of unfavorable transmission conditions or because mass treatment started recently. PMID:25545677

  3. Elimination of African onchocerciasis: modeling the impact of increasing the frequency of ivermectin mass treatment.

    PubMed

    Coffeng, Luc E; Stolk, Wilma A; Hoerauf, Achim; Habbema, Dik; Bakker, Roel; Hopkins, Adrian D; de Vlas, Sake J

    2014-01-01

    The African Programme for Onchocerciasis Control (APOC) is currently shifting its focus from morbidity control to elimination of infection. To enhance the likelihood of elimination and speed up its achievement, programs may consider to increase the frequency of ivermectin mass treatment from annual to 6-monthly or even higher. In a computer simulation study, we examined the potential impact of increasing the mass treatment frequency for different settings. With the ONCHOSIM model, we simulated 92,610 scenarios pertaining to different assumptions about transmission conditions, history of mass treatment, the future mass treatment strategy, and ivermectin efficacy. Simulation results were used to determine the minimum remaining program duration and number of treatment rounds required to achieve 99% probability of elimination. Doubling the frequency of treatment from yearly to 6-monthly or 3-monthly was predicted to reduce remaining program duration by about 40% or 60%, respectively. These reductions come at a cost of additional treatment rounds, especially in case of 3-monthly mass treatment. Also, aforementioned reductions are highly dependent on maintained coverage, and could be completely nullified if coverage of mass treatment were to fall in the future. In low coverage settings, increasing treatment coverage is almost just as effective as increasing treatment frequency. We conclude that 6-monthly mass treatment may only be worth the effort in situations where annual treatment is expected to take a long time to achieve elimination in spite of good treatment coverage, e.g. because of unfavorable transmission conditions or because mass treatment started recently.

  4. Ivermectin use in scabies.

    PubMed

    Fawcett, Robert S

    2003-09-15

    Oral ivermectin is an effective and cost-comparable alternative to topical agents in the treatment of scabies infection. It may be particularly useful in the treatment of severely crusted scabies lesions in immunocompromised patients or when topical therapy has failed. Oral dosing may be more convenient in institutional outbreaks and in the treatment of mentally impaired patients. Ivermectin has been used extensively and safely in the treatment of other parasitic infections, but the U.S. Food and Drug Administration has not approved the drug for the treatment of scabies infection. The safety of oral ivermectin in pregnant and lactating women and young children has yet to be established.

  5. [Successful treatment of Norwegian scabies with ivermectin in a patient with recessive dystrophic epidermolysis bullosa].

    PubMed

    Angelo, C; Pedicelli, C; Provini, A; Annessi, G; Zambruno, G; Paradisi, M

    2004-06-01

    A 14 year-old female born from consanguineous healthy parents was admitted to our institute for the presence of a generalized bullous eruption started at birth. The bullae were asymmetrically distributed all over the cutaneous surface and, over time, evolved into erosions that resolved with scarring areas. On the basis of the clinical picture and the ultrastructural and antigenic studies, a diagnosis of recessive dystrophic epidermolysis bullosa was made. In the following months, the patient began to complain a severe pruritus and the bullae and erosions were accompanied with diffuse erythematous patches and plaques covered by thick scale-crusts situated mostly on the arms. Microscopic examination of the scales revealed the presence of many mites and ova. Since the conventional topical therapies for scabies were uneffective, the patient was treated with a single dose (200 mcg/hg) of ivermectin. Although there was an initial improvement, scabies recurred within 2 months from discontinuation of the therapy. Finally, a further single administration of ivermectin at the same dosage led to the complete and permanent resolution of scabies. The association of recessive dystrophic epidermolysis bullosa and norwegian scabies has been already reported in literature. The case presented suggests that ivermectin represents an effective drug for severe forms of scabies occurring in patients affected by other dermatoses that prevent the use of topical treatments.

  6. The varied beneficial effects of ivermectin (Mectizan) treatment, as observed within onchocerciasis foci in south-eastern Nigeria.

    PubMed

    Anosike, J C; Dozie, I N S; Ameh, G I; Ukaga, C N; Nwoke, B E B; Nzechukwu, C T; Udujih, O S; Nwosu, D C

    2007-10-01

    In the treatment of humans, ivermectin (Mectizan((R))), a semi-synthetic macrocyclic lactone, is now primarily used as a rapid microfilaricide. The drug has several other benefits, however, and these have recently been investigated in five states in south-eastern Nigeria, where there have been mass treatments with ivermectin, for the control of Onchocerca volvulus, for more than 10 years. Between the January and December of 2005, 3125 adult onchocerciasis patients (each aged >/=20 years and known to have at least one clinical sign of onchocerciasis) were enlisted, clinically examined and interviewed. Relevant data were collected in the interviews, using a structured, pre-tested questionnaire, and in personal and focus-group discussions. Overall, 612 (19.6%) of the subjects reported that they had had nodules that had disappeared following repeated doses of ivermectin, although only 83.8% of the 612 attributed their nodule clearance to ivermectin (the other 16.2% being unsure of the cause). A larger percentage of the subjects (24.6%) reported that they had expelled intestinal helminths following the last round of ivermectin treatment (i.e. been dewormed). Other side-benefits reported in the study were improved vision (11.7% of subjects), reversal of secondary amenorrhea (4.5%), increased appetite (22.3%), reduction in arthritic or other musculo-skeletal pain (7.9%), reductions in the severity of body itching (18.5%) and skin rash (17.3%), darkening of leopard skin (6.6%), improved libido in men (6.6%), and clearance of head lice (4.5%). If, via health education, the local communities could be made more aware of the side-benefits of ivermectin treatment, the sustainability of the on-going programme of community-directed treatment with ivermectin (CDTI) in south-eastern Nigeria would probably be improved.

  7. Treatment of Human Scabies with Oral Ivermectin. Eczematous Eruptions as a New Non-Reported Adverse Event.

    PubMed

    Sanz-Navarro, J; Feal, C; Dauden, E

    2017-09-01

    Oral ivermectin is an alternative therapy for human scabies infection due to its ease of administration and good safety profile. However, there is no definitive consensus on the optimal dosing regimen. To describe the treatment of human scabies with different dosages of oral ivermectin and the possible adverse events. 23 patients with human scabies were treated with oral ivermectin: 10 patients received a single oral dose of 200μg/kg and 13 a dose of 400μg/kg. A second, or even a third dose, was administered in cases of treatment failure. A complete clinical response was achieved by all of the patients. The first ten patients required at least two (80%) or three (20%) doses of ivermectin for complete resolution of the infection. The remaining cases resolved with a single 400μg/kg oral dose. Within the first 72h after the administration of oral ivermectin, new cutaneous lesions were observed in eleven patients (47.8%). Cutaneous biopsies showed signs of subacute eczema. The eruption was treated with topical corticosteroids and emollient therapy. There was no other new drug administration or a history of irritants. There was no history of atopic diathesis except for one patient. Oral ivermectin is an effective therapy for the treatment of human scabies. A single 400μg/kg oral dose demonstrated high efficacy and good tolerance. However, the appearance of eczematous cutaneous lesions induced by oral ivermectin has not previously been reported in the literature. Dermatologists should be aware of this possible adverse event. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Treatment of the microfilaraemia of asymptomatic brugian filariasis with single doses of ivermectin, diethylcarbamazine or albendazole, in various combinations.

    PubMed

    Shenoy, R K; Dalia, S; John, A; Suma, T K; Kumaraswami, V

    1999-09-01

    Several new chemotherapeutic tools are now available for the control of lymphatic filariasis. Combinations of single doses of antifilarial drugs are generally superior to single drugs. The efficacy and safety of albendazole in combination with diethylcarbamazine (DEC) or ivermectin, for the treatment of Brugia malayi infection, were investigated, for the first time, in an open, hospital-based study. Fifty-one asymptomatic microfilaraemics (with 108-4034 microfilariae/ml; median = 531) of both sexes and aged 14-70 years were randomly allocated to receive single-dose treatments of ivermectin (200 micrograms/kg) with diethylcarbamazine (DEC; 6 mg/kg), ivermectin (200 micrograms/kg) with albendazole (400 mg), DEC (6 mg/kg) with albendazole (400 mg), or albendazole (400 mg) alone. Albendazole alone had no effect on the microfilarial levels at the 1-year follow-up but both groups given DEC had significantly lower microfilaraemias (P < 0.015 and P < 0.02) than that given ivermectin with albendazole. Overall, 47%-64% of those given DEC but only 14% of those given ivermectin with albendazole appeared to be amicrofilaraemic 1 year post-treatment. The adverse reactions seen in the study were mild, transient and qualitatively similar to those seen earlier with ivermectin and DEC. The combination of DEC and albendazole, both well tested drugs, offers a new option for countries such as India where there is no onchocerciasis or loiasis and where ivermectin may not be immediately available. The direct and indirect effects of albendazole on intestinal helminths would be additional benefits.

  9. African Program for Onchocerciasis Control 1995–2010: Impact of Annual Ivermectin Mass Treatment on Off-Target Infectious Diseases

    PubMed Central

    Noma, Mounkaila; Zouré, Honorat G. M.; Bakoné, Lalle; Amazigo, Uche V.; de Vlas, Sake J.; Stolk, Wilma A.

    2015-01-01

    Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment. Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections. In this study, we roughly assessed the additional impact of APOC activities on the burden of the most important off-target infections: soil-transmitted helminthiases (STH; ascariasis, trichuriasis, hookworm, and strongyloidiasis), lymphatic filariasis (LF), and scabies. Based on a literature review, we formulated assumptions about the impact of ivermectin treatment on the disease burden of these off-target infections. Using data on the number of ivermectin treatments in APOC regions and the latest estimates of the burden of disease, we then calculated the impact of APOC activities on off-target infections in terms of disability-adjusted life years (DALYs) averted. We conservatively estimated that between 1995 and 2010, annual ivermectin mass treatment has cumulatively averted about 500 thousand DALYs from co-endemic STH infections, LF, and scabies. This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported. PMID:26401658

  10. African Program for Onchocerciasis Control 1995-2010: Impact of Annual Ivermectin Mass Treatment on Off-Target Infectious Diseases.

    PubMed

    Krotneva, Stanimira P; Coffeng, Luc E; Noma, Mounkaila; Zouré, Honorat G M; Bakoné, Lalle; Amazigo, Uche V; de Vlas, Sake J; Stolk, Wilma A

    2015-01-01

    Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment. Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections. In this study, we roughly assessed the additional impact of APOC activities on the burden of the most important off-target infections: soil-transmitted helminthiases (STH; ascariasis, trichuriasis, hookworm, and strongyloidiasis), lymphatic filariasis (LF), and scabies. Based on a literature review, we formulated assumptions about the impact of ivermectin treatment on the disease burden of these off-target infections. Using data on the number of ivermectin treatments in APOC regions and the latest estimates of the burden of disease, we then calculated the impact of APOC activities on off-target infections in terms of disability-adjusted life years (DALYs) averted. We conservatively estimated that between 1995 and 2010, annual ivermectin mass treatment has cumulatively averted about 500 thousand DALYs from co-endemic STH infections, LF, and scabies. This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported.

  11. A comparison of the efficacy and pharmacokinetics of ivermectin after spring and autumn treatments against Cyathostominae in horses.

    PubMed

    Sokół, R; Raś-Noryńska, M; Michalczyk, M; Jasiecka, A; Ziółkowski, H; Jaroszewski, J

    2015-01-01

    The aim of the present study was to determine the efficacy of ivermectin against Cyathostominae infections and to describe the drug's pharmacokinetic parameters during two seasonal deworming treatments in horses. The study was performed on warm-blooded mares aged 3-12 years weighing 450-550 kg. A single bolus of an oral paste formulation of ivermectin was administered at a dose of 0.2 mg/kg BW in spring and autumn. Fecal samples were tested before treatment and 1, 2, 3, 4, 6, 10, 20, 30, 40, 50, 60, 75 days after treatment. Ivermectin concentrations in blood samples collected before treatment, 0.5, 1, 2, 3, 4, 6, 12, 24, 36 and 48 hours after treatment, and 3, 4, 6, 8, 10, 15, 20, 25, 30, 40, 50, 60 and 75 days after drug administration were determined by high pressure liquid chromatography. Drug absorption was significantly (p<0.05) slower (tmax: 21.89±11.43 h) in autumn than in spring (tmax: 9.78±8.97 h). Maximum concentrations (Cmax) of ivermectin in the blood plasma of individual horses (8.40-43.08 ng/ml) were observed 2-24 h after drug administration during the spring treatment and 2-36 h (6.43-24.86 ng/ml) after administration during the autumn treatment. Significantly higher (p<0.05) ivermectin concentrations were found during the first 4 hours after administration in spring in comparison with those determined after the autumn treatment. The administration of the recommended dose of ivermectin resulted in 100% elimination of parasitic eggs from feces in spring and autumn treatment.

  12. Comparing the efficacy of oral ivermectin vs malathion 0.5% lotion for the treatment of scabies.

    PubMed

    Goldust, Mohamad; Rezaee, Elham; Raghifar, Ramin; Hemayat, Sevil

    2014-01-01

    Scabies is found worldwide among people of all groups and ages. It is curable with scabicide medications. This study aimed to compare the efficacy and safety of oral ivermectin vs malathion 0.5% lotion for the treatment of scabies. In total, 148 patients with scabies were enrolled and randomized into two groups: the first group received a single dose of oral ivermectin 200 sg/kg body weight, and the second was treated with two applications of topical lindane lotion 1%, with a 1-week interval between applications. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. A single dose of ivermectin provided a cure rate of 60.8% at the 2-week follow-up, which increased to 89.1% at the 4-week follow-up after repeating the treatment. Treatment with two applications oflindane lotion 1%, with a 1-week interval between them, was effective in 47.2% of patients at the 2-week follow-up, which increased to 72.9% at the 4-week follow-up after this treatment was repeated. A single dose of ivermectin was as effective as two applications of lindane lotion 1% at the 2-week follow-up. After repeat treatment, ivermectin was superior to lindane lotion 1% at the 4-week follow-up. The delay in clinical response with ivermectin suggests that it may not be effective against the parasite at all stages in the life cycle.

  13. Acute morbidity associated with scabies and other ectoparasitoses rapidly improves after treatment with ivermectin.

    PubMed

    Worth, Christine; Heukelbach, Jorg; Fengler, Gernot; Walter, Birke; Liesenfeld, Oliver; Hengge, Ulrich; Feldmeier, Hermann

    2012-01-01

    In resource-poor settings, scabies is associated with considerable morbidity. Which factors determine morbidity and how rapidly it recedes after specific treatment is not known. Patients with scabies were recruited in three urban slums in Fortaleza, Northeast Brazil. Diagnosis was established according to dermatoscopy, skin scraping, or adhesive film test. Severity of scabies-associated morbidity was assessed semiquantitatively. Patients and close contacts were treated with oral ivermectin (200 μg/kg, repeated after 7 days) and followed up for 2 weeks. Ninety-five patients were included in the study. Papules were the most common lesion type (98.9%). Excoriations due to scratching were observed in 43.2% and bacterial superinfection in 24.2%. Predilection sites were the arms (82.1%) and the abdomen (81.1%). At baseline, 36.3% of patients complained about intense or severe itching. Intense or severe itch decreased to 6.3% 2 weeks after treatment (p=0.02). Whereas 37.5% of the patients complained about intense or severe itch-related sleep disturbances at baseline, only 8.8% reported the symptom 2 weeks after treatment (p=0.35). At baseline, the degree of itching was correlated with the degree of sleep disturbance (ρ=0.64; p<0.001). One week after the first dose of ivermectin, the intensity of itching and of sleep disturbance decreased significantly (p<0.001). In patients living in resource-poor setting, scabies was associated with considerable morbidity. Treatment with ivermectin rapidly reconstituted health in almost all cases. © 2011 Wiley Periodicals, Inc.

  14. After a decade of annual dose mass ivermectin treatment in Cameroon and Uganda, onchocerciasis transmission continues.

    PubMed

    Katabarwa, Moses; Eyamba, Albert; Habomugisha, Peace; Lakwo, Tom; Ekobo, Same; Kamgno, Joseph; Kuete, Thomas; Ndyomugyenyi, Richard; Onapa, Ambrose; Salifou, Mkpouwoueiko; Ntep, Marcelline; Richards, Frank O

    2008-09-01

    To evaluate the effectiveness of 10 years' annual single dose ivermectin treatment on onchocerciasis transmission in hyperendemic areas of Cameroon and Uganda. Baseline nodule and microfilaria ('skin snip') prevalence data were available from 10 hyperendemic sentinel communities in Cameroon (from 1996) and hyperendemic 20 sentinel communities in Uganda (from 1993). We returned to these villages in 2005, 10 months after the last annual ivermectin distribution, to repeat the cross-sectional surveys. Each sentinel community reported a mean interval treatment coverage of eligible persons of >88% (range 37-100%). Data were analyzed for more than 6200 person examinations. In Cameroon, 719 people >or=10 years were examined at the baseline survey in 1996 and 838 at the follow-up survey in 2005. In Uganda, 1590 people >or=10 years were examined at the baseline survey in 1993 and 2122 people at the follow-up survey in 2005. We also examined children under 10 in Cameroon (1996, n = 185; 2005, n = 448) and Uganda (1993, n = 177; 2005, n = 130). In Uganda, the vitality of worms was judged using standard histological criteria in 80 nodules excised in 2005. The prevalence of microfilaria carriers among older children and adults (>or=10 years) in Cameroon sentinel communities dropped from 70.1% to 7.04% (P < 0.0001) over the 10-year treatment period; that of nodule carriers from 58% to 9.55% (P < 0.0001). Similarly, in Uganda, the prevalence of microfilaria carriers fell from 71.9% to 7.49% (P < 0.0001) over the 13-year treatment period, and that of nodule carriers from 53.21% to 9.66% (P < 0.0001). The number of microfilaria carriers among children <10 years in Cameroon decreased from 29.73% to 3.8% (P < 0.0001), and in Uganda from 33.89% to 3.1% (P < 0.0001). In 2005, worms excised from nodules in Uganda, 81.4% of males remained alive, and 64% of females, with 24% of them inseminated. A decade or more of annual single dose ivermectin treatment in hyperendemic areas has reduced

  15. TREATMENT OF PULMONICOLA COCHLEOTREMA INFECTION WITH IVERMECTIN-PRAZIQUANTEL COMBINATION IN AN ANTILLEAN MANATEE (TRICHECHUS MANATUS MANATUS).

    PubMed

    Borges, João Carlos Gomes; Jung, Larissa Molinari; Santos, Sebastião Silva Dos; Carvalho, Vitor Luz; Ramos, Rafael Antonio Nascimento; Alves, Leucio Câmara

    2017-03-01

    The aim of this study was to report the use of an oral combination of ivermectin plus praziquantel in the treatment of a Pulmonicola cochleotrema in an Antillean manatee ( Trichechus manatus manatus). A female manatee was found exhibiting respiratory changes and the presence of parasites in the nares. Based on clinical manifestations presented by the manatee, a symptomatic therapeutic protocol was employed, which included an anthelmintic treatment using a combination of ivermectin plus praziquantel. The parasites retrieved were identified as P. cochleotrema. The fourth day after the onset of the therapeutic protocol, the clinical signs declined and on the seventh day posttreatment no clinical signs were observed. This is the first time a therapeutic protocol of ivermectin plus praziquantel has been used in the treatment of P. cochleotrema in manatees.

  16. The curative and antioxidative efficiency of ivermectin and ivermectin + vitamin E-selenium treatment on canine Sarcoptes scabiei infestation.

    PubMed

    Behera, Suvendu Kumar; Dimri, Umesh; Singh, Shanker Kumar; Mohanta, Ranjan Kumar

    2011-04-01

    The objective of the present study was to investigate the curative and antioxidative efficacy of ivermectin and ivermectin + vitamin E-selenium, and the influence of these agents on oxidative stress parameters in canines infested by Sarcoptes scabiei. Twenty two sarcoptic mites infested dogs and nine healthy dogs of 6 months to 2 years of age were divided into three groups. Group I comprised of healthy dogs (n=9) whereas animals in group II (n=11) and III (n=11) were positive for scabies. Group II animals were treated with only 1% ivermectin @ 0.2 mg/kg SC whereas group III were additionally treated with Vitamin E and selenium (tocopherol 50 mg + Se 1.5 mg/ml) @ 0.5 ml/20 kg IM at weekly intervals for three times. Blood samples were collected on day 0 and 28 post therapy. The values for hemato-biochemical parameters and activities of antioxidant enzymes were significantly decreased (P<0.05) whereas level of lipid peroxidation was significantly increased in all the infested dogs in comparison to the healthy dogs on day 0 which approached normalcy by day 28 post therapy. The dogs of group III showed better clinical recovery in comparison to group II at the end of therapy. Thus, administration of vitamin E and selenium in addition to standard therapy can alleviate these alterations hastening the clinical recovery of diseased dogs and can be recommended as an adjunct therapy with miticides for canine sarcoptic mange. © Springer Science+Business Media B.V. 2011

  17. Assessment of the safety and efficacy of three concentrations of topical ivermectin lotion as a treatment for head lice infestation.

    PubMed

    Meinking, Terri L; Mertz-Rivera, Kamara; Villar, Maria Elena; Bell, Margie

    2013-01-01

    Ivermectin is a broad-spectrum parasiticide in widespread systemic use, including as an off-label treatment for head lice infestation. The potential of the topical use of ivermectin as a treatment for head lice infestation was suggested by an in vitro report of a novel lotion formulation. This study investigated the relative effectiveness of three ivermectin lotion concentrations (0.15, 0.25, and 0.5%) compared with vehicle placebo in eliminating head lice infestation. In this randomized, blinded study, 78 head lice-infested subjects, aged 2-62 years, received a single, 10-minute application of product on day 1. Evaluations were completed at two and six hours post-application, and on days 2, 8 (±1), and 15 (+2). Safety was assessed according to the evaluations of trained observers and adverse event (AE) reports. Efficacy was assessed according to scalp and hair examinations. Compared with placebo, all ivermectin concentrations resulted in the statistically significant (P ≤ 0.003) eradication of head lice through to day 15, with the highest level of eradication (73.7%) in subjects who received the 0.5% concentration. The severity of pruritus decreased from baseline in all treatment groups, including the placebo group, from six hours post-treatment to day 15, with the greatest reduction in the 0.5% concentration group. No ocular irritation was observed. All three ivermectin treatment strengths and vehicle were well tolerated. A single application of a 0.5% concentration of this ivermectin lotion formulation shows promise as a safe and effective treatment for head lice infestation and the associated signs of pruritus. © 2013 The International Society of Dermatology.

  18. Immunohistological studies on macrophages in lymph nodes of onchocerciasis patients after treatment with ivermectin.

    PubMed

    Knab, J; Darge, K; Büttner, D W

    1997-12-01

    The role of macrophages in the killing and elimination of microfilariae (mf) was studied immunohistologically in 14 lymph nodes from 10 patients with generalized onchocerciasis 20-68 h after treatment with a single oral dose of 150 microg/kg ivermectin. Mf with signs of damage at light microscopical level were surrounded by a cellular infiltrate comprising macrophages, eosinophils and neutrophils, whereas light microscopically intact mf mostly showed no cellular reaction. Resident mature macrophages expressing the CD 68 epitope usually neither migrated nor attached to damaged mf, especially on the first and second day after ivermectin treatment. However, many young invading macrophages labelled for the L1 protein (antibodies 27 E 10, MAC 387, S 36.48 and 8.5C2) were found within the cellular infiltrate around damaged mf and in adherence to the mf in all lymph nodes after ivermectin treatment. Free L1 protein was observed on the cuticle of the mf. The attacking macrophages contained increased amounts of the enzymes lysozyme, alpha-1-antichymotrypsin and alpha-1-antitrypsin compared to resident macrophages. Free enzymes were found on the cuticle of the mf and around them, indicating a role of these enzymes in the inflammatory reaction to the parasites. The attacking macrophages were strongly labelled for human HLA-DR and they showed further an increased expression of the complement receptors CR1 (CD 35) for C3b and CR3 (CD 11b) for C3 bi in comparison to resident macrophages and thus were considered as activated macrophages. Rarely fragments of mf were seen within multinuclear macrophages. We conclude that young activated macrophages play a major role in the elimination of mf transported to the regional lymph nodes after ivermectin treatment. The immunohistological findings are in accordance with the assumption that these activated macrophages together with granulocytes contribute to the killing of the damaged mf. They also help to limit the damage of the host tissue

  19. Ocular findings in a double-blind study of ivermectin versus diethylcarbamazine versus placebo in the treatment of onchocerciasis.

    PubMed

    Dadzie, K Y; Bird, A C; Awadzi, K; Schulz-Key, H; Gilles, H M; Aziz, M A

    1987-02-01

    The effect of ivermectin, a new microfilaricide, was assessed in a double blind trial against diethylcarbamazine citrate (DEC) and placebo. Fifty-nine adult males with moderate to heavy infection with Onchocerca volvulus and with eye involvement were recruited from an area under Onchocerciasis Control Programme (OCP) vector control in Northern Ghana. They were randomly assigned to an eight-day treatment with ivermectin as a single dose of 12 mg on day 1 followed by placebo for the remaining seven days, or DEC, total dose 1.3 g, or placebo, and ophthalmological review was undertaken over a period of one year. DEC acted quickly to eliminate microfilariae from the eye and was associated with reactive ocular changes and in a few cases functional deficit. Ivermectin eliminated microfilariae slowly from the anterior chamber of the eye over a period of six months. The ocular inflammatory reaction was minimal and no functional deficit occurred. It is postulated that the observed slow action of ivermectin on the eye may be attributed in part to its instability to cross the blood-aqueous humour barrier because of its molecular size as a macrocyclic lactone causing microfilariae to leave the eye gradually along a newly created gradient. Ivermectin is an effective microfilaricide with minimal ocular adverse effect and could therefore be suitable for widespread application without strict supervision.

  20. Ocular findings in a double-blind study of ivermectin versus diethylcarbamazine versus placebo in the treatment of onchocerciasis.

    PubMed Central

    Dadzie, K Y; Bird, A C; Awadzi, K; Schulz-Key, H; Gilles, H M; Aziz, M A

    1987-01-01

    The effect of ivermectin, a new microfilaricide, was assessed in a double blind trial against diethylcarbamazine citrate (DEC) and placebo. Fifty-nine adult males with moderate to heavy infection with Onchocerca volvulus and with eye involvement were recruited from an area under Onchocerciasis Control Programme (OCP) vector control in Northern Ghana. They were randomly assigned to an eight-day treatment with ivermectin as a single dose of 12 mg on day 1 followed by placebo for the remaining seven days, or DEC, total dose 1.3 g, or placebo, and ophthalmological review was undertaken over a period of one year. DEC acted quickly to eliminate microfilariae from the eye and was associated with reactive ocular changes and in a few cases functional deficit. Ivermectin eliminated microfilariae slowly from the anterior chamber of the eye over a period of six months. The ocular inflammatory reaction was minimal and no functional deficit occurred. It is postulated that the observed slow action of ivermectin on the eye may be attributed in part to its instability to cross the blood-aqueous humour barrier because of its molecular size as a macrocyclic lactone causing microfilariae to leave the eye gradually along a newly created gradient. Ivermectin is an effective microfilaricide with minimal ocular adverse effect and could therefore be suitable for widespread application without strict supervision. PMID:3548811

  1. Air Sample Conditioner Helps the Waste Treatment Plant Meet Emissions Standards

    SciTech Connect

    Glissmeyer, John A.; Flaherty, Julia E.; Pekour, Mikhail S.

    2014-12-02

    The air in three of the Hanford Site Waste Treatment and Immobilization Plant (WTP) melter off-gas discharge stacks will be hot and humid after passing through the train of emission abatement equipment. The off-gas temperature and humidity levels will be incompatible with the airborne emissions monitoring equipment required for this type of stack. To facilitate sampling from these facilities, an air sample conditioner system will be installed to introduce cool, dry air into the sample stream to reduce the temperature and dew point. This will avoid thermal damage to the instrumentation and problematic condensation. The complete sample transport system must also deliver at least 50% of the particles in the sample airstream to the sample collection and on-line analysis equipment. The primary components of the sample conditioning system were tested in a laboratory setting. The sample conditioner itself is based on a commercially-available porous tube filter design. It consists of a porous sintered metal tube inside a coaxial metal jacket. The hot gas sample stream passes axially through the porous tube, and the dry, cool air is injected into the jacket and through the porous wall of the inner tube, creating an effective sample diluter. The dilution and sample air mix along the entire length of the porous tube, thereby simultaneously reducing the dew point and temperature of the mixed sample stream. Furthermore, because the dilution air enters through the porous tube wall, the sample stream does not come in contact with the porous wall and particle deposition is reduced in this part of the sampling system. Tests were performed with an environmental chamber to supply air with the temperature and humidity needed to simulate the off-gas conditions. Air from the chamber was passed through the conditioning system to test its ability to reduce the temperature and dew point of the sample stream. To measure particle deposition, oil droplets in the range of 9 to 11 micrometer

  2. [Ivermectin. A new drug against onchocerciasis].

    PubMed

    Otterlei, O

    1989-06-30

    Ivermectin is a new drug for treatment of onchocerciasis. Experimental and clinical studies have shown that ivermectin is effective in the treatment of onchocerciasis when given as a single dose of 150 microgram/kilo bodyweight once a year. Ivermectin is registered as Mectizan and is at present supplied free of charge by Merck Sharp & Dohme for treatment programs in 11 developing countries.

  3. Ivermectin in human onchocerciasis: a clinical-pathological study of skin lesions before and three days after treatment.

    PubMed

    Vuong, P N; Traoré, S; Wanji, S; Diarrassouba, S; Balaton, A; Bain, O

    1992-01-01

    Findings are presented from an histological study of 360 skin-snips (from iliac crests, calves, ankles) taken from 30 Ivory Coast onchocerciasis patients before and three days after an oral dose of ivermectin (200 micrograms/kg). This dose causes a nearly complete disappearance of the intralymphatic microfilariae and, surprisingly, of the "extra-vascular" ones. That shows the difficulty to localize the microfilariae on histological sections; these microfilariae are in fact inside the lymphatic pre-capillaries. There was no intensification of acute skin lesions after the treatment, thus showing that, contrary to diethylcarbamazine (DEC), ivermectin does not induce an exit of microfilariae into the extralymphatic connective tissue. Under the influence of ivermectin, paralyzed microfilariae may be carried passively towards the deep sub-cutaneous lymphatics, and then destroyed inside the regional lymph nodes, without producing major changes in the skin.

  4. Ivermectin alone or in combination with benzyl benzoate in the treatment of human immunodeficiency virus-associated scabies.

    PubMed

    Alberici, F; Pagani, L; Ratti, G; Viale, P

    2000-05-01

    In order to establish a safe and reliable treatment for human immunodeficiency virus (HIV)-associated scabies, we have treated 60 episodes of scabies in this setting, occurring in 39 patients, with one of the following regimens: (i) topical treatment with benzyl benzoate solution; (ii) single-dose oral treatment with ivermectin alone; and (iii) combination therapy with benzyl benzoate solution and oral ivermectin, employing the same regimens as single-agent therapy. Patients were stratified according to the severity score of the disease and the outcome (eradication, relapse, failure). We found that both benzyl benzoate and ivermectin alone were quite effective in mild to moderate scabies, but they were both associated with an unacceptable rate of relapse and failure in severe or crusted scabies. In contrast, combined treatment produced an optimal rate of success, without significant treatment-related side-effects. Therefore, we consider that combination treatment with benzyl benzoate solution and oral ivermectin is preferable to single-agent therapy in crusted scabies occurring in HIV/acquired immune deficiency syndrome patients.

  5. Required duration of mass ivermectin treatment for onchocerciasis elimination in Africa: a comparative modelling analysis.

    PubMed

    Stolk, Wilma A; Walker, Martin; Coffeng, Luc E; Basáñez, María-Gloria; de Vlas, Sake J

    2015-10-22

    The World Health Organization (WHO) has set ambitious targets for the elimination of onchocerciasis by 2020-2025 through mass ivermectin treatment. Two different mathematical models have assessed the feasibility of reaching this goal for different settings and treatment scenarios, namely the individual-based microsimulation model ONCHOSIM and the population-based deterministic model EPIONCHO. In this study, we harmonize some crucial assumptions and compare model predictions on common outputs. Using a range of initial endemicity levels and treatment scenarios, we compared the models with respect to the following outcomes: 1) model-predicted trends in microfilarial (mf) prevalence and mean mf intensity during 25 years of (annual or biannual) mass ivermectin treatment; 2) treatment duration needed to bring mf prevalence below a provisional operational threshold for treatment interruption (pOTTIS, i.e. 1.4 %), and 3) treatment duration needed to drive the parasite population to local elimination, even in the absence of further interventions. Local elimination was judged by stochastic fade-out in ONCHOSIM and by reaching transmission breakpoints in EPIONCHO. ONCHOSIM and EPIONCHO both predicted that in mesoendemic areas the pOTTIS can be reached with annual treatment, but that this strategy may be insufficient in very highly hyperendemic areas or would require prolonged continuation of treatment. For the lower endemicity levels explored, ONCHOSIM predicted that the time needed to reach the pOTTIS is longer than that needed to drive the parasite population to elimination, whereas for the higher endemicity levels the opposite was true. In EPIONCHO, the pOTTIS was reached consistently sooner than the breakpoint. The operational thresholds proposed by APOC may have to be adjusted to adequately reflect differences in pre-control endemicities. Further comparative modelling work will be conducted to better understand the main causes of differences in model-predicted trends

  6. Adverse reactions to the ivermectin treatment of onchocerciasis patients: does infection with the human immunodeficiency virus play a role?

    PubMed

    Kipp, W; Bamhuhiiga, J; Rubaale, T; Kabagambe, G

    2005-06-01

    To assess and compare the adverse effects resulting from ivermectin treatment of onchocerciasis patients with and without infection with human immunodeficiency virus (HIV-1), 1256 Ugandan cases of onchocerciasis were investigated as they were treated for the first time with the drug. Treatment followed the protocol of the Mectizan Expert Committee (i.e. a single dose of 150 mug/kg body weight). Adverse reactions to the ivermectin were determined, within 48 h of treatment, through questioning and clinical examinations during house-to-house visits. The HIV-1 status of each patient aged >15 years was initially determined using indirect ELISA, and any ELISA-positives were then confirmed in a western-blot assay. Among the cases aged >15 years, the frequency of adverse reactions to ivermectin was higher among those seropositive for HIV-1 (53.4%) than among the seronegative (45.7%) but the difference was not statistically significant (P = 0.25). The severity of the adverse reactions observed was, however, significantly lower in the HIV-1-positive patients than in the seronegative patients, with median scores of 1.37 and 1.68, respectively (P = 0.044). The conclusion is that ivermectin can be safely used for mass treatment in areas where the prevalences of onchocerciasis and HIV-1 infection are both high.

  7. The safety and efficacy of amocarzine in African onchocerciasis and the influence of ivermectin on the clinical and parasitological response to treatment.

    PubMed

    Awadzi, K; Opoku, N O; Attah, S K; Addy, E T; Duke, B O; Nyame, P K; Kshirsagar, N A

    1997-04-01

    The hundred men from a forest area of Ghana, without vector control or ivermectin distribution, were randomized to receive a single dose of ivermectin (150 micrograms/kg body weight) on day 1 followed by amocarzine (3 mg/kg twice daily after meals) on days 8, 9 and 10 (34 patients), the ivermectin alone (33 patients) or the amocarzine alone (33 patients). Detailed clinical and laboratory examinations were made before, during and after drug administration. On day 120, all palpable nodules were excised, fixed, sectioned, stained and examined by two blinded observers and the results compared with those for nodules from untreated controls. Mazzotti-type reactions, such as itching, rash, peripheral sensory phenomena and swellings, were more severe or frequent with amocarzine than ivermectin. Pretreatment with ivermectin markedly suppressed these reactions to amocarzine but did not affect other manifestations such as dizziness and gaze-evoked nystagmus. Ocular effects were minor in all groups. Ivermectin produced minor macrofilaricidal effects on the adult male worms, marked degeneration of intra-uterine embryos, and potent microfilaricidal effects and suppressed skin microfilariae. Amocarzine did not affect the male worms or the intra-uterine embryos, was a less potent microfilaricide and did not suppress skin microfilariae. The efficacy of ivermectin plus amocarzine was similar to that of ivermectin alone. The present results do not support the findings from the Americas and show that amocarzine has no role in the treatment of onchocerciasis in Africa.

  8. Intention to continue with ivermectin treatment for onchocerciasis control after eight years of annual distribution in Cameroon, Nigeria, and Uganda.

    PubMed

    Okeibunor, Joseph C; Brieger, William R; Abiose, Adenike O; Elhassan, Elizabeth; Ndyomugyenyi, Richard; Wanji, Samuel; Amazigo, Uche V

    This study identified the socio-demographic correlates of intention to comply with ivermectin treatment, from a structured interview of 2,306 persons aged 10 years and above, grouped into high and low compliers, who took ivermectin 6-8 times and 0-2 times respectively. Simple descriptive statistics were employed in characterizing the respondents into high and low compliers, while some socio-demographic and key perceptual factors were employed in regression models constructed to explain levels of compliance among the respondents. Demographic and perceptual factors associated with intention to comply with prolonged treatment with ivermectin were identified. Intention to comply was higher among married persons (91.8%, p < 0.001); local populations (89.8%, p < 0.001); and those with history of complying with treatment (98.2%, p < 0.001). Perception of onchocerciasis and effectiveness of ivermectin influenced intention to continue. The perceptual factors that drive the intention to comply should inform plans for health education at the project and village levels.

  9. Treatment for crusted scabies: limitations and side effects of treatment with ivermectin.

    PubMed

    Fujimoto, Kazuhisa; Kawasaki, Yushi; Morimoto, Kensuke; Kikuchi, Izumi; Kawana, Seiji

    2014-01-01

    Skin eruption with mild itching of the hands and feet developed in a man in his 90s 1 month after he was hospitalized following a traffic accident. Scabies was diagnosed in an attending nurse 3 months after the patient's hospitalization, and infection from the patient was suspected. Cornification of the patient's soles and marked hypertrophy of the nails of both feet were observed. After a large number of scabies mites were detected on microscopic examination, crusted scabies was diagnosed. The patient was given oral ivermectin, 6 mg, once per week for 3 weeks, and crotamiton topical ointment containing 30% benzyl benzoate was applied on the body from the neck down. However, because a large number of scabies mites were detected again on microscopic examination, the dose of ivermectin was increased to 12 mg and administered 3 times. One week after the sixth dose of ivermectin was administered, hemorrhagic scabs around the mouth and erosion of the tongue developed. Mucosal drug eruption was suspected, and eruptions around the mouth and on the tongue resolved within 1 week after ivermectin being discontinued. 1% gamma-benzene hexachloride ointment was applied topically on the body from the neck down once a week, crotamiton ointment containing benzyl benzoate was applied daily, and the hypertrophic parts of the nails were removed. The patient subsequently achieved a full recovery.

  10. Evaluation of ivermectin for treatment of hair loss syndrome in black-tailed deer.

    PubMed

    Foreyt, William J; Hall, Briggs; Bender, Louis

    2004-07-01

    Since 1997, numerous Columbian black-tailed deer (Odocoileus hemionus columbianus) in western Washington (USA) have developed a hair loss syndrome that often preceded emaciation, debilitation, pneumonia, and death. To study this syndrome, eight affected free-ranging Columbian black-tailed deer fawns were captured from western Washington in February 1999 to determine the effect of ivermectin treatment. Fecal examinations indicated that the internal parasites were Dictyocaulus viviparus, Parelaphostrongylus sp., Trichuris sp., Moniezia sp., Eimeria spp., and gastrointestinal strongyles. Biting lice (Tricholipeurus parallelus) were observed on all deer, with up to 5 lice/cm(2) on the index areas counted. Three deer were treated with ivermectin subcutaneously at doses between 0.2 and 1.3 mg/kg of body weight monthly for four consecutive months, and five control deer received no anthelmintic treatment. Complete blood counts, parasite evaluations, weight gains, and hair loss evaluations were used to assess effectiveness of treatment. Two untreated deer died during the experiment compared with no deaths among the three treated deer. Treated deer gained significantly more weight (P<0.05) than the untreated deer (22.4 vs. 12.6 kg, respectively) that survived the experiment, had significantly fewer parasite eggs and larvae (P<0.05) in feces and significantly fewer nematodes (P<0.05) at necropsy, and regrew their hair at a faster rate than untreated deer. Lice and all nematode eggs and larval stages in feces were eliminated or greatly reduced following treatment. On the basis of these data, excessive louse populations, gastrointestinal nematodes, and the lung-worms Parelaphostrongylus sp. and D. viviparus, might be important predisposing factors for this hair loss condition and death of affected animals.

  11. Treatment of co-infection with bancroftian filariasis and onchocerciasis: a safety and efficacy study of albendazole with ivermectin compared to treatment of single infection with bancroftian filariasis

    PubMed Central

    Makunde, William H; Kamugisha, Leo M; Massaga, Julius J; Makunde, Rachel W; Savael, Zakana X; Akida, Juma; Salum, Fred M; Taylor, Mark J

    2003-01-01

    Background In order to use a combination of ivermectin and albendazole for the elimination of lymphatic filariasis, it is important to assess the potential risk of increased adverse events in individuals infected with both lymphatic filariasis and onchocerciasis. We compared the safety and efficacy of albendazole (400 mg) in combination with ivermectin (150 micrograms/kg), for the treatment of co-infections of Wuchereria bancrofti and Onchocerca volvulus with single infection of W. bancrofti. Methods The safety study on co-infections was a crossover, double blind design, while for the single infection of bancroftian filariasis an open design comparing two treatments was used. For co-infection, one group was allocated a single dose of ivermectin (150 micrograms/kg) plus albendazole (400 mg) (Group A). The other group received placebo (Group B). Five days later the treatment regime was reversed, with the Group A receiving placebo and Group B receiving treatment. For the single bancroftian filariasis infection, one group received a single dose of albendazole (400 mg) plus ivermectin (150 μg/kg) (Group C) while the other group received a single dose of albendazole (400 mg) alone (Group D). Blood and skin specimens were collected on admission day, day 0, and on days 2, 3, and 7 to assess drug safety and efficacy. Thereafter, blood and skin specimens were collected during the 12 months follow up for the assessment of drug efficacy. Study individuals were clinically monitored every six hours during the first 48 hours following treatment, and routine clinical examinations were performed during the hospitalisation period and follow-up. Results In individuals co-infected with bancroftian filariasis and onchocerciasis, treatment with ivermectin and albendazole was safe and tolerable. Physiological indices showed no differences between groups with co-infection (W. bancrofti and O. volvulus) or single infection (W. bancrofti). The frequency of adverse events in co

  12. 9 CFR 73.12 - Ivermectin. 1

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS SCABIES IN CATTLE § 73.12 Ivermectin. 1 1 Tissue residues remain following treatment with ivermectin. Cattle treated with ivermectin... edible cattle tissue. With respect to the limitations 21 CFR part 522 provides the following: “For...

  13. 9 CFR 73.12 - Ivermectin. 1

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS SCABIES IN CATTLE § 73.12 Ivermectin. 1 1 Tissue residues remain following treatment with ivermectin. Cattle treated with ivermectin... edible cattle tissue. With respect to the limitations 21 CFR part 522 provides the following: “For...

  14. 9 CFR 73.12 - Ivermectin. 1

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS SCABIES IN CATTLE § 73.12 Ivermectin. 1 1 Tissue residues remain following treatment with ivermectin. Cattle treated with ivermectin... edible cattle tissue. With respect to the limitations 21 CFR part 522 provides the following: “For...

  15. 9 CFR 73.12 - Ivermectin. 1

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS SCABIES IN CATTLE § 73.12 Ivermectin. 1 1 Tissue residues remain following treatment with ivermectin. Cattle treated with ivermectin... edible cattle tissue. With respect to the limitations 21 CFR part 522 provides the following:...

  16. 9 CFR 73.12 - Ivermectin. 1

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS SCABIES IN CATTLE § 73.12 Ivermectin. 1 1 Tissue residues remain following treatment with ivermectin. Cattle treated with ivermectin... edible cattle tissue. With respect to the limitations 21 CFR part 522 provides the following:...

  17. Ivermectin treatment for massive orbital myiasis in an empty socket with concomitant scalp pediculosis.

    PubMed

    Puthran, Neelam; Hegde, Vidya; Anupama, B; Andrew, Sheena

    2012-01-01

    We report a rare case of massive orbital myiasis following recent lid injury, occurring in the empty socket of an elderly lady, who had concurrent scalp pediculosis. The orbital myiasis was effectively treated with the broad-spectrum antiparasitic agent, ivermectin, thus precluding the need for an exploratory surgery. Ivermectin was also effective in managing the concurrent scalp pediculosis.

  18. Ivermectin treatment for massive orbital myiasis in an empty socket with concomitant scalp pediculosis

    PubMed Central

    Puthran, Neelam; Hegde, Vidya; Anupama, B; Andrew, Sheena

    2012-01-01

    We report a rare case of massive orbital myiasis following recent lid injury, occurring in the empty socket of an elderly lady, who had concurrent scalp pediculosis. The orbital myiasis was effectively treated with the broad-spectrum antiparasitic agent, ivermectin, thus precluding the need for an exploratory surgery. Ivermectin was also effective in managing the concurrent scalp pediculosis. PMID:22569389

  19. Treatment of Dirofilaria repens microfilariaemia with a combination of doxycycline hyclate and ivermectin.

    PubMed

    Giannelli, Alessio; Ramos, Rafael Antonio Nascimento; Traversa, Donato; Brianti, Emanuele; Annoscia, Giada; Bastelli, Francesca; Dantas-Torres, Filipe; Otranto, Domenico

    2013-11-08

    Dirofilaria repens is one of the most widespread mosquito-borne filarioid responsible for infestations in dogs, usually characterized by nodules and other skin lesions. Additionally, the zoonotic potential of this nematode is of public health concern, given that D. repens has been often associated to human dirofilariosis in the Old World. In the present study, the therapeutic efficacy against D. repens microfilariae of a protocol based on doxycycline hyclate (Ronaxan(®), Merial), 10mg/kg every day for 30 days, and ivermectin (Cardotek 30(®), Merial), 6 μg/kg every 15 days for 6 months, was preliminarily investigated in two naturally infested dogs. Blood samples were collected every 30 days during 6 months of treatment and examined by a Knott's modified test and a duplex real-time PCR. The results here presented indicate that this therapeutic protocol, applied monthly, could be effective for treating microfilariaemia in dogs affected by subcutaneous dirofilariosis.

  20. Impact of Long-Term Treatment with Ivermectin on the Prevalence and Intensity of Soil-Transmitted Helminth Infections

    PubMed Central

    Moncayo, Ana Lucia; Vaca, Maritza; Amorim, Leila; Rodriguez, Alejandro; Erazo, Silvia; Oviedo, Gisela; Quinzo, Isabel; Padilla, Margarita; Chico, Martha; Lovato, Raquel; Gomez, Eduardo; Barreto, Mauricio L.; Cooper, Philip J.

    2008-01-01

    Background Control of soil-transmitted helminth (STH) infections relies on the periodic and long-term administration of anthelmintic drugs to high-risk groups, particularly school-age children living in endemic areas. There is limited data on the effectiveness of long-term periodic anthelmintic treatment on the prevalence of STHs, particularly from operational programmes. The current study investigated the impact of 15 to 17 years of treatment with the broad-spectrum anthelmintic ivermectin, used for the control of onchocerciasis, on STH prevalence and intensity in school-age and pre-school children. Methods and Findings A cross-sectional study was conducted in communities that had received annual or twice-annual ivermectin treatments and geographically adjacent communities that had not received treatment in two districts of Esmeraldas Province in Ecuador. Stool samples were collected from school-age children and examined for STH infection using the Kato-Katz and formol-ether concentration methods. Samples were collected also from pre-school children and examined by the formol-ether concentration method. Data on risk factors for STH infection were collected by parental questionnaire. We sampled a total of 3,705 school-age children (6–16 years) from 31 treated and 27 non-treated communities, and 1,701 pre-school children aged 0–5 years from 18 treated and 18 non-treated communities. Among school-age children, ivermectin treatment had significant effects on the prevalence (adjusted OR =  0.06, 95% CI 0.03–0.14) and intensity of Trichuris trichiura infection (adjusted RR = 0.28, 95% CI 0.11–0.70), but appeared to have no impact on Ascaris lumbricoides or hookworm infection. Reduced prevalence and intensities of T. trichiura infection were observed among children not eligible to receive ivermectina, providing some evidence of reduced transmission of T. trichiura infection in communities receiving mass ivermectin treatments. Conclusion Annual and twice

  1. Adverse reactions after large-scale treatment of onchocerciasis with ivermectin: combined results from eight community trials.

    PubMed Central

    De Sole, G.; Remme, J.; Awadzi, K.; Accorsi, S.; Alley, E. S.; Ba, O.; Dadzie, K. Y.; Giese, J.; Karam, M.; Keita, F. M.

    1989-01-01

    Eight community trials were carried out by the Onchocerciasis Control Programme in West Africa to determine the safety of the new microfilaricide ivermectin during large-scale treatment of onchocerciasis. The trial areas were located in eight different countries and varied greatly in endemicity level; a total of 50,929 persons were treated and monitored for 72 hours. Overall treatment coverage was 60% of the census population, the main reasons for non-treatment being the exclusion criteria. Of those treated, 9% reported with adverse reactions, 2.4% with moderate reactions, and 0.24% with severe reactions. Most reactions were reported during the first day of follow-up, the most frequent severe reaction being severe symptomatic postural hypotension (in 49 cases). Three cases of severe dyspnoea were life-threatening but their relationship with ivermectin treatment is uncertain. The incidence of adverse reactions was directly related to skin microfilarial load and was highest in the foci with the highest endemicity levels. Treatment resulted in 98% reductions in mean microfilarial loads at all endemicity levels. The benefit of treatment largely compensated for the discomfort due to adverse reactions, which were all transient and managed successfully. Ivermectin thus appears to be sufficiently safe for large-scale treatment but monitoring by resident nurses for at least 36 hours is recommended. PMID:2633886

  2. Long-term efficacy of single-dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis.

    PubMed

    Ismail, M M; Jayakody, R L; Weil, G J; Fernando, D; De Silva, M S; De Silva, G A; Balasooriya, W K

    2001-01-01

    In a 'blinded' trial (in Sri Lanka, 1996-98) of 47 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of 3 single-dose combination regimens were compared: albendazole 400 mg with ivermectin 200 micrograms/kg, albendazole 400 mg with diethylcarbamazine citrate (DEC) 6 mg/kg or albendazole 600 mg with ivermectin 400 micrograms/kg. Treated subjects were followed-up for 24 months. This represents the first long-term study using combinations of albendazole with DEC or ivermectin in the above doses against bancroftian filariasis. All subjects had pre-treatment microfilaria (mf) counts over 100/mL. All 3 treatments significantly reduced mf counts, with the albendazole-DEC-treated group showing the lowest mf levels at 18 and 24 months post-treatment. Filarial antigen tests suggested that all 3 treatments had significant activity against adult W. bancrofti; albendazole-DEC combination had the greatest activity according to this test, with antigen levels decreasing to 30.5% of pre-treatment antigen levels, 24 months after therapy. All 3 treatments were clinically safe and well tolerated. These results suggest that a single dose of albendazole 400 mg together with DEC 6 mg/kg is a safe and effective combination for suppression of microfilaraemia of bancroftian filariasis that could be considered for use in filariasis control programmes based on mass treatment of endemic populations.

  3. [Nosocomial outbreak of scabies in a psychiatric hospital--epidemiological assessment and prophylactic treatment with oral ivermectin].

    PubMed

    Makigami, Kuniko; Ohtaki, Noriko; Sato, Yasuto; Yamaguchi, Naohito

    2005-11-01

    To evaluate the effectiveness of mass treatment with ivermectin of scabies outbreak in institutional settings. To determine the factors, such as host susceptibility and scabetic exposure level associated with the onset of scabies. The authors investigated a nosocomial scabies outbreak in a close psychiatric ward. The index case was a man with steroid-induced localized crusted scabies. Twenty-six patients were diagnosed with scabies, 4 of them had relapse of scabies, while no staff was infested. Despite frequent surveillance and treatment of symptomatic patients with 1% gamma-benzenehexachloride (gamma-BHC: Lindane), new cases were observed. Thus, all 69 patients in the ward were treated with ivermectin (200 microg/kg) simultaneously on day 105 of the outbreak (the mass treatment). Patients who had scabies were compared with patients who had no scabies in terms of age, body weight, diabetes, physical functions, topical administration of corticosteroid, proximity to the index patient, and problematic behavior. The mass treatment was implemented without a significant adverse event. Although two patients developed symptoms of scabies after the mass treatment, no patient in the ward had been diagnosed with scabies since the 98th day of the treatment. Regarding factors associated with the scabies onset, the only statistically significant factor was proximity to the index patient with crusted scabies. Oral ivermectin was safe and effective for controlling scabies in institutional settings. The exposure level to scabetic mites was more important than host susceptibility in determining the risk of scabies onset.

  4. Ivermectin treatment of Loa loa hyper-microfilaraemic baboons (Papio anubis): Assessment of microfilarial load reduction, haematological and biochemical parameters and histopathological changes following treatment

    PubMed Central

    Wanji, Samuel; Eyong, Ebanga-Echi J.; Tendongfor, Nicholas; Ngwa, Che J.; Esuka, Elive N.; Kengne-Ouafo, Arnaud J.; Datchoua-Poutcheu, Fabrice R.; Enyong, Peter; Agnew, Dalen; Eversole, Rob R.; Hopkins, Adrian

    2017-01-01

    Background Individuals with high intensity of Loa loa are at risk of developing serious adverse events (SAEs) post treatment with ivermectin. These SAEs have remained unclear and a programmatic impediment to the advancement of community directed treatment with ivermectin. The pathogenesis of these SAEs following ivermectin has never been investigated experimentally. The Loa/baboon (Papio anubis) model can be used to investigate the pathogenesis of Loa-associated encephalopathy following ivermectin treatment in humans. Methods 12 baboons with microfilarial loads > 8,000mf/mL of blood were randomised into four groups: Group 1 (control group receiving no drug), Group 2 receiving ivermectin (IVM) alone, Group 3 receiving ivermectin plus aspirin (IVM + ASA), and Group 4 receiving ivermectin plus prednisone (IVM + PSE). Blood samples collected before treatment and at Day 5, 7 or 10 post treatment, were analysed for parasitological, hematological and biochemical parameters using standard techniques. Clinical monitoring of animals for side effects took place every 6 hours post treatment until autopsy. At autopsy free fluids and a large number of standard organs were collected, examined and tissues fixed in 10% buffered formalin and processed for standard haematoxylin-eosin staining and specific immunocytochemical staining. Results Mf counts dropped significantly (p<0.05) in all animals following ivermectin treatment with reductions as high as (89.9%) recorded; while no significant drop was observed in the control animals. Apart from haemoglobin (Hb) levels which recorded a significant (p = 0.028) drop post treatment, all other haematological and biochemical parameters did not show any significant changes (p>0.05). All animals became withdrawn 48 hours after IVM administration. All treated animals recorded clinical manifestations including rashes, itching, diarrhoea, conjunctival haemorrhages, lymph node enlargement, pinkish ears, swollen face and restlessness; one animal

  5. Ivermectin treatment of Loa loa hyper-microfilaraemic baboons (Papio anubis): Assessment of microfilarial load reduction, haematological and biochemical parameters and histopathological changes following treatment.

    PubMed

    Wanji, Samuel; Eyong, Ebanga-Echi J; Tendongfor, Nicholas; Ngwa, Che J; Esuka, Elive N; Kengne-Ouafo, Arnaud J; Datchoua-Poutcheu, Fabrice R; Enyong, Peter; Agnew, Dalen; Eversole, Rob R; Hopkins, Adrian; Mackenzie, Charles D

    2017-07-01

    Individuals with high intensity of Loa loa are at risk of developing serious adverse events (SAEs) post treatment with ivermectin. These SAEs have remained unclear and a programmatic impediment to the advancement of community directed treatment with ivermectin. The pathogenesis of these SAEs following ivermectin has never been investigated experimentally. The Loa/baboon (Papio anubis) model can be used to investigate the pathogenesis of Loa-associated encephalopathy following ivermectin treatment in humans. 12 baboons with microfilarial loads > 8,000mf/mL of blood were randomised into four groups: Group 1 (control group receiving no drug), Group 2 receiving ivermectin (IVM) alone, Group 3 receiving ivermectin plus aspirin (IVM + ASA), and Group 4 receiving ivermectin plus prednisone (IVM + PSE). Blood samples collected before treatment and at Day 5, 7 or 10 post treatment, were analysed for parasitological, hematological and biochemical parameters using standard techniques. Clinical monitoring of animals for side effects took place every 6 hours post treatment until autopsy. At autopsy free fluids and a large number of standard organs were collected, examined and tissues fixed in 10% buffered formalin and processed for standard haematoxylin-eosin staining and specific immunocytochemical staining. Mf counts dropped significantly (p<0.05) in all animals following ivermectin treatment with reductions as high as (89.9%) recorded; while no significant drop was observed in the control animals. Apart from haemoglobin (Hb) levels which recorded a significant (p = 0.028) drop post treatment, all other haematological and biochemical parameters did not show any significant changes (p>0.05). All animals became withdrawn 48 hours after IVM administration. All treated animals recorded clinical manifestations including rashes, itching, diarrhoea, conjunctival haemorrhages, lymph node enlargement, pinkish ears, swollen face and restlessness; one animal died 5 hours after IVM

  6. The cost-effectiveness of ivermectin vs. albendazole in the presumptive treatment of strongyloidiasis in immigrants to the United States.

    PubMed Central

    Muennig, P.; Pallin, D.; Challah, C.; Khan, K.

    2004-01-01

    The presumptive treatment of parasitosis among immigrants with albendazole has been shown to save both money and lives, primarily via a reduction in the burden of Strongyloides stercoralis. Ivermectin is more effective than albendazole, but is also more expensive. This coupled with confusion surrounding the cost-effectiveness of guiding therapy based on eosinophil counts has led to disparate practices. We used the newly arrived year 2000 immigrant population as a hypothetical cohort in a decision analysis model to examine the cost-effectiveness of various interventions to reduce parasitosis among immigrants. When the prevalence of S. stercoralis is greater than 2%, the incremental cost-effectiveness ratios of all presumptive treatment strategies were similar. Ivermectin is associated with an incremental cost-effectiveness ratio of 1700 dollars per QALY gained for treatment with 12 mg ivermectin relative to 5 days of albendazole when the prevalence is 10%. Any presumptive treatment strategy is cost-effective when compared with most common medical interventions. PMID:15635962

  7. [Treatment of oestriasis and hypodermosis in red deer (Cervus elaphus hippelaphus) and roe deer (Capreolus c. capreolus) with ivermectin (Ivomec)].

    PubMed

    Kutzer, E

    2000-04-01

    In two test areas in Austria (Burgenland, Lower Austria) ivermectin has been used to control oestrinosis and hypodermosis in red- and roe deer since many years (1985 and 1987, respectively). The results until 1992, using the injectable solution Ivomec-injection 1% only, have been reported (Kutzer, 1994). In continuation of these tests Ivomec-Praemix 0.6% was examined and it turned out that the treatment was extremely successful. In practice Ivomec-Praemix 0.6% has to be given preference due to its stability. The most favourable dosage for red- and roe deer was 2 x 0.4 mg ivermectin/kg bodyweight administered at an interval of one week, although equally good results could be obtained with 1 x 0.3-0.4 mg ivermectin/kg bodyweight. With the above mentioned dosages against Pharyngomyia picta and Cephenemyia stimulator an up to 100% and against Hypoderma actaeon a 100% success of treatment could be achieved. The administration in two doses has the advantage to eradicate intestinal and lung nematodes at the same time if there are any. Finally, it was found that the controlling measures should not be interrupted for more than one year, if no treatment was done in the neighbouring hunting grounds.

  8. Parascaris equorum in foals and in their environment on a Swedish stud farm, with notes on treatment failure of ivermectin.

    PubMed

    Lindgren, K; Ljungvall, O; Nilsson, O; Ljungström, B-L; Lindahl, C; Höglund, J

    2008-02-14

    Environmental contamination and the egg excretion pattern of the ascarid Parascaris equorum (Nematoda) was investigated in relation to anthelmintic treatment on a Swedish stud farm. Faecal samples from 15 foals, dewormed every 8th-week with a paste formulation of ivermectin at the standard dose rate of 0.2 mg/kg bodyweight, were collected at five sampling occasions between August and November 2006. In addition, soil samples were obtained from four paddocks used by these foals in November 2006. The number of eggs per gram (epg) was counted in both faeces and soil. Egg excretion started when the foals were 3-4 months, and reached the highest levels when they were approximately 5-month-old, and was then followed by a decline. Egg excretion seemed to be unaffected by ivermectin despite these foals were dewormed at regular intervals. In four out of five foals examined 10 days after treatment, epg actually increased. In contrast, when either fenbendazol or pyrantel embonate were used instead of ivermectin, treatments were effective. The number of eggs in soil was significantly higher in the permanent paddock compared to in the temporarily used soil paddock and in the summer paddocks.

  9. The efficacy of a single-oral-dose administration of ivermectin and diethylcarbamazine on the treatment of feline Brugia malayi.

    PubMed

    Chansiri, Gaysorn; Khawsak, Phaisan; Phantana, Sirichai; Sarataphan, Nopporn; Chansiri, Kosum

    2005-09-01

    The combination of ivermectin and diethylcarbamazine (DEC) have been shown to be superior to either drug alone for the suppression of Brugia malayi in humans, but their efficacy against infection with B. malayi in cats has never been investigated. Fourteen asymptomatic microfilaremic (1-200 microfilariae/20 microl blood) cats received oral doses of ivermectin (400 microg/kg body weight) and DEC (6 mg/kg body weight) as a single treatment. A two-month post-treatment examination revealed that 87-100% of the microfilariae in each subject had been cleared, with two of the subjects being amicrofilaremic. A further reduction in microfilarial levels was observed until the final follow-up, at 8 months post-treatment, when the mean clearance rate was 99% and 12 out of the 14 subjects (86%) were amicrofilaremic. The combination of ivermectin and DEC demonstrated a microfilaricidal effect superior to that of either drug used alone, both in the initial rapid clearance of microfilariae, and in sustaining the effect for 8 months. This finding has important implications for the control of brugian lymphatic filariasis in the cat reservoir.

  10. Effects of annual mass treatment with ivermectin for onchocerciasis on the prevalence of intestinal helminths.

    PubMed

    Gutman, Julie; Emukah, Emmanuel; Okpala, Njideka; Okoro, Chinyere; Obasi, Andrew; Miri, Emmanuel S; Richards, Frank O

    2010-09-01

    We evaluated the effect of annual ivermectin (IV) distribution for onchocerciasis on the prevalence of soil transmitted helminth (STH) infections in school-aged (SAC) and preschool-aged (PAC) children by comparing children in villages that had received treatment for 13 years to those from socioeconomically similar villages in untreated areas. We enrolled 1,031 SAC and 211 PAC for Kato Katz examinations. Treated areas had a lower prevalence of Ascaris (SAC: 3% versus 12%, P < 0.0001; PAC: 3% versus 10%, P < 0.051) and Trichuris (SAC: 6% versus 10%, P = 0.012; PAC: 1% versus 8%, P = 0.019), but not hookworm (SAC: 38% versus 42%, P = 0.20; PAC: 21% versus 27%, P = 0.30). The prevalence of Ascaris or Trichuris in treated areas was below the WHO threshold for mass antihelminthic treatment (MDA), but not for hookworm. We conclude that benzimidazole MDA in IV treatment areas is indicated to effectively control hookworm.

  11. Effects of Annual Mass Treatment with Ivermectin for Onchocerciasis on the Prevalence of Intestinal Helminths

    PubMed Central

    Gutman, Julie; Emukah, Emmanuel; Okpala, Njideka; Okoro, Chinyere; Obasi, Andrew; Miri, Emmanuel S.; Richards, Frank O.

    2010-01-01

    We evaluated the effect of annual ivermectin (IV) distribution for onchocerciasis on the prevalence of soil transmitted helminth (STH) infections in school-aged (SAC) and preschool-aged (PAC) children by comparing children in villages that had received treatment for 13 years to those from socioeconomically similar villages in untreated areas. We enrolled 1,031 SAC and 211 PAC for Kato Katz examinations. Treated areas had a lower prevalence of Ascaris (SAC: 3% versus 12%, P < 0.0001; PAC: 3% versus 10%, P < 0.051) and Trichuris (SAC: 6% versus 10%, P = 0.012; PAC: 1% versus 8%, P = 0.019), but not hookworm (SAC: 38% versus 42%, P = 0.20; PAC: 21% versus 27%, P = 0.30). The prevalence of Ascaris or Trichuris in treated areas was below the WHO threshold for mass antihelminthic treatment (MDA), but not for hookworm. We conclude that benzimidazole MDA in IV treatment areas is indicated to effectively control hookworm. PMID:20810817

  12. Predictors of compliance with community-directed treatment with ivermectin for onchocerciasis control in Kabo area, southwestern Ethiopia.

    PubMed

    Endale, Adugna; Erko, Berhanu; Weldegebreal, Fitsum; Legesse, Mengistu

    2015-02-15

    Compliance with annual ivermectin treatment is a major challenge in community-directed treatment with ivermectin (CDTI) implementation. There are individuals who do not comply with the annual mass treatment, which contributes to the continuity for disease transmission. Hence, ensuring high treatment coverage and sustained compliance should be given due emphasis in the control of onchocerciasis. The aim of this study was to determine CDTI compliance rate and predictors of compliance where the CDTI was in its 9(th) round in Kabo area, southwestern Ethiopia. Community-based cross-sectional study was conducted in Kabo area, three weeks after the 9th round of annual ivermectin distribution. Systematic random sampling was used to select head of households and structured, pre-tested questionnaire was used to interview the study participants. Data was analyzed using SPSS version 16. Descriptive statistics was used to compute mean and standard deviation of continuous variables and frequency for categorical variables, while bivariate and multivariate logistic regressions were used to assess the effects of independent variables on the outcome variable. Variables which showed association in multivariate analysis were considered as final predictors of compliance and strength of association was measured through adjusted odds ratio (AOR). A total of 308 respondents (age range 18-70, mean age ± SD, 32.21 ± 9.64) participated in the study. Of these, 249 (80.8%) reported that they took ivermectin during the 9th round annual treatment. Significantly higher rate of treatment compliance was reported by participants age ≥35 years (AOR = 5.48, 95% CI; 1.97 - 15.23), participants who stayed in the area for more than ten years (AOR = 3.86, 95% CI; 1.83- 8.11), participants who perceive that they are at risk of contracting the disease(AOR = 7.05, 2.70- 18.43), participants who perceive community drug distributors (CDDs) are doing their work well (AOR = 2.35 95% CI; 1

  13. Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia

    PubMed Central

    Forrer, Armelle; Khieu, Virak; Schindler, Christian; Schär, Fabian; Marti, Hanspeter; Char, Meng Chuor; Muth, Sinuon; Odermatt, Peter

    2016-01-01

    Background Strongyloides stercoralis is the only soil-transmitted helminth with the ability to replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the epidemiology of S. stercoralis remains scarce and modalities for its large-scale control are yet to be determined. Methodology/Principal Findings A community-based two-year cohort study was conducted among the general population in a rural province in North Cambodia. At each survey, participants infected with S. stercoralis were treated with a single oral dose of ivermectin (200μg/kg BW). Diagnosis was performed using a combination of the Baermann method and Koga agar plate culture on two stool samples. The cohort included participants from eight villages who were either positive or negative for S. stercoralis at baseline. Mixed logistic regression models were employed to assess risk factors for S. stercoralis infection at baseline and re-infection at follow-up. A total of 3,096 participants were examined at baseline, revealing a S. stercoralis prevalence of 33.1%. Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage. Conclusions/Significance Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. The integration of S. stercoralis into existing STH control programs should be considered

  14. Ivermectin treatment of bovine psoroptic mange: effects on serum chemistry, hematology, organ weights, and leather quality.

    PubMed

    Rehbein, S; Visser, M; Meyer, M; Lindner, T

    2016-04-01

    Psoroptic mange is a skin disease which may result in serious health and welfare problems and important economic losses. Apart from the effect on weight gain, little information is available concerning other responses of the organism consequent to the successful therapy of bovine psoroptic mange. Accordingly, serum chemistry, hematology, organ weights, and leather quality of young bulls with experimentally induced clinical Psoroptes ovis mange and treated with either ivermectin long-acting injection (IVM LAI; IVOMEC(®) GOLD, Merial) or saline (n = 16 each) were examined 8 weeks after treatment when all IVM LAI-treated bulls were free of live P. ovis mites while the saline-treated bulls maintained clinical mange. IVM LAI-treated bulls had higher (p < 0.05) alkaline phosphatase, creatinine, cholesterol, glucose, and albumin levels and lower (p < 0.01) total protein and β- and γ-globulin levels than the saline-treated bulls. Complete blood counts revealed higher leukocyte counts associated with higher eosinophil counts and higher platelet counts in the saline-treated compared to the IVM LAI-treated bulls (p < 0.01). Correlating with body weight, the warm carcass weight of the saline-treated bulls was lower than that of the IVM LAI-treated bulls (p < 0.05). Absolute and relative (organ weight divided by body weight) weights of the spleen, thymus, omental fat, and perirenal fat were higher (p < 0.01) for the IVM LAI-treated bulls than for the saline-treated bulls, while the IVM LAI-treated bulls had lower (p < 0.05) absolute and relative weights of the liver, adrenal glands, and selected lymph nodes than the saline-treated bulls. The leathers produced from the IVM LAI-treated bulls showed significantly (p < 0.001) less severe gouging or etching than leathers from the saline-treated bulls, and significantly (p < 0.05) more leather from the IVM LAI-treated bulls was of usable quality than the size of leather from the saline

  15. Efficacy, Safety, and Pharmacokinetics of Coadministered Diethylcarbamazine, Albendazole, and Ivermectin for Treatment of Bancroftian Filariasis.

    PubMed

    Thomsen, Edward K; Sanuku, Nelly; Baea, Manasseh; Satofan, Samson; Maki, Elit; Lombore, Bart; Schmidt, Mark S; Siba, Peter M; Weil, Gary J; Kazura, James W; Fleckenstein, Lawrence L; King, Christopher L

    2016-02-01

    Available treatments for lymphatic filariasis (LF) are limited in their longterm clearance of microfilaria from the blood. The safety and efficacy of a single-dose triple-drug therapy of the antifilarial drugs diethylcarbamazine (DEC), ivermectin (IVM), and albendazole (ALB) for LF are unknown. We performed a pilot study to test the efficacy, safety, and pharmacokinetics of single-dose DEC, IVM, and ALB in Wuchereria bancrofti-infected Papua New Guineans. Adults were randomized into 2 treatment arms, DEC 6 mg/kg + ALB 400 mg (N = 12) or DEC 6 mg/kg + ALB 400 mg + IVM 200 μg/kg (N = 12), and monitored for microfilaria, parasite antigenemia, adverse events (AEs), and serum drug levels. Triple-drug therapy induced >2-log reductions in microfilaria levels at 36 and 168 hours after treatment compared with approximately 1-log reduction with 2 drugs. All 12 individuals who received 3 drugs were microfilaria negative 1 year after treatment, whereas 11 of 12 individuals in the 2-drug regimen were microfilaria positive. In 6 participants followed 2 years after treatment, those who received 3 drugs remained microfilaria negative. AEs, particularly fever, myalgias, pruritus, and proteinuria/hematuria, occurred in 83% vs 50% of those receiving triple-drug compared to 2-drug treatment respectively (P = .021); all resolved within 7 days after treatment. No serious AEs were observed in either group. There was no significant effect of IVM on DEC or ALB drug levels. Triple-drug therapy is safe and more effective than DEC + ALB for Bancroftian filariasis and has the potential to accelerate elimination of lymphatic filariasis. NCT01975441. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  16. Efficacy of single dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis.

    PubMed

    Ismail, M M; Jayakody, R L; Weil, G J; Nirmalan, N; Jayasinghe, K S; Abeyewickrema, W; Rezvi Sheriff, M H; Rajaratnam, H N; Amarasekera, N; de Silva, D C; Michalski, M L; Dissanaike, A S

    1998-01-01

    In a 'blind' trial on 50 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of a single dose of albendazole (alb) 600 mg alone or in combination with ivermectin (iver) 400 micrograms/kg or diethylcarbamazine citrate (DEC) 6 mg/kg was compared with a single dose of the combination DEC 6 mg/kg and iver 400 micrograms/kg over a period of 15 months after treatment. All but one subject, with 67 microfilariae (mf)/mL, had pre-treatment counts > 100 mf/mL. All 4 treatments significantly reduced mf counts, but alb/iver was the most effective regimen for clearing mf from night blood: 9 of 13 subjects (69%) were amicrofilaraemic by membrane filtration 15 months after treatment compared to one of 12 (8%), 3 of 11 (27%), and 3 of 10 (30%) in the groups treated with alb, alb/DEC, and DEC/iver, respectively. Filarial antigen tests suggested that all 4 treatments had significant activity against adult W. bancrofti; alb/DEC had the greatest activity according to this test, with antigen levels decreasing by 77% 15 months after therapy. All 4 regimens were well tolerated and clinically safe, although mild, self-limited systemic reactions were observed in all treatment groups. These results suggest that alb/iver is a safe and effective single dose regimen for suppression of microfilaraemia in bancroftian filariasis that could be considered for control programmes. Additional benefits of this combination are its potent, broad spectrum activity against intestinal helminths and potential relative safety in areas of Africa where DEC cannot be used for filariasis control because of co-endemicity with onchocerciasis or loiasis.

  17. The chemotherapy of onchocerciasis X. An assessment of four single dose treatment regimes of MK-933 (ivermectin) in human onchocerciasis.

    PubMed

    Awadzi, K; Dadzie, K Y; Shulz-Key, H; Haddock, D R; Gilles, H M; Aziz, M A

    1985-02-01

    Nineteen patients from an area of vector control in the savanna region of Northern Ghana, all with moderate to heavy infections with Onchocerca volvulus and some with ocular involvement, were treated with 50, 100, 150 or 200 micrograms kg-1 of ivermectin. Detailed monitoring of clinical and ocular reactions and of alterations in skin microfilarial counts and laboratory indices were carried out during the first 28 days. Microfilarial counts in skin snips and detailed ocular examinations were then repeated at intervals over a period of nine months. Ivermectin slowly eliminated microfilariae from the skin and eye without serious adverse clinical or ocular reactions in all treated groups. There was little difference in efficacy between doses of 100, 150 and 200 micrograms kg-1, and these were more effective than the 50 micrograms kg-1 dose. Very low levels of skin microfilariae were maintained for nine months. Microfilariae were not eliminated from the eye for at least three months. The drug was neither macrofilaricidal nor embryotoxic. However, it produced a dose-dependent stimulation of embryogenesis manifest at one month and succeeded by a suppression of embryogenesis at three months after therapy. In areas where transmission of onchocerciasis has been interrupted, ivermectin may need not be given more often than once a year. The efficacy of the drug on single dosage and the mild adverse reactions produced, if confirmed in subsequent controlled studies, would greatly simplify the treatment of onchocerciasis and would reintroduce new concepts of the role of chemotherapy in the control of onchocerciasis.

  18. Fuel conditioner

    SciTech Connect

    Nelson, M.L.; Nelson, O.L. Jr.

    1988-06-28

    A fuel conditioner is described comprising 10 to 80% of a polar oxygenated hydrocarbon having an average molecular weight from about 250 to about 500, an acid acid number from about 25 to about 125, and a saponification number from about 30 to about 250; and 5 to 50% of an oxygenated compatibilizing agent having a solubility parameter of from about 8.8 to about 11.5 and moderate to strong hydrogen-bonding capacity.

  19. Two-year follow-up of the microfilaraemia of asymptomatic brugian filariasis, after treatment with two, annual, single doses of ivermectin, diethylcarbamazine and albendazole, in various combinations.

    PubMed

    Shenoy, R K; John, A; Babu, B S; Suma, T K; Kumaraswami, V

    2000-09-01

    Repeated, single, oral doses of combinations of ivermectin, diethylcarbamazine (DEC) or albendazole are recognized as important tools for parasite control in lymphatic filariasis. In order to assess the effects of re-treatment using these combinations in Brugia malayi infections, 40 asymptomatic microfilaraemics were re-treated at the end of the first year, with an additional, single, dose of the combination they had previously received. They were then followed-up for another year. The subjects, of both sexes and aged 14-70 years, each received a two-drug combination: ivermectin (200 micrograms/kg) with DEC (6 mg/kg); ivermectin (200 micrograms/kg) with albendazole (400 mg); or DEC (6 mg/kg) with albendazole (400 mg). The kinetics of microfilarial clearance were similar to that seen during the first treatment, the members of the two groups given DEC having less intense microfilaraemias, 1 year after the re-treatment, than those given ivermectin with albendazole (P < 0.001 for each comparison). At this time, the two DEC groups also had a higher proportion of amicrofilaraemic individuals (22 of 26) than the ivermectin + albendazole group (three of nine). There were fewer adverse reactions in all the groups after re-treatment than seen after the first treatment. In countries such as India, where there is no co-endemicity of onchocerciasis or loiasis, the options for control programmes in areas where brugian filariasis is endemic are DEC alone or DEC in combination with ivermectin or albendazole. Where there is no access to ivermectin, transmission control must be based on DEC alone or in combination with albendazole.

  20. Reproductive Status of Onchocerca volvulus after Ivermectin Treatment in an Ivermectin-Naïve and a Frequently Treated Population from Cameroon

    PubMed Central

    Bopda, Jean; Kengne-Ouafo, Jonas A.; Njiokou, Flobert; Prichard, Roger K.; Wanji, Samuel; Kamgno, Joseph; Boussinesq, Michel

    2014-01-01

    Background For two decades, onchocerciasis control has been based on mass treatment with ivermectin (IVM), repeated annually or six-monthly. This drug kills Onchocerca volvulus microfilariae (mf) present in the skin and the eyes (microfilaricidal effect) and prevents for 3–4 months the release of new mf by adult female worms (embryostatic effect). In some Ghanaian communities, the long-term use of IVM was associated with a more rapid than expected skin repopulation by mf after treatment. Here, we assessed whether the embryostatic effect of IVM on O. volvulus has been altered following frequent treatment in Cameroonian patients. Methodology Onchocercal nodules were surgically removed just before (D0) and 80 days (D80) after a standard dose of IVM in two cohorts with different treatment histories: a group who had received repeated doses of IVM over 13 years, and a control group with no history of large-scale treatments. Excised nodules were digested with collagenase to isolate adult worms. Embryograms were prepared with females for the evaluation of their reproductive capacities. Principal Findings Oocyte production was not affected by IVM. The mean number of intermediate embryos (morulae and coiled mf) decreased similarly in the two groups between D0 and D80. In contrast, an accumulation of stretched mf, either viable or degenerating, was observed at D80. However, it was observed that the increase in number of degenerating mf between D0 and D80 was much lower in the frequently treated group than in the control one (Incidence Rate Ratio: 0.25; 95% CI: 0.10–0.63; p = 0.003), which may indicate a reduced sequestration of mf in the worms from the frequently treated group. Conclusion/Significance IVM still had an embryostatic effect on O. volvulus, but the effect was reduced in the frequently treated cohort compared with the control population. PMID:24762816

  1. Does Increasing Treatment Frequency Address Suboptimal Responses to Ivermectin for the Control and Elimination of River Blindness?

    PubMed Central

    Frempong, Kwadwo K.; Walker, Martin; Cheke, Robert A.; Tetevi, Edward Jenner; Gyan, Ernest Tawiah; Owusu, Ebenezer O.; Wilson, Michael D.; Boakye, Daniel A.; Taylor, Mark J.; Biritwum, Nana-Kwadwo; Osei-Atweneboana, Mike; Basáñez, María-Gloria

    2016-01-01

    Background. Several African countries have adopted a biannual ivermectin distribution strategy in some foci to control and eliminate onchocerciasis. In 2010, the Ghana Health Service started biannual distribution to combat transmission hotspots and suboptimal responses to treatment. We assessed the epidemiological impact of the first 3 years of this strategy and quantified responses to ivermectin over 2 consecutive rounds of treatment in 10 sentinel communities. Methods. We evaluated Onchocerca volvulus community microfilarial intensity and prevalence in persons aged ≥20 years before the first, second, and fifth (or sixth) biannual treatment rounds using skin snip data from 956 participants. We used longitudinal regression modeling to estimate rates of microfilarial repopulation of the skin in a cohort of 217 participants who were followed up over the first 2 rounds of biannual treatment. Results. Biannual treatment has had a positive impact, with substantial reductions in infection intensity after 4 or 5 rounds in most communities. We identified 3 communities—all having been previously recognized as responding suboptimally to ivermectin—with statistically significantly high microfilarial repopulation rates. We did not find any clear association between microfilarial repopulation rate and the number of years of prior intervention, coverage, or the community level of infection. Conclusions. The strategy of biannual ivermectin treatment in Ghana has reduced O. volvulus microfilarial intensity and prevalence, but suboptimal responses to treatment remain evident in a number of previously and consistently implicated communities. Whether increasing the frequency of treatment will be sufficient to meet the World Health Organization's 2020 elimination goals remains uncertain. PMID:27001801

  2. Ivermectin-facilitated immunity in onchocerciasis. Reversal of lymphocytopenia, cellular anergy and deficient cytokine production after single treatment.

    PubMed Central

    Soboslay, P T; Dreweck, C M; Hoffmann, W H; Lüder, C G; Heuschkel, C; Görgen, H; Banla, M; Schulz-Key, H

    1992-01-01

    A longitudinal investigation has been conducted into the cell-mediated immune responses of onchocerciasis patients after a single-dose treatment with ivermectin. Untreated patients tested for delayed cutaneous hypersensitivity (DCH) to seven recall antigens showed lower responses than infection-free control individuals (P less than 0.01), but 6 and 14 months after treatment DCH reactions increased to similar levels to those seen in the controls. The in vitro cellular reactivity to Onchocerca volvulus-derived antigen (OvAg) was reduced in untreated patients as compared with controls, and the lymphocyte blastogenic responses to OvAg and streptolysin-O clearly improved up to 14 months after treatment. Peripheral blood mononuclear cells (PBMC) from untreated patients produced IL-1 beta, tumour necrosis factor-alpha (TNF-alpha) and IL-6 in response to mitogenic stimulation with phytohaemagglutinin (PHA), only low levels of IL-1 beta, IL-2 and TNF-alpha in response to OvAg, but higher amounts of IL-4 and interferon-gamma (IFN-gamma) in response to OvAg than control individuals. After ivermectin treatment, the OvAg-induced production of IL-1 beta and TNF-alpha increased significantly 1 and 14 months after treatment. The PHA-induced production of IL-2 and IL-4 increased 1 month after treatment and remained significantly elevated until 14 months after treatment, whereas the OvAg-specific secretion of IL-2, IL-4 and IFN-gamma did not change after ivermectin treatment. Flow cytometric analysis of lymphocyte-subsets in the peripheral blood of untreated patients revealed a relative and absolute (P less than 0.01) diminution of CD4+ cells and a significantly smaller CD4+/CD8+ cell ratio as compared with controls. By 4 weeks after treatment and thereafter, CD4+ T cells increased relatively and absolutely (P less than 0.01); likewise there was an absolute increase in T-helper-inducer cells (CD4+CD45RO+) and a temporarily improved CD4+/CD8+ cell ratio (P = 0.001). The expression of

  3. Ivermectin-facilitated immunity in onchocerciasis. Reversal of lymphocytopenia, cellular anergy and deficient cytokine production after single treatment.

    PubMed

    Soboslay, P T; Dreweck, C M; Hoffmann, W H; Lüder, C G; Heuschkel, C; Görgen, H; Banla, M; Schulz-Key, H

    1992-09-01

    A longitudinal investigation has been conducted into the cell-mediated immune responses of onchocerciasis patients after a single-dose treatment with ivermectin. Untreated patients tested for delayed cutaneous hypersensitivity (DCH) to seven recall antigens showed lower responses than infection-free control individuals (P less than 0.01), but 6 and 14 months after treatment DCH reactions increased to similar levels to those seen in the controls. The in vitro cellular reactivity to Onchocerca volvulus-derived antigen (OvAg) was reduced in untreated patients as compared with controls, and the lymphocyte blastogenic responses to OvAg and streptolysin-O clearly improved up to 14 months after treatment. Peripheral blood mononuclear cells (PBMC) from untreated patients produced IL-1 beta, tumour necrosis factor-alpha (TNF-alpha) and IL-6 in response to mitogenic stimulation with phytohaemagglutinin (PHA), only low levels of IL-1 beta, IL-2 and TNF-alpha in response to OvAg, but higher amounts of IL-4 and interferon-gamma (IFN-gamma) in response to OvAg than control individuals. After ivermectin treatment, the OvAg-induced production of IL-1 beta and TNF-alpha increased significantly 1 and 14 months after treatment. The PHA-induced production of IL-2 and IL-4 increased 1 month after treatment and remained significantly elevated until 14 months after treatment, whereas the OvAg-specific secretion of IL-2, IL-4 and IFN-gamma did not change after ivermectin treatment. Flow cytometric analysis of lymphocyte-subsets in the peripheral blood of untreated patients revealed a relative and absolute (P less than 0.01) diminution of CD4+ cells and a significantly smaller CD4+/CD8+ cell ratio as compared with controls. By 4 weeks after treatment and thereafter, CD4+ T cells increased relatively and absolutely (P less than 0.01); likewise there was an absolute increase in T-helper-inducer cells (CD4+CD45RO+) and a temporarily improved CD4+/CD8+ cell ratio (P = 0.001). The expression of

  4. Effect of two successive annual treatments with single doses of ivermectin on microfilaraemia due to Wuchereria bancrofti var. pacifica.

    PubMed

    Cartel, J L; Celerier, P; Spiegel, A; Plichart, R; Roux, J F

    1990-01-01

    Between 1986 and 1988 a single-blind, dose-ranging study was carried out in French Polynesia to determine the efficacy and tolerability of single 50, 100, 150 and 200 micrograms/kg doses of ivermectin in Wuchereria bancrofti carriers. Forty male microfilariae (mf) carriers between 18 and 50 years of age, in whom mf density was greater than or equal to 20 mf/ml, were treated twice at a one-year interval. Twelve months after the second treatment, in carriers who were given a dose greater than or equal to 100 micrograms/kg, mean mf density was 4-7% of the initial pretreatment mf density. Therefore, several successive annual treatments with single doses greater than or equal to 100 micrograms/kg of ivermectin should result in reducing mf densities to a very low level. Nevertheless, at 9 months after the second treatment, residual parasitaemia ranged from 1 to 2182 mf/ml (median 85) in 30 patients. Finally, in patients with pretreatment mf counts less than or equal to 150 mf/ml, mean mf density was 2.8 and 8.9 mf/ml, respectively, during the 2 six-month periods following treatment, while in patients with pretreatment mf densities greater than 150 mf/ml (median 1500) it was 92.3 and 334.1 mf/ml during the same periods. These results suggest that, when implementing filariasis control programmes, the best strategy might be administration of several treatments with a single dose of ivermectin every 6 months to the entire population, at least in French Polynesia. Afterwards, when mf densities had been reduced to a relatively low level (100-150 mf/ml), annual treatments could be considered.

  5. Selective mass treatment with ivermectin to control intestinal helminthiases and parasitic skin diseases in a severely affected population.

    PubMed Central

    Heukelbach, Jörg; Winter, Benedikt; Wilcke, Thomas; Muehlen, Marion; Albrecht, Stephan; de Oliveira, Fabíola Araújo Sales; Kerr-Pontes, Lígia Regina Sansigolo; Liesenfeld, Oliver; Feldmeier, Hermann

    2004-01-01

    OBJECTIVE: To assess the short-term and long-term impact of selective mass treatment with ivermectin on the prevalence of intestinal helminthiases and parasitic skin diseases in an economically depressed community in north-east Brazil. METHODS: An intervention was carried out in a traditional fishing village in north-east Brazil where the population of 605 is heavily affected by ectoparasites and enteroparasites. The prevalence of intestinal helminths was determined by serial stool examination and the prevalence of parasitic skin diseases by clinical inspection. A total of 525 people out of a target population of 576 were treated at baseline. The majority of these were treated with ivermectin (200 microg/kg with a second dose given after 10 days). If ivermectin was contraindicated, participants were treated with albendazole or mebendazole for intestinal helminths or with topical deltamethrin for ectoparasites. Follow-up examinations were performed at 1 month and 9 months after treatment. FINDINGS: Prevalence rates of intestinal helminthiases before treatment and at 1 month and 9 months after mass treatment were: hookworm disease 28.5%, 16.4% and 7.7%; ascariasis 17.1%, 0.4% and 7.2%; trichuriasis 16.5%, 3.4% and 9.4%; strongyloidiasis 11.0%, 0.6% and 0.7%; and hymenolepiasis 0.6%; 0.4% and 0.5%, respectively. Prevalence rates of parasitic skin diseases before treatment and 1 month and 9 months after mass treatment were: active pediculosis 16.1%, 1.0% and 10.3%; scabies 3.8%, 1.0% and 1.5%; cutaneous larva migrans 0.7%, 0% and 0%; tungiasis 51.3%, 52.1% and 31.2%, respectively. Adverse events occurred in 9.4% of treatments. They were all of mild to moderate severity and were transient. CONCLUSION: Mass treatment with ivermectin was an effective and safe means of reducing the prevalence of most of the parasitic diseases prevalent in a poor community in north-east Brazil. The effects of treatment lasted for a prolonged period of time. PMID:15375445

  6. Impact of Six Years Community Directed Treatment with Ivermectin in the Control of Onchocerciasis, Western Ethiopia.

    PubMed

    Samuel, Abdi; Belay, Tariku; Yehalaw, Delenasaw; Taha, Mohammed; Zemene, Endalew; Zeynudin, Ahmed

    2016-01-01

    The African Program for Onchocerciais Control (APOC) with a main strategy of community directed treatment with ivermectin (CDTI) was established with the aim of eliminating Onchocerciasis as a disease of public health and socio-economic importance. The study area was a hyper endemic area just before the implementation of CDTI. It has been implemented for six years in this district but yet not been evaluated. So, the objective of this study was to evaluate the impact of six years CDTI on parasitological and clinical indices of Onchocerciasis. This study employed a pre-post impact evaluation design. The minimum sample size for this study was 1318; the respondents were selected by multi-stage sampling technique. Data on socio-demographic characteristics using a semi-structured questionnaire, clinical examination for skin signs and symptoms of Onchocerciasis and two bloodless skin snips from each side of the gluteal fold were taken from the entire study participants. SPSS version 16.0 and Medcalc version 12.2.1.0 were used for analysis. The microfilaridermia reduced from the pre-intervention value of 74.8% to 40.7%, indicating a 45.6% reduction, mean intensity from 32.1(SD = 61.5) mf/mg skin snip to 18.7(SD = 28.7)indicating 41.75% reduction, CMFL from 19.6 mf/mg skin snip to 4.7 indicating 76% reduction. The result also showed that microfilaridermia and mean intensity decreased as the number of treatment taken increased. Pruritis, leopard skin, onchocercomata and hanging groin reduced by 54.4%, 61.3%, 77.7% and 88.5% respectively. The implementation of CDTI significantly reduced the parasitological and clinical indices of Onchocerciasis, so, efforts should be made to improve the annual treatment coverage and sustainability of CDTI to drastically reduce the micro filarial load to the level the disease would no longer be a public health problem.

  7. Feasibility of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa: First Evidence from Studies in Mali and Senegal

    PubMed Central

    Diawara, Lamine; Traoré, Mamadou O.; Badji, Alioune; Bissan, Yiriba; Doumbia, Konimba; Goita, Soula F.; Konaté, Lassana; Mounkoro, Kalifa; Sarr, Moussa D.; Seck, Amadou F.; Toé, Laurent; Tourée, Seyni; Remme, Jan H. F.

    2009-01-01

    Background Mass treatment with ivermectin is a proven strategy for controlling onchocerciasis as a public health problem, but it is not known if it can also interrupt transmission and eliminate the parasite in endemic foci in Africa where vectors are highly efficient. A longitudinal study was undertaken in three hyperendemic foci in Mali and Senegal with 15 to 17 years of annual or six-monthly ivermectin treatment in order to assess residual levels of infection and transmission and test whether ivermectin treatment could be safely stopped in the study areas. Methodology/Principal Findings Skin snip surveys were undertaken in 126 villages, and 17,801 people were examined. The prevalence of microfilaridermia was <1% in all three foci. A total of 157,500 blackflies were collected and analyzed for the presence of Onchocerca volvulus larvae using a specific DNA probe, and vector infectivity rates were all below 0.5 infective flies per 1,000 flies. Except for a subsection of one focus, all infection and transmission indicators were below postulated thresholds for elimination. Treatment was therefore stopped in test areas of 5 to 8 villages in each focus. Evaluations 16 to 22 months after the last treatment in the test areas involved examination of 2,283 people using the skin snip method and a DEC patch test, and analysis of 123,000 black flies. No infected persons and no infected blackflies were detected in the test areas, and vector infectivity rates in other catching points were <0.2 infective flies per 1,000. Conclusion/Significance This study has provided the first empirical evidence that elimination of onchocerciasis with ivermectin treatment is feasible in some endemic foci in Africa. Although further studies are needed to determine to what extent these findings can be extrapolated to other endemic areas in Africa, the principle of elimination has been established. The African Programme for Onchocerciasis Control has adopted an additional objective to assess

  8. Feasibility of onchocerciasis elimination with ivermectin treatment in endemic foci in Africa: first evidence from studies in Mali and Senegal.

    PubMed

    Diawara, Lamine; Traoré, Mamadou O; Badji, Alioune; Bissan, Yiriba; Doumbia, Konimba; Goita, Soula F; Konaté, Lassana; Mounkoro, Kalifa; Sarr, Moussa D; Seck, Amadou F; Toé, Laurent; Tourée, Seyni; Remme, Jan H F

    2009-07-21

    Mass treatment with ivermectin is a proven strategy for controlling onchocerciasis as a public health problem, but it is not known if it can also interrupt transmission and eliminate the parasite in endemic foci in Africa where vectors are highly efficient. A longitudinal study was undertaken in three hyperendemic foci in Mali and Senegal with 15 to 17 years of annual or six-monthly ivermectin treatment in order to assess residual levels of infection and transmission and test whether ivermectin treatment could be safely stopped in the study areas. Skin snip surveys were undertaken in 126 villages, and 17,801 people were examined. The prevalence of microfilaridermia was <1% in all three foci. A total of 157,500 blackflies were collected and analyzed for the presence of Onchocerca volvulus larvae using a specific DNA probe, and vector infectivity rates were all below 0.5 infective flies per 1,000 flies. Except for a subsection of one focus, all infection and transmission indicators were below postulated thresholds for elimination. Treatment was therefore stopped in test areas of 5 to 8 villages in each focus. Evaluations 16 to 22 months after the last treatment in the test areas involved examination of 2,283 people using the skin snip method and a DEC patch test, and analysis of 123,000 black flies. No infected persons and no infected blackflies were detected in the test areas, and vector infectivity rates in other catching points were <0.2 infective flies per 1,000. This study has provided the first empirical evidence that elimination of onchocerciasis with ivermectin treatment is feasible in some endemic foci in Africa. Although further studies are needed to determine to what extent these findings can be extrapolated to other endemic areas in Africa, the principle of elimination has been established. The African Programme for Onchocerciasis Control has adopted an additional objective to assess progress towards elimination endpoints in all onchocerciasis control

  9. Household-wide ivermectin treatment for head lice in an impoverished community: randomized observer-blinded controlled trial.

    PubMed

    Pilger, Daniel; Heukelbach, Jorg; Khakban, Adak; Oliveira, Fabiola Araujo; Fengler, Gernot; Feldmeier, Hermann

    2010-02-01

    To generate evidence on the effectiveness of household-wide treatment for preventing the transmission of pediculosis capitis (head lice) in resource-poor communities. We studied 132 children without head lice who lived in a slum in north-eastern Brazil. We randomized the households of the study participants into an intervention and a control group and prospectively calculated the incidence of infestation with head lice among the children in each group. In the intervention group, all of the children's family members who lived in the household were treated with ivermectin; in the control group, no family member was treated. We used the chi(2) test with continuity correction or Fisher's exact test to compare proportions. We performed survival analysis using Kaplan-Meier estimates with log rank testing and the Mann-Whitney U test to analyse the length of lice-free periods among sentinel children, and we used Cox regression to analyse survival data on a multivariate level. We also carried out a subgroup analysis based on gender. Children in the intervention group remained free from infestation with head lice significantly longer than children in the control group. The median infestation-free period in the intervention group was 24 days (interquartile range, IQR: 11-45), as compared to 14 days (IQR: 11-25) in the control group (P = 0.01). Household-wide treatment with ivermectin proved significantly more effective among boys than among girls (P = 0.005). After treatment with ivermectin, the estimated number of annual episodes of head lice infestation was reduced from 19 to 14 in girls and from 15 to 5 in boys. Female sex and extreme poverty were independent risk factors associated with a shortened disease-free period. In an impoverished community, girls and the poorest of the poor are the population groups that are most vulnerable for head lice infestation. To decrease the number of head lice episodes per unit of time, control measures should include the treatment of all

  10. Household-wide ivermectin treatment for head lice in an impoverished community: randomized observer-blinded controlled trial

    PubMed Central

    Pilger, Daniel; Heukelbach, Jorg; Khakban, Adak; Oliveira, Fabiola Araujo; Fengler, Gernot

    2010-01-01

    Abstract Objective To generate evidence on the effectiveness of household-wide treatment for preventing the transmission of pediculosis capitis (head lice) in resource-poor communities. Methods We studied 132 children without head lice who lived in a slum in north-eastern Brazil. We randomized the households of the study participants into an intervention and a control group and prospectively calculated the incidence of infestation with head lice among the children in each group. In the intervention group, all of the children’s family members who lived in the household were treated with ivermectin; in the control group, no family member was treated. We used the χ² test with continuity correction or Fisher’s exact test to compare proportions. We performed survival analysis using Kaplan–Meier estimates with log rank testing and the Mann–Whitney U test to analyse the length of lice-free periods among sentinel children, and we used Cox regression to analyse survival data on a multivariate level. We also carried out a subgroup analysis based on gender. Findings Children in the intervention group remained free from infestation with head lice significantly longer than children in the control group. The median infestation-free period in the intervention group was 24 days (interquartile range, IQR: 11–45), as compared to 14 days (IQR: 11–25) in the control group (P = 0.01). Household-wide treatment with ivermectin proved significantly more effective among boys than among girls (P = 0.005). After treatment with ivermectin, the estimated number of annual episodes of head lice infestation was reduced from 19 to 14 in girls and from 15 to 5 in boys. Female sex and extreme poverty were independent risk factors associated with a shortened disease-free period. Conclusion In an impoverished community, girls and the poorest of the poor are the population groups that are most vulnerable for head lice infestation. To decrease the number of head lice episodes per unit of

  11. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection.

    PubMed

    Gardon, J; Gardon-Wendel, N; Demanga-Ngangue; Kamgno, J; Chippaux, J P; Boussinesq, M

    1997-07-05

    In 1995, the World Bank launched an African Programme for Onchocerciasis Control to eliminate Onchocerca volvulus disease from 19 African countries by means of community-based ivermectin treatment (CBIT). Several cases of encephalopathy have been reported after ivermectin in people heavily infected with microfilariae of Loa loa (loiasis). We assessed the incidence of serious events in an area where onchocerciasis and loiasis are both endemic. Ivermectin (at 150 micrograms/kg) was given to 17877 people living in the Lékié area of Cameroon. 50 microL samples of capillary blood were taken during the daytime before treatment from all adults (aged > or = 15 years), and the numbers of L loa and Mansonella perstans microfilariae in them were counted. Patients were monitored for 7 days after treatment. Adverse reactions were classified as mild, marked, or serious. Serious reactions were defined as those associated with a functional impairment that required at least a week of full-time assistance to undertake normal activities. We calculated the relative risk of developing marked or serious reactions for increasing L loa microfilarial loads. Risk factors for serious reactions were identified and assessed with a logistic regression model. 20 patients (0-11%) developed serious reactions without neurological signs but associated with a functional impairment lasting more than a week. Two other patients were in coma for 2-3 days, associated with L loa microfilariae in cerebrospinal fluid. Occurrence of serious reactions was related to the intensity of pretreatment L loa microfilaraemia. The relative risk of developing marked or serious reactions was significantly higher when the L loa load exceeded 8000 microfilariae/mL; for serious reactions, the risk is very high (odds ratio > 1000) for loads above 50000 microfilariae/mL. Epidemiological surveys aimed at assessing the intensity of infection with L loa microfilariae should be done before ivermectin is distributed for

  12. Ivermectin cream for rosacea.

    PubMed

    2015-11-01

    Rosacea is a chronic facial skin disease that mainly occurs in people aged over 30 years. It is common, with an estimated incidence of 1·7 per 1,000 person-years in general practice in the UK.(1,2) Rosacea can cause embarrassment, anxiety, low self-esteem and lack of confidence.(3) A new topical treatment has become available for the treatment of one of the clinical subtypes of rosacea. Ivermectin 10mg/g (1%) cream (Soolantra-Galderma) has received marketing authorisation for the treatment of inflammatory lesions of papulopustular rosacea in adults.(4) Here we review the safety and effectiveness of ivermectin cream in the treatment of rosacea and assess how it compares with standard therapies.

  13. Traditional kinship system enhanced classic community-directed treatment with ivermectin (CDTI) for onchocerciasis control in Uganda.

    PubMed

    Katabarwa, Moses N; Habomugisha, Peace; Agunyo, Stella; McKelvey, Alanna C; Ogweng, Nicholas; Kwebiiha, Solomon; Byenume, Fredrick; Male, Ben; McFarland, Deborah

    2010-04-01

    The challenges of community-directed treatment with ivermectin (CDTI) for onchocerciasis control in Africa have been: maintaining a desired treatment coverage, demand for monetary incentives, high attrition of community distributors and low involvement of women. This study assessed how challenges could be minimised and performance improved using existing traditional kinship structures. In classic CDTI areas, community members decide upon selection criteria for community distributors, centers for health education and training, and methods of distributing ivermectin. In kinship enhanced CDTI, similar procedures were followed at the kinship level. We compared 14 randomly selected kinship enhanced CDTI communities with 25 classic CDTI communities through interviews of 447 and 750 household members and 127 and 64 community distributors respectively. Household respondents from kinship enhanced CDTI reported better performance (P<0.001) than classic CDTI on the following measures of program effectiveness: (a) treatment coverage (b) decision on treatment location and (c) mobilization for CDTI activities. There were more female distributors in kinship enhanced CDTI than in classic CDTI. Attrition was not a problem. Kinship enhanced CDTI had a higher number of community distributors per population working among relatives, and were more likely to be involved in additional health care activities. The results suggest that kinship enhanced CDTI was more effective than classic CDTI. Copyright 2009 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  14. Treatment and control of bovine sarcoptic and psoroptic mange infestation with ivermectin long-acting injectable (IVOMEC(®) GOLD).

    PubMed

    Hamel, Dietmar; Joachim, Anja; Löwenstein, Michael; Pfister, Kurt; Silaghi, Cornelia; Visser, Martin; Winter, Renate; Yoon, Stephen; Cramer, Luiz; Rehbein, Steffen

    2015-02-01

    The efficacy of ivermectin long-acting injection (IVM LAI, IVOMEC® GOLD, Merial; 3.15 % ivermectin w/v) formulation was evaluated in cattle with induced Sarcoptes scabiei var. bovis or Psoroptes ovis infestations. A total of 64 cattle were included in this series of four studies, with 16 animals per study. Approximately, 8 weeks following initial induced mite infestation, cattle were allocated to treatment groups based on decreasing pre-treatment bodyweights. Treatments (saline (control) or IVM LAI (630 mcg ivermectin/kg bodyweight) at 1 mL/50 kg bodyweight) were administered by a single subcutaneous injection in front of the right shoulder on Day 0. Skin scrapings were collected prior to treatment and at approximately weekly intervals for 8 weeks thereafter to establish live mite counts. Character and extent of skin lesions were evaluated at each sampling. Animals were weighed before treatment and at the end of the studies. Mite counts of the IVM LAI-treated animals were significantly (p < 0.05) lower than those of the controls in all four studies at all occasions post-treatment. In the two Sarcoptes studies, IVM LAI-treated cattle were free of mites at 14 days after treatment and in the Psoroptes studies at 13 or 28 days post-treatment. All IVM LAI-treated cattle remained free of mites to the end of the studies while all control animals remained infested. Mange lesions of the IVM LAI-treated animals improved significantly (p < 0.05) compared to those of the controls from Day 21 (Sarcoptes studies) and from Days 28 or 34 (Psoroptes studies). In all studies, mean weight gain over the 8 week post-treatment period was significantly (p < 0.05) higher for the IVM LAI-treated animals than for the controls: Sarcoptes studies, 64.1 and 68.6 kg vs. 46.9 and 48.6 kg, respectively; Psoroptes studies, 43.0 and 43.4 kg vs. 20.8 and 34.9 kg, respectively. All animals accepted the treatment well, and no treatment-related health problems and adverse events were

  15. Programmatic and Communication Issues in Relation to Serious Adverse Events Following Ivermectin Treatment in areas Co-endemic for Onchocerciasis and Loiasis

    PubMed Central

    Haselow, Nancy J; Akame, Julie; Evini, Cyrille; Akongo, Serge

    2003-01-01

    In areas co-endemic for loiasis and onchocerciasis, the classic Community-Directed Treatment using ivermectin (Mectizan®) must be adapted as additional program activities, better communication and tighter control of ivermectin stocks are required to minimize risk and manage serious adverse events following ivermectin treatment in patients co-infected with Loa loa. The importance of these serious adverse events on community participation in onchocerciasis control efforts has not been adequately studied. Program implementers do not as of yet fully understand the psychological impact of serious adverse events on communities and therefore have not designed communication strategies that adequately address the real concerns of community members. It is clear, however, that along with an effective case detection and management strategy, a reinforced communication strategy will be required to motivate at least 65% of the total population in onchocerciasis and loiasis co-endemic areas to participate in the treatment program and to take ivermectin over an extended period. This strategy must be based on research undertaken at the community level in order to address the concerns, fears and issues associated with adverse events due to ivermectin – to ensure that communities believe that the benefits of taking ivermectin outweigh the risks. In addition to an overall increase in the time required to sustain onchocerciasis control programs in co-endemic areas, each aspect of the reinforced program and communication strategy – rapid epidemiological assessments, materials development, training, advocacy, community sensitization and mobilization, case management and counselling, supervision, monitoring and evaluation will require additional resources and support from all stakeholders concerned. PMID:14975067

  16. Programmatic and Communication Issues in Relation to Serious Adverse Events Following Ivermectin Treatment in areas Co-endemic for Onchocerciasis and Loiasis.

    PubMed

    Haselow, Nancy J; Akame, Julie; Evini, Cyrille; Akongo, Serge

    2003-10-24

    In areas co-endemic for loiasis and onchocerciasis, the classic Community-Directed Treatment using ivermectin (Mectizan(R)) must be adapted as additional program activities, better communication and tighter control of ivermectin stocks are required to minimize risk and manage serious adverse events following ivermectin treatment in patients co-infected with Loa loa. The importance of these serious adverse events on community participation in onchocerciasis control efforts has not been adequately studied. Program implementers do not as of yet fully understand the psychological impact of serious adverse events on communities and therefore have not designed communication strategies that adequately address the real concerns of community members. It is clear, however, that along with an effective case detection and management strategy, a reinforced communication strategy will be required to motivate at least 65% of the total population in onchocerciasis and loiasis co-endemic areas to participate in the treatment program and to take ivermectin over an extended period. This strategy must be based on research undertaken at the community level in order to address the concerns, fears and issues associated with adverse events due to ivermectin - to ensure that communities believe that the benefits of taking ivermectin outweigh the risks. In addition to an overall increase in the time required to sustain onchocerciasis control programs in co-endemic areas, each aspect of the reinforced program and communication strategy - rapid epidemiological assessments, materials development, training, advocacy, community sensitization and mobilization, case management and counselling, supervision, monitoring and evaluation will require additional resources and support from all stakeholders concerned.

  17. Double blind study on efficacy and safety of single doses of ivermectin and diethylcarbamazine for treatment of Polynesian Wuchereria bancrofti carriers. Results at six months.

    PubMed

    Cartel, J L; Spiegel, A; Nguyen, L; Genelle, B; Roux, J F

    1991-03-01

    In 1989, a double-blind trial was implemented in Tahiti to compare both efficacy and tolerability of single doses of ivermectin and diethylcarbamazine (DEC) for treatment of Wuchereria bancrofti carriers. Of 58 carriers, in whom microfilarial (mf) density was greater than or equal to 100 mf/ml, 23, 24 and 11 were randomly allocated to treatment with respectively ivermectin 100 mcg/kg, DEC 3 and DEC 6 mg/kg. One week after treatment, clearance of microfilaremia was complete in 22 of the 23 carriers treated with ivermectin and in one only of the 35 treated with DEC. Adjusted geometric mean for mf densities was significantly lower (p less than 0.001) in carriers treated with ivermectin than in those treated with DEC at one, but neither at 3 (p = 0.26) nor at 6 months (p = 0.63). At 3 and 6 months, mf levels were 14 and 28%, 21.6 and 19.4%, and 10.2 and 8.4% of pretreatment mf levels in carriers treated respectively with ivermectin 100 mcg/kg, DEC 3 and DEC 6 mg/kg. Side effects were experienced by 51 carriers (88%) of whom only 8 (14%) suffered a grade 3 reaction. Onset and intensity of side effects were significantly associated (p less than 0.01) with both pretreatment mf densities and peripheral blood parasite clearance. Efficacy of ivermectin single dose was superior to that of DEC single dose in terms of immediate mf clearance but not in terms of sustained mf decrease at 6 months.

  18. Ivermectin treatment of free-ranging endangered Australian sea lion (Neophoca cinerea) pups: effect on hookworm and lice infection status, haematological parameters, growth, and survival.

    PubMed

    Marcus, Alan D; Higgins, Damien P; Gray, Rachael

    2015-07-01

    A placebo-controlled study was used to investigate the effectiveness of ivermectin to treat hookworm (Uncinaria sanguinis) and lice (Antarctophthirus microchir) infections in free-ranging Australian sea lion (Neophoca cinerea) pups and to test the hypotheses that these parasitic infections cause anaemia, systemic inflammatory responses, and reduced growth, and contribute towards decreased pup survival. Ivermectin was identified as an effective and safe anthelmintic in this species. Pups administered ivermectin had significantly higher erythrocyte counts and significantly lower eosinophil counts compared to controls at 1-2 months post-treatment, confirming that U. sanguinis and/or A. microchir are causatively associated with disease and demonstrating the positive effect of ivermectin treatment on clinical health parameters. Higher growth rates were not seen in ivermectin-treated pups and, unexpectedly, relatively older pups treated with ivermectin demonstrated significantly reduced growth rates when compared to matched saline-control pups. Differences in survival were not identified between treatment groups; however, this was attributed to the unexpectedly low mortality rate of recruited pups, likely due to the unintended recruitment bias towards pups >1-2 months of age for which mortality due to hookworm infection is less likely. This finding highlights the logistical and practical challenges associated with treating pups of this species shortly after birth at a remote colony. This study informs the assessment of the use of anthelmintics as a tool for the conservation management of free-ranging wildlife and outlines essential steps to further the development of strategies to ensure the effective conservation of the Australian sea lion and its parasitic fauna.

  19. Maintenance of remission following successful treatment of papulopustular rosacea with ivermectin 1% cream vs. metronidazole 0.75% cream: 36-week extension of the ATTRACT randomized study.

    PubMed

    Taieb, A; Khemis, A; Ruzicka, T; Barańska-Rybak, W; Berth-Jones, J; Schauber, J; Briantais, P; Jacovella, J; Passeron, T

    2016-05-01

    There are a limited number of approved treatments for papulopustular rosacea (PPR) and remission is difficult to maintain after successful treatment. To investigate remission over a 36-week extension period in patients with moderate to severe PPR successfully treated with 16 weeks' treatment with ivermectin 1% cream once daily (QD) or metronidazole 0.75% cream twice daily (BID) in a randomized, parallel-group Phase III study. Treatment was discontinued in patients initially successfully treated [Investigator's Global Assessment (IGA) score of 0 or 1] with ivermectin 1% cream QD (n = 399) or metronidazole 0.75% cream BID (n = 365; Part A) and patients were followed every 4 weeks for up to 36 weeks (Part B). Treatment with the same study treatment as used in Part A was only re-initiated if patients relapsed (IGA ≥ 2). Efficacy assessments were: time to first relapse; relapse rate; and number of days free of treatment. Safety assessments included incidence of adverse events and local cutaneous signs and symptoms. The median time to first relapse was significantly longer (115 days vs. 85 days) and relapse rates at the end of the study period significantly lower (62.7% vs. 68.4%) for patients initially successfully treated with ivermectin 1% compared with metronidazole 0.75%; Kaplan-Meier plot demonstrated a statistically significant difference between the two arms (P = 0.0365). The median number of days free of treatment was higher for ivermectin compared with metronidazole (196 days vs. 169.5 days; P = 0.026). The percentage of patients who experienced a related adverse event was equally low in both groups. The results of this relapse study showed that an initial successful treatment with ivermectin 1% cream QD significantly extended remission of rosacea compared with initial treatment with metronidazole 0.75% cream BID following treatment cessation. © 2015 European Academy of Dermatology and Venereology.

  20. Impact of repeated ivermectin treatments against onchocerciasis on the transmission of loiasis: an entomologic evaluation in central Cameroon

    PubMed Central

    2013-01-01

    Background Annual community-directed treatment with ivermectin (CDTI) have been carried out since 1999 in the Lekie division (central region of Cameroon where most cases of Loa-related post ivermectin severe adverse events were reported) as part of the joined activities of the African Programme for Onchocerciasis Control (APOC) and Mectizan® Donation Program (MDP). As large-scale administration of ivermetine was demonstrated to be an efficient means to control loiasis transmission, it was hypothesized that CDTI would have lowered or halted the transmission of Loa loa in the Lekie division after 13 years of annual drug administration, indicating a possible reduction in the occurrence of Loa-related post-ivermectin severe adverse events. Methods A 4-month entomologic study was carried out from March to June 2012 in the Lekie division to evaluate the impact of 13 years of CDTI on the transmission of L. loa whose baseline data were recorded in 1999–2000. Results There was a significant reduction in the infection rate for Chrysops silacea and C. dimidiata from 6.8 and 9% in 1999–2000 to 3 and 3.6% in 2012, respectively. The differences in the infective rate (IR) (percentage of flies harboring head L3 larvae), potential infective rate (PIR) (percentage of flies bearing L3 larvae), mean head L3 larvae load (MHL3) (average L3 per infective fly) and mean fly L3 larvae load (MFL3) (average L3 per potentially infective fly) for both C. silacea and C. dimidiata were not significantly different between the two investigation periods. The biting density (BD) was almost three-fold higher in 2012 for C. silacea but not for C. dimidiata. The transmission potential (TP) which is a function of the BD, was higher in the present study than in the baseline investigation for each species. Conclusion The infection rate remaining high, the high TP and the stability observed in the IR, PIR, MHL3 and MFL3 after 13 years of CDTI suggest that transmission of L. loa is still active. This is

  1. Prevalence of onchocerciasis in the Fundong Health District, Cameroon after 6 years of continuous community-directed treatment with ivermectin.

    PubMed

    Kamga, Henri Lucien Fouamno; Shey, Dickson Nsagha; Assob, Jules Clement Nguedia; Njunda, Anna Longdoh; Nde Fon, Peter; Njem, Peter Kindong

    2011-01-01

    Onchocerciasis is one of the leading infectious causes of blindness affecting over 37 million people of which 99% are in Africa. The purpose of this study was to determine the prevalence of onchocerciasis in the Fundong Health District, a locality where community-directed treatment with ivermectin has been carried out for 6 consecutive years. Questionnaires covering participants' identity, Rapid Epidemiological Assessment (REA) for onchocerciasis and parasitological parameters were distributed to participants. Skin snip (SS) was collected for laboratory investigation. A total of 404 participants belonging to 200 households were randomly selected from the Fundong Health District, of which 134 (33.2%) were males and 270(66.8%) were females, 14 (3.5%) had microfilaredermia and 15(3.7%) had nodules. There was no significant difference in the prevalence of microfilaredermia with respect to age of participants (X(2)=2.749, P=0.601). There was however a statistically significant difference in the prevalence of nodule and impaired vision/eye itching (IVIE) with respect to age (X(2)=24.67, P<0.001). The greatest rate of infection was found among farmers (2.5%) followed by students (0.7%) and businessmen (0.25%). This study shows that the study area is now hypo-endemic for onchocerciasis, following 6 years of continuous treatment with ivermectin. Careful monitoring of onchocerciasis should however be continued to avoid that the area returns to its initial hyper endemicity.

  2. A model for evaluating the sustainability of community-directed treatment with ivermectin in the African Program for Onchocerciasis Control.

    PubMed

    Okeibunor, Joseph; Bump, Jesse; Zouré, Honorat G M; Sékétéli, Azodoga; Godin, Christine; Amazigo, Uche V

    2012-01-01

    Onchocerciasis is controlled by mass treatment of at-risk populations with ivermectin. Ivermectin is delivered through community-directed treatment (CDTI) approach. A model has been developed to evaluate the sustainability of the approach and has been tested at 35 projects in 10 countries of the African Program for Onchocerciasis Control (APOC). It incorporates quantitative and qualitative data collection and analysis, taking account of two factors identified as crucial to project sustainability. These are (i) the provision of project performance information to partners, and (ii) evidence-based support for project implementation. The model is designed to provide critical indicators of project performance of the model to implementing, coordinating, and funding partners. The model's participatory and flexible nature makes it culturally sensitive and usable by project management. This model is able to analyze the different levels involved in project implementation and arrive at a judgment for the whole project. It has inbuilt mechanisms for ensuring data reliability and validity. The model addresses the complex issue of sustainability with a cross-sectional design focusing on how and at which operational level of implementation to strengthen a CDTI project. The unique attributes and limitations of the model for evaluating the sustainability of projects were described. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Prevalence of onchocerciasis in the Fundong Health District, Cameroon after 6 years of continuous community-directed treatment with ivermectin

    PubMed Central

    Kamga, Henri Lucien Fouamno; Shey, Dickson Nsagha; Assob, Jules Clement Nguedia; Njunda, Anna Longdoh; Nde Fon, Peter; Njem, Peter Kindong

    2011-01-01

    Introduction Onchocerciasis is one of the leading infectious causes of blindness affecting over 37 million people of which 99% are in Africa. The purpose of this study was to determine the prevalence of onchocerciasis in the Fundong Health District, a locality where community-directed treatment with ivermectin has been carried out for 6 consecutive years. Methods Questionnaires covering participants’ identity, Rapid Epidemiological Assessment (REA) for onchocerciasis and parasitological parameters were distributed to participants. Skin snip (SS) was collected for laboratory investigation. Results A total of 404 participants belonging to 200 households were randomly selected from the Fundong Health District, of which 134 (33.2%) were males and 270(66.8%) were females, 14 (3.5%) had microfilaredermia and 15(3.7%) had nodules. There was no significant difference in the prevalence of microfilaredermia with respect to age of participants (X2=2.749, P=0.601). There was however a statistically significant difference in the prevalence of nodule and impaired vision/eye itching (IVIE) with respect to age (X2=24.67, P<0.001). The greatest rate of infection was found among farmers (2.5%) followed by students (0.7%) and businessmen (0.25%). Conclusion This study shows that the study area is now hypo-endemic for onchocerciasis, following 6 years of continuous treatment with ivermectin. Careful monitoring of onchocerciasis should however be continued to avoid that the area returns to its initial hyper endemicity. PMID:22187616

  4. Fifteen Years of Annual Mass Treatment of Onchocerciasis with Ivermectin Have Not Interrupted Transmission in the West Region of Cameroon

    PubMed Central

    Katabarwa, Moses N.; Eyamba, Albert; Nwane, Philippe; Enyong, Peter; Kamgno, Joseph; Kueté, Thomas; Yaya, Souleymanou; Aboutou, Rosalie; Mukenge, Léonard; Kafando, Claude; Siaka, Coulibaly; Mkpouwoueiko, Salifou; Ngangue, Demanga; Biholong, Benjamin Didier; Andze, Gervais Ondobo

    2013-01-01

    We followed up the 1996 baseline parasitological and entomological studies on onchocerciasis transmission in eleven health districts in West Region, Cameroon. Annual mass ivermectin treatment had been provided for 15 years. Follow-up assessments which took place in 2005, 2006, and 2011 consisted of skin snips for microfilariae (mf) and palpation examinations for nodules. Follow-up Simulium vector dissections for larval infection rates were done from 2011 to 2012. mf prevalence in adults dropped from 68.7% to 11.4%, and nodule prevalence dropped from 65.9% to 12.1%. The decrease of mf prevalence in children from 29.2% to 8.9% was evidence that transmission was still continuing. mf rates in the follow-up assessments among adults and in children levelled out after a sharp reduction from baseline levels. Only three health districts out of 11 were close to interruption of transmission. Evidence of continuing transmission was also observed in two out of three fly collection sites that had infective rates of 0.19% and 0.18% and ATP of 70 (Foumbot) and 300 (Massangam), respectively. Therefore, halting of annual mass treatment with ivermectin cannot be done after 15 years as it might escalate the risk of transmission recrudescence. PMID:23691275

  5. The Cost of Annual versus Biannual Community-Directed Treatment of Onchocerciasis with Ivermectin: Ghana as a Case Study

    PubMed Central

    Turner, Hugo C.; Osei-Atweneboana, Mike Y.; Walker, Martin; Tettevi, Edward J.; Churcher, Thomas S.; Asiedu, Odame; Biritwum, Nana-Kwadwo; Basáñez, María-Gloria

    2013-01-01

    Background It has been proposed that switching from annual to biannual (twice yearly) mass community-directed treatment with ivermectin (CDTI) might improve the chances of onchocerciasis elimination in some African foci. However, historically, relatively few communities have received biannual treatments in Africa, and there are no cost data associated with increasing ivermectin treatment frequency at a large scale. Collecting cost data is essential for conducting economic evaluations of control programmes. Some countries, such as Ghana, have adopted a biannual treatment strategy in selected districts. We undertook a study to estimate the costs associated with annual and biannual CDTI in Ghana. Methodology The study was conducted in the Brong-Ahafo and Northern regions of Ghana. Data collection was organized at the national, regional, district, sub-district and community levels, and involved interviewing key personnel and scrutinizing national records. Data were collected in four districts; one in which treatment is delivered annually, two in which it is delivered biannually, and one where treatment takes place biannually in some communities and annually in others. Both financial and economic costs were collected from the health care provider's perspective. Principal Findings The estimated cost of treating annually was US Dollars (USD) 0.45 per person including the value of time donated by the community drug distributors (which was estimated at USD 0.05 per person per treatment round). The cost of CDTI was approximately 50–60% higher in those districts where treatment was biannual than in those where it was annual. Large-scale mass biannual treatment was reported as being well received and considered sustainable. Conclusions/Significance This study provides rigorous evidence of the different costs associated with annual and biannual CDTI in Ghana which can be used to inform an economic evaluation of the debate on the optimal treatment frequency required to control

  6. The cost of annual versus biannual community-directed treatment of onchocerciasis with ivermectin: Ghana as a case study.

    PubMed

    Turner, Hugo C; Osei-Atweneboana, Mike Y; Walker, Martin; Tettevi, Edward J; Churcher, Thomas S; Asiedu, Odame; Biritwum, Nana-Kwadwo; Basáñez, María-Gloria

    2013-01-01

    It has been proposed that switching from annual to biannual (twice yearly) mass community-directed treatment with ivermectin (CDTI) might improve the chances of onchocerciasis elimination in some African foci. However, historically, relatively few communities have received biannual treatments in Africa, and there are no cost data associated with increasing ivermectin treatment frequency at a large scale. Collecting cost data is essential for conducting economic evaluations of control programmes. Some countries, such as Ghana, have adopted a biannual treatment strategy in selected districts. We undertook a study to estimate the costs associated with annual and biannual CDTI in Ghana. The study was conducted in the Brong-Ahafo and Northern regions of Ghana. Data collection was organized at the national, regional, district, sub-district and community levels, and involved interviewing key personnel and scrutinizing national records. Data were collected in four districts; one in which treatment is delivered annually, two in which it is delivered biannually, and one where treatment takes place biannually in some communities and annually in others. Both financial and economic costs were collected from the health care provider's perspective. The estimated cost of treating annually was US Dollars (USD) 0.45 per person including the value of time donated by the community drug distributors (which was estimated at USD 0.05 per person per treatment round). The cost of CDTI was approximately 50-60% higher in those districts where treatment was biannual than in those where it was annual. Large-scale mass biannual treatment was reported as being well received and considered sustainable. This study provides rigorous evidence of the different costs associated with annual and biannual CDTI in Ghana which can be used to inform an economic evaluation of the debate on the optimal treatment frequency required to control (or eliminate) onchocerciasis in Africa.

  7. Single versus repeated doses of ivermectin and diethylcarbamazine for the treatment of Wuchereria bancrofti var. pacifica microfilaremia. Results at 12 months of a double-blind study.

    PubMed

    Cartel, J L; Spiegel, A; Nguyen Ngnoc, L; Cardines, R; Plichart, R; Martin, P M; Roux, J F

    1991-12-01

    In October 1989, 58 apparently healthy Polynesian Wuchereria bancrofti carriers in whom microfilarial (mf) density was greater than or equal to 100 mf/ml were randomly allocated to treatment groups receiving single doses of either ivermectin at 100 mcg/kg or diethylcarbamazine (DEC) at 3 and 6 mg/kg. Six months later, half of the carriers initially treated with ivermectin 100 mcg/kg or DEC 3 mg/kg were given a second similar dose while the rest were given a placebo. By day 360 (6 months after retreatment), comparison of adjusted geometric mean mf counts per group indicated that (i) among the 3 treatments given once a year the DEC 6 mg/kg dose resulted in the highest efficacy, (ii) nevertheless, regarding either ivermectin 100 mcg/kg or DEC 3 mg/kg, 2 successive doses resulted in higher efficacy than one annual dose and (iii) though no significant difference could be evidenced between efficacy of ivermectin 100 mcg/kg and DEC 3 mg/kg given twice a year, DEC seemed to sustain the mf reduction for a longer period of time. During the 3 days following retreatment, adverse reactions (mild to moderate) were observed in 46% of carriers treated with microfilaricidal drugs and in 20% of those treated with placebo. These results suggest that single dose therapy with either DEC or ivermectin is safe and effective for prevention of lymphatic filariasis due to Wuchereria bancrofti in French Polynesia. The real impact on transmission by the vector, Aedes polynesiensis, of the complete negativation of microfilaremia observed during the previous part of the trial in carriers treated with ivermectin should be evaluated in a community-based trial including entomological study.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Lymph nodes of onchocerciasis patients after treatment with ivermectin: reaction of eosinophil granulocytes and their cationic granule proteins.

    PubMed

    Wildenburg, G; Darge, K; Knab, J; Tischendorf, F W; Bonow, I; Büttner, D W

    1994-06-01

    Lymph node and skin biopsies from Liberian patients with generalized and localized (sowda) onchocerciasis were studied 12-68 hours after oral administration of ivermectin at a single dose of 150 micrograms/kg body weight. Electron microscopic examination and immunohistochemical staining with antibodies against two different forms of eosinophil cationic protein (ECP EG1, ECP EG2), eosinophil peroxidase (EPO) and cationic leukocyte antigen (CLA) were performed. Following their disappearance from the skin, a large number of microfilariae was found in the regional lymph nodes. The lymph nodes from treated patients had over ten times more eosinophils compared to those from untreated persons with a peak of eosinophil density at 40-48 hours after treatment. Degenerating microfilariae in the lymph nodes were encircled by eosinophils, which showed positive immunostaining for ECP, EPO or CLA. Intra- and extracellular eosinophil granules revealed a great variation in their condition. In some specific granules a variety of structural alterations in the crystalloid cores occurred while in others different stages of deficiency in the matrix electron density were observed. The frequent necrosis of eosinophils in the immediate vicinity and at some distance from the microfilariae, with subsequent release of granules and the deposition of toxic cationic granule proteins onto the microfilarial cuticle during the eosinophil-parasite adherence reaction, demonstrated the function of these proteins in the ivermectin-reinforced killing of microfilariae in lymph nodes.

  9. Effects of parasitic helminths and ivermectin treatment on clinical parameters in the European wild boar (Sus scrofa).

    PubMed

    López-Olvera, Jorge R; Höfle, Ursula; Vicente, Joaquín; Fernández-de-Mera, Isabel G; Gortázar, Christian

    2006-05-01

    Limited information exists on serum biochemistry and haematology of the European wild boar, and few correlations have been found between parasitic burden and clinical parameters in this species. Naturally infected wild boars were experimentally treated to study the effect of nematode parasites and ivermectin treatment on phytohaemagglutinin (PHA) skin reaction and haematological and serum biochemical parameters. White blood cells decreased in untreated wild boars, whereas triglyceride, lactate and creatinine concentrations increased in ivermectin-treated wild boars, and total protein and aspartate aminotransferase activity increased in both groups. Band neutrophils variation was positively correlated with the number of total adult parasites. Band neutrophils, creatinine and total protein variations were negatively correlated with both total egg counts and Metastrongylus eggs per gram variations. Alkaline phosphatase activity showed a negative correlation with Ascaris sp. eggs. The PHA skin reaction was positively correlated with the number of total adult parasites in untreated wild boars and with Metastrongylus sp. eggs of all wild boars at time 0. Two models including leukocytic and serum biochemical parameters were also highly correlated with the variation of Metastrongylus sp. eggs. Clinical parameters were thus in our study affected by helminth parasitism in the European wild boar, particularly those related to nutrients uptake, physical condition and immune response. Therefore, they could be useful in studies on subclinical effects of parasites, and parasitic burden must be considered when assessing the physical condition of European wild boars through haematological and serum biochemical parameters.

  10. Drawing and interpreting data: Children's impressions of onchocerciasis and community-directed treatment with ivermectin (CDTI) in four onchocerciasis endemic countries in Africa

    PubMed Central

    Amuyunzu-Nyamongo, Mary; Tchounkeu, Yolande Flore Longang; Oyugi, Rahel Akumu; Kabali, Asaph Turinde; Okeibunor, Joseph C.; Manianga, Cele; Amazigo, Uche V.

    2011-01-01

    Although the depiction of a child leading a blind man is the most enduring image of onchocerciasis in Africa, research activities have hardly involved children. This paper aims at giving voice to children through drawings and their interpretation. The study was conducted in 2009 in Cameroon, Democratic Republic of Congo (DRC), Nigeria and Uganda. Children aged 6–16 years were asked to draw their perceptions of onchocerciasis and community-directed treatment with ivermectin (CDTI) in their communities. A total of 50 drawings were generated. The drawings depicted four main aspects of onchocerciasis: (1) the disease symptoms, (2) the negative consequences of onchocerciasis among children and in the community generally, (3) the ivermectin distribution process, and (4) the benefits or effects of taking ivermectin. Out of the 50 drawings, 30 were on symptoms, 7 on effects of the disease on children, 8 on distribution process, and 5 represented multiple perceptions on symptoms, drug distribution processes, benefits, and effects of treatment. The lack of clarity when treatment with ivermectin can be stopped in endemic areas requires working with children to ensure continued compliance with treatment into the future. Children's drawings should be incorporated into health education interventions. PMID:21637349

  11. Significant decrease in the prevalence of Wuchereria bancrofti infection in anopheline mosquitoes following the addition of albendazole to annual, ivermectin-based, mass treatments in Nigeria.

    PubMed

    Richards, F O; Pam, D D; Kal, A; Gerlong, G Y; Onyeka, J; Sambo, Y; Danboyi, J; Ibrahim, B; Terranella, A; Kumbak, D; Dakul, A; Lenhart, A; Rakers, L; Umaru, J; Amadiegwu, S; Withers, P C; Mafuyai, H; Jinadu, M Y; Miri, E S; Eigege, A

    2005-03-01

    A prospective entomological survey was conducted in four sentinel villages in central Nigeria from 1999-2002, to assess the impact of annual, single-dose, mass drug administrations (MDA), with a combination of ivermectin and albendazole, on the transmission of Wuchereria bancrofti. As they were also endemic for human onchocerciasis, the four villages had received annual MDA based on ivermectin alone for 7 years prior to the addition of albendazole. Resting Anophelines gambiae s. l., An. funestus and Culex species were collected from 92 sequentially sampled households and dissected. Mosquitoes harbouring any larval stage of W. bancrofti were classified as 'infected', and those containing the third-stage larvae of the parasite were classified as 'infective'. Over the 41-month observation period, 4407 mosquitoes were captured and dissected, of which 64% were An. gambiae s. l., 34% An. funestus, and 1% Culex species. The baseline data, from dissections performed before the addition of albendazole to the MDA, showed high prevalences of mosquito infection (8.9%) and infectivity (2.9%), despite apparently good treatment coverages during the years of annual ivermectin monotherapy. Only the anopheline mosquitoes were found to harbour W. bancrofti larvae. After the third round of MDA with the ivermectin-albendazole combination, statistically significant decreases in the prevalences of mosquito infection (down to 0.6%) and infectivity (down to 0.4%) were observed (P<0.0001 for each). The combination of albendazole and ivermectin appears to be superior to ivermectin alone for reducing the frequency of W. bancrofti infection in mosquitoes.

  12. The efficacy of pour-on ivermectin in bison (Bison bison)

    PubMed Central

    Woodbury, Murray R.; Lewis, W. Roy

    2011-01-01

    To test the effectiveness of pour-on ivermectin in parasitized bison, changes in fecal parasite egg counts after treatment with ivermectin injectable or pour-on preparations were compared to a negative control group. There was no difference between the two ivermectin groups, and both forms of ivermectin were effective in reducing fecal parasite egg counts in parasitized bison. PMID:22043076

  13. Involvement and performance of women in community-directed treatment with ivermectin for onchocerciasis control in Rukungiri District, Uganda.

    PubMed

    Katabarwa, Moses N; Habomugisha, Peace; Agunyo, Stella

    2002-09-01

    The present study aimed: (1) to assess and improve the level of women's involvement in a strategy to control onchocerciasis by community-directed treatment with ivermectin (CDTI) in three parishes of Rukungiri District, Uganda; (2) to measure the performance of female community-directed health workers (CDHWs) in comparison with males; and (3) to identify culturally acceptable means of enhancing women's involvement in community-directed healthcare. Health education sessions were used to instruct community members to select female CDHWs in Masya Parish and to stress their potential importance in Karangara Parish; this subject was not raised in Mukono Parish. In all, 403 mature women who were randomly selected from the three parishes were interviewed as to their: (1) knowledge of the classes of people not eligible to take ivermectin; (2) knowledge and beliefs about the benefits of ivermectin; (3) participation in decision-making; and (4) attitudes on the performance of female CDHWs. For analysis, the respondees were divided into: (1) those who had or had not taken ivermectin treatment during the previous year; and (2) those who had or had not attended health education sessions. During the period when face-to-face interviews with women in randomly selected households were being carried out, participatory evaluation meetings (PEMs) were conducted in selected communities from the same parishes in order to reach a consensus on issues which could not easily be included in individual face-to-face interviews. Participant observations were also made regarding: how communities selected their CDHWs; how the CDHWs organised the distribution exercise and treated community members; and how the CDHWs kept records in order to understand issues which were deliberately hidden from the researchers during face-to-face interviews and PEMs. Significantly, the women who had been treated or health educated in Masya Parish were: (1) more knowledgeable on the groups which were not supposed to

  14. Ivermectin: A Review in Rosacea.

    PubMed

    Deeks, Emma D

    2015-10-01

    Ivermectin 1% cream (Soolantra(®); Rosiver™; Izefla(®)) is a novel topical agent indicated for the once-daily treatment of inflammatory lesions of rosacea. Ivermectin is a derivative of the avermectin family of macrocyclic lactone parasiticides. It displays anti-inflammatory properties as well as broad-spectrum anti-parasitic activity, both of which may contribute to its efficacy in treating rosacea. In phase III trials of 12 or 16 weeks' duration in adults with moderate to severe papulopustular rosacea, once-daily ivermectin 1% cream improved the symptoms of rosacea (as per Investigator Global Assessment and inflammatory lesion count) and health-related quality of life versus vehicle, and was more effective than twice-daily metronidazole 0.75% cream in terms of these measures. Ivermectin 1% cream continues to provide benefit for up to 52 weeks of treatment, according to extension studies, and is well tolerated, with the most common treatment-related adverse events (skin burning sensation, pruritus, dry skin and skin irritation) each occurring with low incidence (<2%). Thus, ivermectin 1% cream is an effective and well tolerated option for the topical treatment of inflammatory lesions of rosacea, with the convenience of once-daily application.

  15. Results of a safety trial on single-dose treatments with 400 mcg/kg of ivermectin in bancroftian filariasis.

    PubMed

    Cartel, J L; Moulia-Pelat, J P; Glaziou, P; Nguyen, L N; Chanteau, S; Roux, J F

    1992-12-01

    Two groups of Polynesian Wuchereria bancrofti carriers, 17 females aged 21 to 84 years and 20 males aged 26 to 57 years, in whom microfilaraemia ranged from 1 to 10,121 mf/ml and from 1 to 6,484 mf/ml, respectively, were given a supervised singledose treatment with 400 mcg/kg of ivermectin. Carriers were examined and questioned regarding their experience of adverse reactions, which were graded 0 to 3 according to severity, at 6, 12 and 24 hours and at 4 days after treatment. Biological examinations which included determination of microfilaraemia, complete blood count, liver function tests and assessment of creatinine and urea levels were performed at 4 days before and 4 days after treatment. Adverse reactions were observed in 65% of female and in 70% of male carriers; they were of grade > or = 2 in 35% of carriers in both groups. None as considered serious; they all disappeared in 24-48 hours. The main symptoms were headache, fever > or = 37.5 degrees C and myalgia in females. One male vomited 3 hours after treatment; as a result the drug was not ingested and no decrease of microfilaraemia was noted. Twelve days afterwards, he was given a second 400 mcg/kg dose, he experienced again a grade 1 reaction and his microfilaraemia fell to zero. The 37 carriers in the present study were matched with 37 other Polynesian carriers treated with a 100 mcg/kg single dose of ivermectin in previous trials for pretreatment mf density and sex: no significant difference could be found in adverse reactions between the 2 treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Serratospiculosis in falcons from Kuwait: incidence, pathogenicity and treatment with melarsomine and ivermectin.

    PubMed

    Tarello, W

    2006-03-01

    The aims of this study were to determine the incidence of the filarial avian nematode Serratospiculum seurati in falcons from Kuwait, report clinical signs and find an effective therapy. Naturally occurring S. seurati infestation was diagnosed in 149 (8.7%) out of 1,706 captive falcons examined between May 2003 and April 2005, and 140 of these were treated with melarsomine at dosage of 0.25 mg/kg injected intramuscularly for two days, and ivermectin, injected once at the dose of 1 mg/kg, 10 days later. Infestation was reportedly symptomatic in 107 (71.8%) and non-symptomatic in 42 (28.2%) falcons. Signs reported more often were dyspnoea (58.8%), reduced speed and strength in flight (56%), weight loss (38.3%), anorexia/poor appetite (22.4%) and lethargy (16.8%). After administration of melarsomine, signs disappeared within 1-10 days in symptomatic birds and improvement of flight performances was noted in non-symptomatic birds. Dead adult parasites were ejected in 22 cases. Embryonated eggs were not detected in coproscopic checks made 10 and 40 days after the end of therapy, in association with lasting clinical remission. The main conclusion is that Serratospiculum seurati is overall pathogenic for birds of prey in the Middle East and that melarsomine + ivermectin can be an effective protocol of therapy eliminating both clinical signs and parasites.

  17. Treatment of mange infection in a weaner flock of sheep with ivermectin at sheep breeding farm Hardishiva of Kashmir valley.

    PubMed

    Iqbal, Asif; Baba, M Ashraf; Shah, Maroof; Mushtaq, Iram; Sakina, Abeen; Wani, Shamim

    2015-06-01

    An outbreak of Sarcoptes scabiei mange occured in a weaner flock that comprised of 74 animals including 31 male and 43 female at sheep breeding farm Hardishiva of Kashmir valley. All the animals in the flock were affected. Animals were very weak and emaciated skin lesions were confined to the lips, nostrils, ears, face, and were characterized by pruritus, erythema, papule formation, alopecia and scab formation. Microscopic examination of skin scraping revealed S. scabiei mange infestation. The affected animals were treated with ivermectin at 1 ml/50 kg b.wt. S/C, as single dose along with supportive therapy. 7th day post treatment scrapping examinations revealed absence of mites or their eggs in these scrapings.

  18. A randomised, double-blind field trial of ivermectin alone and in combination with albendazole for the treatment of Mansonella perstans infections in Uganda.

    PubMed

    Asio, Santa Maria; Simonsen, Paul E; Onapa, Ambrose W

    2009-03-01

    The effect of a single dose of ivermectin alone (150-200microg/kg body weight) or in combination with albendazole (total of 400mg) in Mansonella perstans infection was assessed in a randomised, double-blind field trial in two endemic communities in Mukono and Luwero districts of Uganda. No side effects were observed or reported during the first 7 days after treatment. The effect on microfilaraemia was analysed among individuals with >or=20 microfilariae (mf) per 100mul of blood at baseline, who took the treatment and who attended follow-up examinations at 6 months and 12 months after treatment (48 and 46 in Mukono and 48 and 40 in Luwero for the ivermectin and combination treatment, respectively). In both communities, the combination treatment appeared slightly more effective than ivermectin alone, but the difference was not statistically significant. Both drug regimens were more effective in Luwero than in Mukono, probably owing to different diets in the two areas. However, in general both treatment regimens in both communities had limited effect on microfilarial intensities, and only one individual (given combination treatment in Luwero) was mf-negative at 6 months and 12 months after treatment. [ClinicalTrials.gov identifier: NCT00215280].

  19. Comparative efficacy and safety of topical permethrin, topical ivermectin, and oral ivermectin in patients of uncomplicated scabies.

    PubMed

    Chhaiya, Sunita B; Patel, Varsha J; Dave, Jayendra N; Mehta, Dimple S; Shah, Hiral A

    2012-01-01

    Ivermectin has opened a new era in the management of scabies as orally effective drug. However, topical route has been little explored for ivermectin. To compare the efficacy and safety of topical permethrin, oral ivermectin, and topical ivermectin in the treatment of uncomplicated scabies. This was an open-label, randomized, comparative, parallel clinical trial conducted in 315 patients, randomly allocated to 3 groups. First group received permethrin 5% cream as single application, second group received tablet ivermectin 200 mcg/kg as single dose, and third group received ivermectin 1% lotion as single application. All the patients received anti-histaminic for pruritus. The patients were followed up at intervals of 1, 2, 3, and 4 weeks. If there were no signs of cure, the same intervention was repeated at each follow up. Primary efficacy variable was clinical cure of lesions. Statistical analysis was done by chi square test and one way ANOVA test using SPSS version 12. At the end of first week, cure rate was 74.8% in permethrin group, 30% in oral ivermectin group, and 69.3% in topical ivermectin group (P < 0.05). At the end of second week, cure rate was 99% in permethrin group, 63% in oral ivermectin group, and 100% in topical ivermectin group (P < 0.05). At the end of third week, 100% cure rate was observed in permethrin and topical ivermectin group while 99% in oral ivermectin group (P = 0.367). No serious adverse events were observed. Permethrin and topical ivermectin were equally effective against scabies while oral ivermectin was significantly less effective up to 2 weeks. Topical ivermectin can be used as an alternative to permethrin.

  20. Ticks, ivermectin, and experimental Chagas disease.

    PubMed

    Dias, João Carlos Pinto; Schofield, Christopher J; Machado, Evandro Mm; Fernandes, Alexandre José

    2005-12-01

    Following an infestation of dogticks in kennels housing dogs used for long-term studies of the pathogenesis of Chagas disease, we examined the effect of ivermectin treatment on the dogs, ticks, trypanosome parasites, and also on triatomine vectors of Chagas disease. Ivermectin treatment was highly effective in eliminating the ticks, but showed no apparent effect on the dogs nor on their trypanosome infection. Triatominae fed on the dogs soon after ivermectin treatment showed high mortality, but this effect quickly declined for bugs fed at successive intervals after treatment. In conclusion, although ivermectin treatment may have a transient effect on peridomestic populations of Triatominae, it is not the treatment of choice for this situation. The study also showed that although the dogticks could become infected with Trypanosoma cruzi, this only occurred when feeding on dogs in the acute phase of infection, and there was no evidence of subsequent parasite development in the ticks.

  1. Reaching the london declaration on neglected tropical diseases goals for onchocerciasis: an economic evaluation of increasing the frequency of ivermectin treatment in Africa.

    PubMed

    Turner, Hugo C; Walker, Martin; Churcher, Thomas S; Osei-Atweneboana, Mike Y; Biritwum, Nana-Kwadwo; Hopkins, Adrian; Prichard, Roger K; Basáñez, María-Gloria

    2014-10-01

    Recently, there has been a shift in onchocerciasis control policy, changing from prevention of morbidity toward elimination of infection. Switching from annual to biannual ivermectin distribution may accelerate progress toward the elimination goals. However, the settings where this strategy would be cost effective in Africa have not been described. An onchocerciasis transmission framework (EpiOncho) was coupled to a disease model in order to explore the impact on disability-adjusted life years averted, program cost, and program duration of biannual ivermectin treatment in different epidemiological and programmatic scenarios in African savannah. While biannual treatment yields only small additional health gains, its benefit is pronounced in the context of the elimination goals, shortening the time frames for and increasing the feasibility of reaching the proposed operational thresholds for stopping treatment. In settings with high precontrol endemicity (and/or poor coverage and compliance), it may not be possible to reach such thresholds even within 50 years of annual ivermectin, requiring adoption of biannual treatment. Our projections highlight the crucial role played by coverage and compliance in achieving the elimination goals. Biannual ivermectin treatment improves the chances of reaching the 2020/2025 elimination goals, potentially generating programmatic cost savings in settings with high precontrol endemicity. However, its benefit and cost are highly sensitive to levels of systematic noncompliance and, in many settings, it will lead to an increase in costs. Furthermore, it may not always be feasible to implement biannual treatment, particularly in hard-to-reach populations. This highlights the continued need for a macrofilaricide. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  2. Reaching the London Declaration on Neglected Tropical Diseases Goals for Onchocerciasis: An Economic Evaluation of Increasing the Frequency of Ivermectin Treatment in Africa

    PubMed Central

    Turner, Hugo C.; Walker, Martin; Churcher, Thomas S.; Osei-Atweneboana, Mike Y.; Biritwum, Nana-Kwadwo; Hopkins, Adrian; Prichard, Roger K.; Basáñez, María-Gloria

    2014-01-01

    Background. Recently, there has been a shift in onchocerciasis control policy, changing from prevention of morbidity toward elimination of infection. Switching from annual to biannual ivermectin distribution may accelerate progress toward the elimination goals. However, the settings where this strategy would be cost effective in Africa have not been described. Methods. An onchocerciasis transmission framework (EpiOncho) was coupled to a disease model in order to explore the impact on disability-adjusted life years averted, program cost, and program duration of biannual ivermectin treatment in different epidemiological and programmatic scenarios in African savannah. Results. While biannual treatment yields only small additional health gains, its benefit is pronounced in the context of the elimination goals, shortening the time frames for and increasing the feasibility of reaching the proposed operational thresholds for stopping treatment. In settings with high precontrol endemicity (and/or poor coverage and compliance), it may not be possible to reach such thresholds even within 50 years of annual ivermectin, requiring adoption of biannual treatment. Our projections highlight the crucial role played by coverage and compliance in achieving the elimination goals. Conclusions. Biannual ivermectin treatment improves the chances of reaching the 2020/2025 elimination goals, potentially generating programmatic cost savings in settings with high precontrol endemicity. However, its benefit and cost are highly sensitive to levels of systematic noncompliance and, in many settings, it will lead to an increase in costs. Furthermore, it may not always be feasible to implement biannual treatment, particularly in hard-to-reach populations. This highlights the continued need for a macrofilaricide. PMID:24944228

  3. Current trend in ivermectin usage for scabies.

    PubMed

    Santoro, Anthony F; Rezac, Mark A; Lee, Jason B

    2003-08-01

    Ivermectin, an anti-parasitic agent widely used for onchocerciasis in humans, is emerging as an oral antiscabietic that is as safe and effective as the topical antiscabietics. In the recent reports, all groups of population responded to ivermectin in the treatment of scabies, including immunocompetent, immunocompromised, and other high-risk populations such as individuals with Down's syndrome. This report reviews the efficacy, the mechanism of action, and the safety profile of ivermectin in the treatment of scabies, particularly its utility in crusted scabies and outbreaks of scabies in institutional settings.

  4. Treatment of microfilaraemia in asymptomatic brugian filariasis: the efficacy and safety of the combination of single doses of ivermectin and diethylcarbamazine.

    PubMed

    Shenoy, R K; George, L M; John, A; Suma, T K; Kumaraswami, V

    1998-07-01

    Although combinations of ivermectin and diethylcarbamazine (DEC) have been shown to be superior to either drug alone in the suppression of bancroftian microfilariae, their efficacy against infections with Brugia malayi has never been investigated. The present, open trial is the first on the efficacy and safety of a combination of single doses of ivermectin and DEC when used against microfilaraemias of brugian filariasis. Twenty-one, asymptomatic but microfilaraemic (109-6934 microfilariae/ml blood, with a median of 841/ml) men, aged 18-48 years, each received oral doses of ivermectin (400 micrograms/kg) and DEC (6 mg/kg) as a single treatment. Twelve hours post-treatment, 96.5%-100% of the microfilariae in each subject had been cleared and 12 of the subjects were amicrofilaraemic. A further reduction in microfilarial counts was evident 1 month post-treatment (mean clearance = 99.0%) and the counts continued to fall at least until the last follow-up, at 1 year post-treatment, when the mean clearance was 99.9% and 13 (68.4%) of the 19 subjects then investigated were amicrofilaraemic. All subjects experienced adverse reactions of one form or another, lasting for up to 48 h post-treatment; these included fever, myalgia, headache, and lethargy. Postural hypotension was recorded in two subjects and dilated, inflamed lymphatic channels were seen in another two. The combination of ivermectin and DEC demonstrated a microfilaricidal effect superior to that of either drug used alone, both in the initial rapid clearance of microfilariae and in sustaining the effect for 1 year. This finding has important implications for the control of lymphatic filariasis.

  5. Long-term efficacy of single-dose treatment with 400 micrograms.kg-1 of ivermectin in bancroftian filariasis: results at one year.

    PubMed

    Moulia-Pelat, J P; Glaziou, P; Nguyen, L N; Chanteau, S; Martin, P M; Cartel, J L

    1993-12-01

    In April 1992, a safety trial was performed with a single dose of ivermectin 400 micrograms.kg-1 (IVER 400). In 37 bancroftian filariasis carriers, 6 and 12 months after IVER 400 treatment, the microfilaremia recurrences were 3.2% and 13.5%, respectively. As compared to results from other studies with diethylcarbamazine and IVER at different dosages and periodicities, the dosage of IVER 400 seems the most effective; but a yearly intake might not be sufficient.

  6. Implementing community-directed treatment with ivermectin for the control of onchocerciasis in Uganda (1997-2000): an evaluation.

    PubMed

    Katabarwa, M N; Habomugisha, P; Richards, F O

    2002-01-01

    Over the period 1997-2000, an evaluation was made, in 10 districts of Uganda, of the onchocerciasis-control programme based on community-directed treatment with ivermectin (CDTI). This programme is supported by the Ministry of Health, the African Progamme for Onchocerciasis Control (APOC) and The Carter Center Global 2000 River Blindness Programme. The data analysed came from: (1) monthly and annual reports; (2) annual interviews, in randomly-selected communities in selected districts, with heads of household, community leaders and ivermectin distributors; (3) participatory evaluation meetings (PEM); (4) participant observation studies; and (5) key informants. The percentage of treated communities in the 10 study districts achieving satisfactory treatment coverage [i.e. > or = 90% of the annual treatment objective (ATO)] rose from 46.0 in 1997 to 86.8 in 2000. This improvement was largely attributable to the adoption of collective CDTI decision-making by community members, avoidance of paving monetary incentives to the ivermectin distributors, and the satisfaction with the programme of those who had been treated. Coverage improved as the numbers of community members who were involved in choosing the method of distribution and in selecting their own community-directed health workers (CDHW) increased. Health education was also critical in improving individual members' involvement in decision-making, and in mobilizing other community members to take part in CDTI. Involvement of kinship groups, as well as educated community members as supervisors of CDHW, also helped to increase coverage. In a regression model, satisfaction with the programme was revealed as a significant predictor of the achievement of the target coverage (P<0.001). Cost per person, as an indicator for sustainability, varied with the size of the population under treatment, from at least U.S. $0.40 when the district ATO was <15,000 people, to U.S. $0.26 with an ATO of 15,000-40,000 and less than U

  7. The disappearance of onchocerciasis from the Itwara focus, western Uganda after elimination of the vector Simulium neavei and 19 years of annual ivermectin treatments.

    PubMed

    Lakwo, T L; Garms, R; Rubaale, T; Katabarwa, M; Walsh, F; Habomugisha, P; Oguttu, D; Unnasch, T; Namanya, H; Tukesiga, E; Katamanywa, J; Bamuhiiga, J; Byamukama, E; Agunyo, S; Richards, F

    2013-06-01

    The Itwara onchocerciasis focus is located around the Itwara forest reserve in western Uganda. In 1991, annual treatments with ivermectin started in the focus. They were supplemented in 1995 by the control of the vector Simulium neavei, which was subsequently eliminated from the focus. The impact of the two interventions on the disease was assessed in 2010 by nodule palpations, examinations of skin snips by microscopy and PCR, and Ov16 recombinant ELISA. There was no evidence of any microfilaria in 688 skin snips and only 2 (0.06%) of 3316 children examined for IgG4 were slightly above the arbitrary cut off of 40. A follow up of the same children 21 months later in 2012 confirmed that both were negative for diagnostic antigen Ov-16, skin snip microscopy and PCR. Based on the World Health Organization (WHO) elimination criteria of 2001 and the Uganda onchocerciasis certification guidelines, it was concluded that the disease has disappeared from the Itwara focus after 19 years of ivermectin treatments and the elimination of the vector around 2001. Ivermectin treatments were recommended to be halted.

  8. A Knowledge, Attitudes and Practices Survey Conducted Three Years after Halting Ivermectin Mass Treatment for Onchocerciasis in Guatemala.

    PubMed

    Richards, Frank O; Klein, Robert E; de León, Oscar; Mendizábal-Cabrera, Renata; Morales, Alba Lucía; Cama, Vitaliano; Crovella, Carol G; Díaz Espinoza, Carlos E; Morales, Zoraida; Sauerbrey, Mauricio; Rizzo, Nidia

    2016-06-01

    Mass drug administration (MDA) with ivermectin for onchocerciasis was provided in Guatemala's Central Endemic Zone (CEZ) over a 24 year period (1988-2011). Elimination of Onchocerca volvulus transmission was declared in 2015 after a three year post MDA surveillance period (2012-2014) showed no evidence of recrudescence. The purpose of the present study was to evaluate the knowledge, attitudes and practices (KAP) towards onchocerciasis and ivermectin among residents in the post endemic CEZ. A major interest in this study was to determine what community residents thought about the end of the ivermectin MDA program. A total of 148 interviews were conducted in November 2014 in four formerly hyperendemic communities using a standard questionnaire on smart phones. The majority (69%) of respondents knew that the MDA program had ended because the disease was no longer present in their communities, but a slight majority (53%) was personally unsure that onchocerciasis had really been eliminated. Sixty-three percent wanted to continue to receive ivermectin because of this uncertainty, or because ivermectin is effective against intestinal worms. Eighty-nine percent of respondents said that they would seek medical attention immediately if a family member had symptoms of onchocerciasis (especially the presence of a nodule), which is a finding very important for ongoing surveillance. Many respondents wanted to continue receive ivermectin and more than half did not believe onchocerciasis had been eliminated. The ministry of health outreach services should be prepared to address ongoing concerns about onchocerciasis in the post endemic CEZ.

  9. Experimental infections of baboons (Papio spp.) and vervet monkeys (Cercopithecus aethiops) with Trichinella zimbabwensis and successful treatment with ivermectin.

    PubMed

    Mukaratirwa, S; Dzoma, B M; Matenga, E; Ruziwa, S D; Sacchi, L; Pozio, E

    2008-06-01

    Experimental Trichinella zimbabwensis infections were established in three baboons (Papio sp.) and four vervet monkeys (Cercopithecus aethiops) and the clinical-pathological manifestations assessed. The infected animals showed clinical signs ranging from fever, diarrhoea, periorbital oedema and muscular pain in varying degrees. One baboon became blind due to the infection. Levels of creatinine phosphokinase and lactate dehydrogenase increased to reach a peak on Day 42 post-infection (pi) for both baboons and monkeys. Blood parameters such as packed cell volume, levels of red blood cells and white blood cells did not change significantly from the normal ranges except for the levels of eosinophils which peaked above the normal ranges at Day 28 and 56 pi in baboons and at Day 56 pi in monkeys. Two baboons and two monkeys died during the course of the experiment. They were emaciated and showed lesions such as ascites, hydropericardium, congested liver and enlarged gall bladder. Histopathological findings of various muscles included a basophilic transformation of muscle cells, the disappearance of sarcomere myofibrils and basophilic sarcoplasm with the presence of Trichinella larvae in the sarcoplasm. These changes were mainly in the massetter and were of various intensities in the tail, gastrocnemius and biceps muscles. Five consecutive treatments with an oxfendazole-levamisole combination on surviving animals failed to clear the infection whereas ivermectin cleared the infection after one treatment in two monkeys and after two treatments in a baboon.

  10. Water Conditioner

    NASA Technical Reports Server (NTRS)

    1991-01-01

    A home use water treatment incorporates technology developed to purify water aboard Space Shuttle Orbiters. The General Ionics Model IQ Bacteriostatic Water Softener softens water and inhibits bacteria growth in the filtering unit. Ionics used NASA silver ion technology as a basis for development of a silver carbon dense enough to remain on top of the water softening resin bed.

  11. Proof-of-Principle of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa: Final Results of a Study in Mali and Senegal

    PubMed Central

    Traore, Mamadou O.; Sarr, Moussa D.; Badji, Alioune; Bissan, Yiriba; Diawara, Lamine; Doumbia, Konimba; Goita, Soula F.; Konate, Lassana; Mounkoro, Kalifa; Seck, Amadou F.; Toe, Laurent; Toure, Seyni; Remme, Jan H. F.

    2012-01-01

    Background Mass treatment with ivermectin controls onchocerciasis as a public health problem, but it was not known if it could also interrupt transmission and eliminate the parasite in endemic foci in Africa where vectors are highly efficient. A longitudinal study was undertaken in three hyperendemic foci in Mali and Senegal with 15 to 17 years of annual or six-monthly ivermectin treatment in order to assess residual levels of infection and transmission, and test whether treatment could be safely stopped. This article reports the results of the final evaluations up to 5 years after the last treatment. Methodology/Principal Findings Skin snip surveys were undertaken in 131 villages where 29,753 people were examined and 492,600 blackflies were analyzed for the presence of Onchocerca volvulus larva using a specific DNA probe. There was a declining trend in infection and transmission levels after the last treatment. In two sites the prevalence of microfilaria and vector infectivity rate were zero 3 to 4 years after the last treatment. In the third site, where infection levels were comparatively high before stopping treatment, there was also a consistent decline in infection and transmission to very low levels 3 to 5 years after stopping treatment. All infection and transmission indicators were below postulated thresholds for elimination. Conclusion/Significance The study has established the proof of principle that onchocerciasis elimination with ivermectin treatment is feasible in at least some endemic foci in Africa. The study results have been instrumental for the current evolution from onchocerciasis control to elimination in Africa. PMID:23029586

  12. Contribution and performance of female Community-Directed Distributors in the treatment of onchocerciasis with Ivermectin in Sub-Saharan Africa: a systematic review

    PubMed Central

    Vouking, Marius Zambou; Tamo, Violette Claire; Tadenfok, Carine Nouboudem

    2015-01-01

    The African Program for Onchocerciasis Control (APOC) was launched in 1995 with the main goal being to boost the fight against onchocerciasis in Africa. In 2011, over 80 million people benefited from this intervention thanks to the contribution of 268.718 Community-Directed Distributors (CDD). These significant results obscure the role of women CDD in this fight. Indeed, the insufficient involvement of female CDD has been identified as a concern by the APOC partners early in the program. The present study aims to assess the contribution and performance of women involved in a strategy to control onchocerciasis by community-directed treatment with ivermectin in sub Saharan Africa. We searched the following electronic databases from January 1995 to July 2013: Medline, Embase (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), LILAS (Latin American and Caribbean Literature on Health Sciences), International Bibliography of Social Sciences, Social Services Abstracts, and Sociological Abstracts. Two research team members independently conducted data extraction from the final sample of articles by using a pre-established data extraction sheet. The primary outcome was the contribution of female CDD in the control of onchocerciasis by community-directed treatment with Ivermectin. Of 25 hits, 7 papers met the inclusion criteria. For the management of onchocerciasis, female CDDs are elected by the health committee from the communities they will serve. The significant proportion of those treated (about 61%) were women, although only 24% of CDDs were women. Many community members reported that women were more committed, persuasive and more patient than men in the distribution of ivermectin. Some studies have identified underutilization of female CDD as one reason for the limited effectiveness or, in some cases, pure failure related to the distribution of Ivermectin interventions in the fight against onchocerciasis in sub-Saharan Africa

  13. Contribution and performance of female Community-Directed Distributors in the treatment of onchocerciasis with Ivermectin in Sub-Saharan Africa: a systematic review.

    PubMed

    Vouking, Marius Zambou; Tamo, Violette Claire; Tadenfok, Carine Nouboudem

    2015-01-01

    The African Program for Onchocerciasis Control (APOC) was launched in 1995 with the main goal being to boost the fight against onchocerciasis in Africa. In 2011, over 80 million people benefited from this intervention thanks to the contribution of 268.718 Community-Directed Distributors (CDD). These significant results obscure the role of women CDD in this fight. Indeed, the insufficient involvement of female CDD has been identified as a concern by the APOC partners early in the program. The present study aims to assess the contribution and performance of women involved in a strategy to control onchocerciasis by community-directed treatment with ivermectin in sub Saharan Africa. We searched the following electronic databases from January 1995 to July 2013: Medline, Embase (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), LILAS (Latin American and Caribbean Literature on Health Sciences), International Bibliography of Social Sciences, Social Services Abstracts, and Sociological Abstracts. Two research team members independently conducted data extraction from the final sample of articles by using a pre-established data extraction sheet. The primary outcome was the contribution of female CDD in the control of onchocerciasis by community-directed treatment with Ivermectin. Of 25 hits, 7 papers met the inclusion criteria. For the management of onchocerciasis, female CDDs are elected by the health committee from the communities they will serve. The significant proportion of those treated (about 61%) were women, although only 24% of CDDs were women. Many community members reported that women were more committed, persuasive and more patient than men in the distribution of ivermectin. Some studies have identified underutilization of female CDD as one reason for the limited effectiveness or, in some cases, pure failure related to the distribution of Ivermectin interventions in the fight against onchocerciasis in sub-Saharan Africa

  14. Ivermectin Inhibits Growth of Chlamydia trachomatis in Epithelial Cells

    PubMed Central

    Pettengill, Matthew A.; Lam, Verissa W.; Ollawa, Ikechukwu; Marques-da-Silva, Camila; Ojcius, David M.

    2012-01-01

    Ivermectin is currently approved for treatment of both clinical and veterinary infections by nematodes, including Onchocerca cervicalis in horses and Onchocerca volvulus in humans. However, ivermectin has never been shown to be effective against bacterial pathogens. Here we show that ivermectin also inhibits infection of epithelial cells by the bacterial pathogen, Chlamydia trachomatis, at doses that could be envisioned clinically for sexually-transmitted or ocular infections by Chlamydia. PMID:23119027

  15. Ivermectin in dermatology.

    PubMed

    del Giudice, Pascal; Chosidow, Olivier; Caumes, Eric

    2003-01-01

    Ivermectin, a broad-spectrum anti-parasitic agent first used in veterinary medicine, is active against numerous species of helminths and arthropods. For the past few years, world-wide reports on the use of ivermectin in various parasitic diseases with cutaneous tropism have led to its use in the field of skin parasitology. In this paper we review parasitoses which have been treated with ivermectin; mainly, filariasis, strongyloidiasis, cutaneous larva migrans, and scabies and head lice.

  16. Loa loa encephalopathy temporally related to ivermectin administration reported from onchocerciasis mass treatment programs from 1989 to 2001: implications for the future

    PubMed Central

    Twum-Danso, Nana AY

    2003-01-01

    Of the 207 Serious Adverse Events (SAEs) following treatment with Mectizan® (ivermectin, Merck, Sharpe & Dohme) that were reported from 1989 to 2001 through the passive SAE surveillance system required of all onchocerciasis mass treatment programs, 65 were cases of 'Probable' or 'Possible' Loa loa Encephalopathy temporally Related to treatment with Mectizan® (PLERM). A retrospective analysis of these 65 PLERM cases revealed that 97% were from southern Cameroon, 85% were male and 93% were being treated with ivermectin for the first time. The mean time to onset of symptoms was 1.7 days (95% CI: 1.3, 2.2) but the mean time to receiving medical attention after the onset of symptoms was 2.0 days (95% CI: 1.5, 2.6). Hospitalization was reported in 53 cases with a mean duration of 27.5 days (95% CI: 13.3, 41.6, n = 35). Clinical outcome was reported in 34 cases: 64.7% recovered fully, 11.8% had partial neurologic deficit and 23.5% died. For the 32 cases where quantitative L. loa data were reported, the arithmetic means with 95% confidence intervals were for 1) peripheral blood: pre-treatment – 164,250 mf/ml (79,537, 248,963; n = 4); post-treatment within 1 month – 3926 mf/ml (2,128, 5,725; n = 21) and within 5 to 6 months – 7800 mf/ml (3417, 12,183; n = 7); and for 2) cerebrospinal fluid: 32 mf/ml (7, 37; n = 10) within 1 month post-treatment. Pending further research on practical methods to exclude individuals with high intensity L. loa infection from onchocerciasis mass treatment programs, more emphasis should be placed on surveillance and monitoring to ensure early recognition, referral and management of SAEs, during the first 2 years when majority of the population is presumably naïve to ivermectin. PMID:14975064

  17. A Knowledge, Attitudes and Practices Survey Conducted Three Years after Halting Ivermectin Mass Treatment for Onchocerciasis in Guatemala

    PubMed Central

    Richards, Frank O.; Klein, Robert E.; de León, Oscar; Mendizábal-Cabrera, Renata; Morales, Alba Lucía; Cama, Vitaliano; Crovella, Carol G.; Díaz Espinoza, Carlos E.; Morales, Zoraida; Sauerbrey, Mauricio; Rizzo, Nidia

    2016-01-01

    Background Mass drug administration (MDA) with ivermectin for onchocerciasis was provided in Guatemala’s Central Endemic Zone (CEZ) over a 24 year period (1988–2011). Elimination of Onchocerca volvulus transmission was declared in 2015 after a three year post MDA surveillance period (2012–2014) showed no evidence of recrudescence. The purpose of the present study was to evaluate the knowledge, attitudes and practices (KAP) towards onchocerciasis and ivermectin among residents in the post endemic CEZ. A major interest in this study was to determine what community residents thought about the end of the ivermectin MDA program. Methodology/Principal Findings A total of 148 interviews were conducted in November 2014 in four formerly hyperendemic communities using a standard questionnaire on smart phones. The majority (69%) of respondents knew that the MDA program had ended because the disease was no longer present in their communities, but a slight majority (53%) was personally unsure that onchocerciasis had really been eliminated. Sixty-three percent wanted to continue to receive ivermectin because of this uncertainty, or because ivermectin is effective against intestinal worms. Eighty-nine percent of respondents said that they would seek medical attention immediately if a family member had symptoms of onchocerciasis (especially the presence of a nodule), which is a finding very important for ongoing surveillance. Conclusions/Significance Many respondents wanted to continue receive ivermectin and more than half did not believe onchocerciasis had been eliminated. The ministry of health outreach services should be prepared to address ongoing concerns about onchocerciasis in the post endemic CEZ. PMID:27341104

  18. Combined ivermectin and doxycycline treatment has microfilaricidal and adulticidal activity against Dirofilaria immitis in experimentally infected dogs.

    PubMed

    Bazzocchi, C; Mortarino, M; Grandi, G; Kramer, L H; Genchi, C; Bandi, C; Genchi, M; Sacchi, L; McCall, J W

    2008-10-01

    There is still a pressing need for effective adulticide treatment for human and animal filarial infections. Like many filarial nematodes, Dirofilaria immitis, the causative agent of canine heartworm disease, harbours the bacterial endosymbiont Wolbachia, which has been shown to be essential for worm development, fecundity and survival. Here the authors report the effect of different treatment regimens in dogs experimentally infected with adult D. immitis on microfilariemia, antigenemia, worm recovery and Wolbachia content. Treatment with ivermectin (IVM; 6 microg/kg per os weekly) combined with doxycycline (DOXY; 10 mg/kg/day orally from Weeks 0-6, 10-12, 16-18, 22-26 and 28-34) resulted in a significantly faster decrease of circulating microfilariae and higher adulticidal activity compared with either IVM or DOXY alone. Quantitative PCR analysis of ftsZ (Wolbachia DNA) and 18S rDNA (nematode DNA) absolute copy numbers showed significant decreases in Wolbachia content compared with controls in worms recovered from DOXY-treated dogs that were not, however, associated with worm death. Worms from IVM/DOXY-treated dogs, on the other hand, had Wolbachia/nematode DNA ratios similar to those of control worms, suggesting a loss of both Wolbachia and nematode DNA as indicated by absolute copy number values. Histology and transmission electron microscopy of worms recovered from the IVM/DOXY combination group showed complete loss of uterine content in females and immunohistochemistry for Wolbachia was negative. Results indicate that the combination of these two drugs causes adult worm death. This could have important implications for control of human and animal filarial infections.

  19. Safety trial of single-dose treatments with a combination of ivermectin and diethylcarbamazine in bancroftian filariasis.

    PubMed

    Moulia-Pelat, J P; Nguyen, L N; Glaziou, P; Chanteau, S; Gay, V M; Martin, P M; Cartel, J L

    1993-06-01

    A supervised safety trial of the treatment with a combination of ivermectin 400 micrograms.kg-1 (IVER 400) plus increasing doses of diethylcarbamazine (DEC), given simultaneously in single dose, was performed on five groups of Polynesian Wuchereria bancrofti carriers, 49 males aged 25 to 73 years, in whom microfilaremia ranged from 1 to 6,137 mf/ml. The trial was hospital-based, open, dose-escalating (1 group per week). Safety of an unchanging dose of IVER 400 and ascending doses of DEC were studied in the 5 following groups: group 1- IVER 400 plus DEC 1 mg.kg-1, 12 patients; group 2- IVER 400 plus DEC 3 mg.kg-1, 17 patients; group 3- IVER 400 plus DEC 6 mg.kg-1, 10 patients. Two control groups were included in the study, group 4- DEC 6 mg.kg-1 alone, 5 patients; group 5-: IVER 400 alone, 5 patients. Carriers were examined and questioned regarding their experience of adverse reactions, which were graded 0 to 3 according to severity, at 6, 12 and 24 hours and at 4 days after treatment. Biological examination was performed 4 days before and 4 days after treatment and included determination of microfilaremia, complete blood count, liver function tests and assessment of creatinine and urea levels. Adverse reactions were observed in 51% of 49 carriers (15 of grade 1, 8 of grade 2, 2 of grade 3). None was considered serious and they all disappeared in 2 days. The main symptoms were fever > or = 37.5 degrees C, myalgia, arthralgia, headache, asthenia, anorexia, vertigo and chills. Adverse reactions of patients were not significantly different between the five groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Ivermectin for onchocercal eye disease (river blindness)

    PubMed Central

    Ejere, Henry OD; Schwartz, Ellen; Wormald, Richard; Evans, Jennifer R

    2015-01-01

    Background It is believed that ivermectin (a microfilaricide) could prevent blindness due to onchocerciasis. However, when given to everyone in communities where onchocerciasis is common, the effects of ivermectin on lesions affecting the eye are uncertain and data on whether the drug prevents visual loss are unclear. Objectives The aim of this review was to assess the effectiveness of ivermectin in preventing visual impairment and visual field loss in onchocercal eye disease. The secondary aim was to assess the effects of ivermectin on lesions affecting the eye in onchocerciasis. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 3), MEDLINE (January 1950 to April 2012), EMBASE (January 1980 to April 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 2 April 2012. Selection criteria We included randomised controlled trials with at least one year of follow-up comparing ivermectin with placebo or no treatment. Participants in the trials were people normally resident in endemic onchocercal communities with or without one or more characteristic signs of ocular onchocerciasis. Data collection and analysis Two review authors independently extracted data and assessed trial quality. We contacted study authors for additional information. As trials varied in design and setting, we were unable to perform a meta-analysis. Main results The review included four trials: two small studies (n = 398) in which people with onchocercal infection were given one dose of ivermectin or placebo and followed up for one year; and two larger community-based studies (n = 4941) whereby all individuals in

  1. Plasma pharmacokinetic profile of fluralaner (Bravecto™) and ivermectin following concurrent administration to dogs.

    PubMed

    Walther, Feli M; Allan, Mark J; Roepke, Rainer K A

    2015-10-06

    Fluralaner is a novel systemic ectoparasiticide for dogs providing immediate and persistent flea, tick and mite control after a single oral dose. Ivermectin has been used in dogs for heartworm prevention and at off label doses for mite and worm infestations. Ivermectin pharmacokinetics can be influenced by substances affecting the p-glycoprotein transporter, potentially increasing the risk of ivermectin neurotoxicity. This study investigated ivermectin blood plasma pharmacokinetics following concurrent administration with fluralaner. Ten Beagle dogs each received a single oral administration of either 56 mg fluralaner (Bravecto™), 0.3 mg ivermectin or 56 mg fluralaner plus 0.3 mg ivermectin/kg body weight. Blood plasma samples were collected at multiple post-treatment time points over a 12-week period for fluralaner and ivermectin plasma concentration analysis. Ivermectin blood plasma concentration profile and pharmacokinetic parameters Cmax, tmax, AUC∞ and t½ were similar in dogs administered ivermectin only and in dogs administered ivermectin concurrently with fluralaner, and the same was true for fluralaner pharmacokinetic parameters. Concurrent administration of fluralaner and ivermectin does not alter the pharmacokinetics of either compound. Based on the plasma pharmacokinetic profile and the clinical observations, there is no evident interaction between fluralaner and ivermectin, and co-administration does not increase the risk of ivermectin associated neurotoxicity.

  2. Air Conditioner/Dehumidifier

    NASA Technical Reports Server (NTRS)

    1986-01-01

    An ordinary air conditioner in a very humid environment must overcool the room air, then reheat it. Mr. Dinh, a former STAC associate, devised a heat pipe based humidifier under a NASA Contract. The system used heat pipes to precool the air; the air conditioner's cooling coil removes heat and humidity, then the heat pipes restore the overcooled air to a comfortable temperature. The heat pipes use no energy, and typical savings are from 15-20%. The Dinh Company also manufactures a "Z" coil, a retrofit cooling coil which may be installed on an existing heater/air conditioner. It will also provide free hot water. The company has also developed a photovoltaic air conditioner and solar powered water pump.

  3. Air Conditioner/Dehumidifier

    NASA Astrophysics Data System (ADS)

    1986-01-01

    An ordinary air conditioner in a very humid environment must overcool the room air, then reheat it. Mr. Dinh, a former STAC associate, devised a heat pipe based humidifier under a NASA Contract. The system used heat pipes to precool the air; the air conditioner's cooling coil removes heat and humidity, then the heat pipes restore the overcooled air to a comfortable temperature. The heat pipes use no energy, and typical savings are from 15-20%. The Dinh Company also manufactures a "Z" coil, a retrofit cooling coil which may be installed on an existing heater/air conditioner. It will also provide free hot water. The company has also developed a photovoltaic air conditioner and solar powered water pump.

  4. Ivermectin for treatment of bancroftian filariasis in French Polynesia: efficacy in man, effect on transmission by vector Aedes polynesiensis.

    PubMed

    Cartel, J L; Sechan, Y; Boutin, J P; Celerier, P; Plichart, R; Roux, J F

    1990-09-01

    Forty male Polynesian W. bancrofti carriers with mf counts greater than or equal to 20/ml were treated with a single ivermectin 50, 100, 150 or 200 mcg/kg dose. Following therapy, mf levels fell to less than 1% of pretreatment levels in the carriers treated with the 3 highest doses. After one month, negativation rate was 40% in patients treated with a 50 mcg/kg dose, significantly lower than in patients treated with higher doses. Recurrence of microfilaremia was observed by 3 months, mf recurrence percentages were significantly lower in patients treated with the 3 highest doses than in patients treated with a 50 mcg/kg dose. At 6 months, mf recurrence percentages reached 49.8, 12.6, 14 and 5.4% of pretreatment levels in carriers treated with 50, 100, 150 and 200 mcg/kg, respectively. No significant difference was observed between mf levels by group at 6 and 12 months. With respect to efficacy, a dose greater than or equal to 100 mcg/kg appeared superior to 50 mcg/kg dose; no significant difference between the 3 highest doses was observed. Some patients developed headache, myalgia and fever within 24 hours following therapy, none of adverse reactions were considered serious. In vector Ae. polynesiensis fed on carriers 6 months after treatment, average numbers of mf ingested and average numbers of L3 cephalic larvae were lower than those observed in mosquitoes fed on non-treated carriers with comparable mf counts.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Onchocerciasis in Anambra State, Southeast Nigeria: clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI).

    PubMed

    Mbanefo, Evaristus C; Eneanya, Christine I; Nwaorgu, Obioma C; Oguoma, Victor M; Otiji, Moses O; Ogolo, Bernice A

    2010-10-01

    A cross-sectional study was performed to determine the psychological impact of onchocerciasis, and assess sustainability of the decade-old community directed treatment with ivermectin (CDTI) in Ayamelum Local Council, Anambra State, Southeast Nigeria. Skin manifestations assessed using the rapid assessment method (RAM) in 894 subjects from 13 communities selected by multi-stage sampling were classified based on the anatomical sites affected. Focus group discussions and in-depth interviews were used to obtain information on the psychological impacts and sustainability of the CDTI programme. Qualitative data were summarised while quantitative data generated were analysed using charts and tables. Anatomical distribution showed a preponderance of onchodermatitis on the limbs (the most exposed parts of the body) and buttocks (an area considered 'private'), thus revealing some reasons for the psychological impacts of the skin disease and the psychosocial inclination of the victims. Itching (40%) and onchocercal skin manifestations (OSDs) (34.3%) were identified as the most troublesome signs and symptoms, while the most worrisome consequence of onchocerciasis was social seclusion (or stigmatisation) (34.3%). Focus group responses revealed the persistence of psychological impacts on the victims, affecting almost all facets of their lives. The CDTI programme has performed creditably well when assessed using the sustainability indicators, yet there are still challenges in the areas of coverage, monitoring, resources, and participation. A 'quick-win' was identified whereby the CDTI chain could be utilised to deliver other health interventions. It is recommended that onchocerciasis control programmes should include aspects that would address its psychosocial impacts and threats to the sustainability of the CDTI programme.

  6. Genotypic analysis of β-tubulin in Onchocerca volvulus from communities and individuals showing poor parasitological response to ivermectin treatment

    PubMed Central

    Osei-Atweneboana, Mike Y.; Boakye, Daniel A.; Awadzi, Kwablah; Gyapong, John O.; Prichard, Roger K.

    2012-01-01

    Ivermectin (IVM) has been in operational use for the control of onchocerciasis for two decades and remains the only drug of choice. To investigate the parasitological responses and genetic profile of Onchocerca volvulus, we carried out a 21 month epidemiological study to determine the response of the parasite to IVM in 10 Ghanaian endemic communities. Onchocerca nodules were surgically removed from patients in three IVM response categories (good, intermediate and poor) and one IVM naïve community. DNA from adult worms was analyzed to determine any association between genotype and IVM response phenotypic. Embryogramme analysis showed significantly higher reproductive activity in worms from poor response communities, which had up to 41% of females with live stretched microfilaria (mf) in utero, despite IVM treatment, compared with good response communities, which had no intra-uterine stretched mf. β-tubulin isotype 1 gene has been shown to be linked to IVM selection in O. volvulus and also known to be associated with IVM resistance in veterinary nematodes. We have genotyped the full length genomic DNA sequence of the β-tubulin gene from 127 adult worms obtained from the four community categories. We found SNPs at 24 sites over the entire 3696 bp. Eight of the SNPs occurred at significantly higher (p < 0.05) frequencies in the poor response communities compared with the good response communities and the IVM naïve community. Phenotypic and genotypic analyses show that IVM resistance has been selected and the genotype (1183GG/1188CC/1308TT/1545GG) was strongly associated with the resistance phenotype. Since the region in the β-tubulin gene where these four SNPs occur is within 362 bp, it is feasible to develop a genetic marker for the early detection of IVM resistance. PMID:24533268

  7. Clinical characteristics of post-treatment reactions to ivermectin/albendazole for Wuchereria bancrofti in a region co-endemic for Mansonella perstans.

    PubMed

    Keiser, Paul B; Coulibaly, Yaya I; Keita, Falaye; Traore, Diakaridia; Diallo, Abdallah; Diallo, Dapa A; Semnani, Roshanak T; Doumbo, Ogobara K; Traore, Sekou F; Klion, Amy D; Nutman, Thomas B

    2003-09-01

    Post-treatment reactions to single-dose ivermectin (200 microg/kg) and albendazole (400 mg) were studied in a filarial endemic region of Mali. The prevalence of Wuchereria bancrofti in this region was 48.3% (69 of 143), and coinfection with Mansonella perstans was common (30 of 40, 75%). Microfilarial levels of M. perstans correlated positively with age (P = 0.006) and with W. bancrofti microfilarial levels (P = 0.006). Forty individuals (28 infected and 12 uninfected) were treated, with mild post-treatment reactions occurring in 35.7% (7 of 28) of the W. bancrofti-infected subjects. Reaction severity correlated with pretreatment W. bancrofti microfilarial levels (P = 0.001). There were no significant differences in the prevalence or severity of post-treatment reactions in those who were co-infected with M. perstans. It is concluded that co-infection with M. perstans does not significantly alter the post-treatment reaction profile to single-dose ivermectin/albendazole in W. bancrofti infection in this community, and that acute post-treatment reactions should not limit patient compliance in community-based programs to eliminate lymphatic filariasis.

  8. Ongoing Transmission of Onchocerca volvulus after 25 Years of Annual Ivermectin Mass Treatments in the Vina du Nord River Valley, in North Cameroon

    PubMed Central

    Eisenbarth, Albert; Achukwi, Mbunkah Daniel; Renz, Alfons

    2016-01-01

    Background Recent reports of transmission interruption of Onchocerca volvulus, the causing agent of river blindness, in former endemic foci in the Americas, and more recently in West and East Africa, raise the question whether elimination of this debilitating disease is underway after long-term treatment of the population at risk with ivermectin. The situation in Central Africa has not yet been clearly assessed. Methods and findings Entomologic data from two former endemic river basins in North Cameroon were generated over a period of 43 and 48 months to follow-up transmission levels in areas under prolonged ivermectin control. Moreover, epidemiologic parameters of animal-borne Onchocerca spp. transmitted by the same local black fly vectors of the Simulium damnosum complex were recorded and their impact on O. volvulus transmission success evaluated. With mitochondrial DNA markers we unambiguously confirmed the presence of infective O. volvulus larvae in vectors from the Sudan savannah region (mean Annual Transmission Potential 2009–2012: 98, range 47–221), but not from the Adamawa highland region. Transmission rates of O. ochengi, a parasite of Zebu cattle, were high in both foci. Conclusions/significance The high cattle livestock density in conjunction with the high transmission rates of the bovine filaria O. ochengi prevents the transmission of O. volvulus on the Adamawa plateau, whereas transmission in a former hyperendemic focus was markedly reduced, but not completely interrupted after 25 years of ivermectin control. This study may be helpful to gauge the impact of the presence of animal-filariae for O. volvulus transmission in terms of the growing human and livestock populations in sub-Saharan countries. PMID:26926855

  9. Ivermectin and clorsulon (ivomec super) in treatment of goats naturally infested with scab mites and biting lice.

    PubMed

    Morsy, T A; Habib, K S; Haridy, F M

    2001-08-01

    Five goats naturally infested with Sarcoptes scabiei, Psoroptes ovis and Bovicola caprae were treated with a combination of ivermectin and clorsulon. A subcutaneous injection in a dose of 1 ml/50 kg live weight was given. This provides dose levels of 200 ug ivermectin and 2 mg clorsulon. Four goats were cured from the three ectoparasites within one to two weeks. The last elder goat, which was anaemic and naturally infected with Trichostrongylus colubriformis, was still infested with the two scab mites, but was free from B. caprae. A postal dose of 0.5 ml/50 kg live weight was given one week later (=3 weeks after the 1st injection). This goat was cured within a week, but still passed some T. colibriformis eggs. The result was discussed.

  10. Transmission of Onchocerca volvulus Continues in Nyagak-Bondo Focus of Northwestern Uganda after 18 Years of a Single Dose of Annual Treatment with Ivermectin

    PubMed Central

    Katabarwa, Moses N.; Lakwo, Tom; Habomugisha, Peace; Agunyo, Stella; Byamukama, Edson; Oguttu, David; Tukesiga, Ephraim; Unoba, Dickson; Dramuke, Patrick; Onapa, Ambrose; Tukahebwa, Edridah M.; Lwamafa, Dennis; Walsh, Frank; Unnasch, Thomas R.

    2013-01-01

    The objective of the study was to determine whether annual ivermectin treatment in the Nyagak-Bondo onchocerciasis focus could safely be withdrawn. Baseline skin snip microfilariae (mf) and nodule prevalence data from six communities were compared with data collected in the 2011 follow-up in seven communities. Follow-up mf data in 607 adults and 145 children were compared with baseline (300 adults and 58 children). Flies collected in 2011were dissected, and poolscreen analysis was applied to ascertain transmission. Nodule prevalence in adults dropped from 81.7% to 11.0% (P < 0.0001), and mf prevalence dropped from 97.0% to 23.2% (P < 0.0001). In children, mf prevalence decreased from 79.3% to 14.1% (P < 0.0001). Parous and infection rates of 401 flies that were dissected were 52.9% and 1.5%, respectively, whereas the infective rate on flies examination by polymerase chain reaction (PCR) was 1.92% and annual transmission potential was 26.9. Stopping ivermectin treatment may result in onchocerciasis recrudescence. PMID:23690555

  11. Transmission of Onchocerca volvulus continues in Nyagak-Bondo focus of northwestern Uganda after 18 years of a single dose of annual treatment with ivermectin.

    PubMed

    Katabarwa, Moses N; Lakwo, Tom; Habomugisha, Peace; Agunyo, Stella; Byamukama, Edson; Oguttu, David; Tukesiga, Ephraim; Unoba, Dickson; Dramuke, Patrick; Onapa, Ambrose; Tukahebwa, Edridah M; Lwamafa, Dennis; Walsh, Frank; Unnasch, Thomas R

    2013-08-01

    The objective of the study was to determine whether annual ivermectin treatment in the Nyagak-Bondo onchocerciasis focus could safely be withdrawn. Baseline skin snip microfilariae (mf) and nodule prevalence data from six communities were compared with data collected in the 2011 follow-up in seven communities. Follow-up mf data in 607 adults and 145 children were compared with baseline (300 adults and 58 children). Flies collected in 2011 were dissected, and poolscreen analysis was applied to ascertain transmission. Nodule prevalence in adults dropped from 81.7% to 11.0% (P < 0.0001), and mf prevalence dropped from 97.0% to 23.2% (P < 0.0001). In children, mf prevalence decreased from 79.3% to 14.1% (P < 0.0001). Parous and infection rates of 401 flies that were dissected were 52.9% and 1.5%, respectively, whereas the infective rate on flies examination by polymerase chain reaction (PCR) was 1.92% and annual transmission potential was 26.9. Stopping ivermectin treatment may result in onchocerciasis recrudescence.

  12. A comparative study of the effects of four treatment regimes on ivermectin efficacy, body weight and pasture contamination in lambs naturally infected with gastrointestinal nematodes in Scotland

    PubMed Central

    Kenyon, Fiona; McBean, David; Greer, Andrew W.; Burgess, Charlotte G.S.; Morrison, Alison A.; Bartley, David J.; Bartley, Yvonne; Devin, Leigh; Nath, Mintu; Jackson, Frank

    2013-01-01

    Refugia-based drenching regimes have been widely recommended to slow development of anthelmintic resistance but there are few comparisons between different treatment approaches in the UK. The impact of four ivermectin treatment regimes on drug efficacy, lamb body weight and nematode contamination during a 154 day grazing season were evaluated in a consecutive five year field study. Regimes were whole-flock treatment every 4 weeks (NST), targeted selective treatment (TST) based on individual performance, strategic whole-flock treatments at pre-determined times (SPT) or whole-flock treatment when clinical signs were apparent (MT). Mean numbers of ivermectin drenches administered per season were 4.0, 1.8, 2.0 and 1.4 for NST, TST, SPT and MT groups, respectively. The mean anthelmintic efficacy (AE) for each treatment group was based on faecal egg count reduction post-treatment employing a bootstrap sampling based algorithm. Mean AE was 95–98% for all groups in 2006 and mean AE (95% confidence limits) for NST declined to 62% (55%, 68%) in 2010. In comparison, AE for TST, SPT and MT in 2010 were 86% (81%, 92%), 86% (83%, 90%) and 83% (78%, 88%), respectively. Body weight in TST and SPT was similar to NST in all years (p > 0.05), however MT lambs were lighter than NST in 2006–2008 (p ⩽ 0.04). Tracer lamb worm burdens was lowest in NST but was not significantly different between other groups. Overall, both the TST and SPT regimes appeared to maintain animal performance and conserve anthelmintic efficacy compared with a neo-suppressive anthelmintic treatment regime. PMID:24533296

  13. Ivermectin resistant Haemonchus contortus in Louisiana lambs.

    PubMed

    Miller, J E; Barras, S R

    1994-12-01

    Fifteen weaned crossbred (Suffolk x Louisiana Native) lambs were treated with albendazole (10 mg kg-1) to remove existing nematode infections. They were inoculated with Haemonchus contortus infective larvae from a residual population surviving treatment with the oral formulation of ivermectin (0.2 mg kg-1). One group of five lambs remained untreated, another group of five was treated with the injectable formulation of ivermectin (0.2 mg kg-1), and a third group of five was treated with the oral formulation of ivermectin (0.2 mg kg-1). Subsequent to the treatments, there was essentially no difference in mean fecal egg count or mean number of H. contortus recovered at necropsy between the three groups.

  14. Physiological Signal Conditioner

    NASA Technical Reports Server (NTRS)

    Friedericks, C.

    1999-01-01

    Sensors 2000! is developing a Physiological Signal Conditioner (PSC) for monitoring of astronauts in the ISS Human Research Facility. The PSC is battery powered and worn by the crew. The Engineering Development Unit (PSC EDU) and the form-and-fit PSC Tooling Model will be displayed along with associated graphics and text explanations. Results of a recent advanced PSC-2 feasibility study will be presented. The presentation will stimulate discussion of the functional capabilities of a wireless, crew worn Physiological Signal Conditioner. Application of advanced technology to meet the conflicting demands of size, power, and functional capability will be of interest.

  15. Cardio-Muscular Conditioner

    NASA Technical Reports Server (NTRS)

    1993-01-01

    In the mid-sixties, Gary Graham, a Boeing designer, developed a cardiovascular conditioner for a planned Air Force orbiting laboratory. After the project was cancelled, Graham participated in space station conditioning studies for the Skylab program. Twenty years later, he used this expertise to develop the Shuttle 2000-1, a physical therapy and athletic development conditioner, available through Contemporary Designs. The machine is used by football teams, sports clinics and medical rehabilitation centers. Cardiovascular fitness and muscular strength development are promoted through both kinetic and plyometric exercises.

  16. Comparative study of the efficacy of eprinomectin versus ivermectin, and field efficacy of eprinomectin only, for the treatment of chorioptic mange in alpacas.

    PubMed

    D'Alterio, G L; Jackson, A P; Knowles, T G; Foster, A P

    2005-06-30

    The efficacy of eprinomectin versus ivermectin (Study 1: a single-centre, randomised, treatment-controlled, blinded field trial), and the field efficacy of eprinomectin (Study 2: a single-centre, open, un-controlled field trial) for the treatment of chorioptic infestation in naturally infested alpacas were assessed in two studies. Thirty alpacas, all positive for Chorioptes sp. mite, were randomly allocated to two treatment groups in Study 1. Group A received a single topical administration of a 0.5% formulation of eprinomectin at the dose rate of 500mug/kg. Group B received three subcutaneous administrations at 14 days interval of a 1% formulation of ivermectin at the dose rate of 400mug/kg. Response to treatment was assessed by periodic mite count, and skin lesions scored. In Study 2, one group of 19 alpacas received four administrations at weekly interval of topical eprinomectin at the dose rate of 500mug/kg, and response to treatment was monitored by mite counts. No localised or systemic side effects were observed in either trial. There was a statistically significant decrease in mite counts on day 7 (P<0.001) within treatment Groups A and B of Study 1, but mite counts increased again on day 14 and remained high for the duration of the trial in both treatment groups. On day 14 of Study 2, there was a statistically significant reduction in mite counts (P<0.008) and the mite counts remained very low throughout the remainder of the study. The eprinomectin protocol employed in Study 2, consisting of four weekly topical administrations at the dose rate of 500mug/kg of body weight, proved highly effective at reducing the Chorioptes mite burden in alpacas.

  17. Impact of long-term treatment of onchocerciasis with ivermectin in Kaduna State, Nigeria: first evidence of the potential for elimination in the operational area of the African Programme for Onchocerciasis Control

    PubMed Central

    2012-01-01

    Background Onchocerciasis can be effectively controlled as a public health problem by annual mass drug administration of ivermectin, but it was not known if ivermectin treatment in the long term would be able to achieve elimination of onchocerciasis infection and interruption of transmission in endemic areas in Africa. A recent study in Mali and Senegal has provided the first evidence of elimination after 15-17 years of treatment. Following this finding, the African Programme for Onchocerciasis Control (APOC) has started a systematic evaluation of the long-term impact of ivermectin treatment projects and the feasibility of elimination in APOC supported countries. This paper reports the first results for two onchocerciasis foci in Kaduna, Nigeria. Methods In 2008, an epidemiological evaluation using skin snip parasitological diagnostic method was carried out in two onchocerciasis foci, in Birnin Gwari Local Government Area (LGA), and in the Kauru and Lere LGAs of Kaduna State, Nigeria. The survey was undertaken in 26 villages and examined 3,703 people above the age of one year. The result was compared with the baseline survey undertaken in 1987. Results The communities had received 15 to 17 years of ivermectin treatment with more than 75% reported coverage. For each surveyed community, comparable baseline data were available. Before treatment, the community prevalence of O. volvulus microfilaria in the skin ranged from 23.1% to 84.9%, with a median prevalence of 52.0%. After 15 to 17 years of treatment, the prevalence had fallen to 0% in all communities and all 3,703 examined individuals were skin snip negative. Conclusions The results of the surveys confirm the finding in Senegal and Mali that ivermectin treatment alone can eliminate onchocerciasis infection and probably disease transmission in endemic foci in Africa. It is the first of such evidence for the APOC operational area. PMID:22313631

  18. Impact of long-term treatment of onchocerciasis with ivermectin in Kaduna State, Nigeria: first evidence of the potential for elimination in the operational area of the African Programme for Onchocerciasis Control.

    PubMed

    Tekle, Afework Hailemariam; Elhassan, Elizabeth; Isiyaku, Sunday; Amazigo, Uche V; Bush, Simon; Noma, Mounkaila; Cousens, Simon; Abiose, Adenike; Remme, Jan H

    2012-02-07

    Onchocerciasis can be effectively controlled as a public health problem by annual mass drug administration of ivermectin, but it was not known if ivermectin treatment in the long term would be able to achieve elimination of onchocerciasis infection and interruption of transmission in endemic areas in Africa. A recent study in Mali and Senegal has provided the first evidence of elimination after 15-17 years of treatment. Following this finding, the African Programme for Onchocerciasis Control (APOC) has started a systematic evaluation of the long-term impact of ivermectin treatment projects and the feasibility of elimination in APOC supported countries. This paper reports the first results for two onchocerciasis foci in Kaduna, Nigeria. In 2008, an epidemiological evaluation using skin snip parasitological diagnostic method was carried out in two onchocerciasis foci, in Birnin Gwari Local Government Area (LGA), and in the Kauru and Lere LGAs of Kaduna State, Nigeria. The survey was undertaken in 26 villages and examined 3,703 people above the age of one year. The result was compared with the baseline survey undertaken in 1987. The communities had received 15 to 17 years of ivermectin treatment with more than 75% reported coverage. For each surveyed community, comparable baseline data were available. Before treatment, the community prevalence of O. volvulus microfilaria in the skin ranged from 23.1% to 84.9%, with a median prevalence of 52.0%. After 15 to 17 years of treatment, the prevalence had fallen to 0% in all communities and all 3,703 examined individuals were skin snip negative. The results of the surveys confirm the finding in Senegal and Mali that ivermectin treatment alone can eliminate onchocerciasis infection and probably disease transmission in endemic foci in Africa. It is the first of such evidence for the APOC operational area.

  19. Fasciola hepatica: influence of gender and liver biotransformations on flukicide treatment efficacy of rats infested and cured with either clorsulon/ivermectin or triclabendazole.

    PubMed

    Sibille, P; Calléja, C; Carreras, F; Bigot, K; Galtier, P; Boulard, C

    2000-04-01

    Two fasciolicide preparations have been compared in 130 rats experimentally infected with Fasciola hepatica. Parasitological, immunological, and biochemical parameters have been followed to monitor the efficacy of the treatments. While Fascinex (triclabendazole) efficiently cured both male and female rats when administered as soon as 4 weeks postinfection, treatment with Ivomec-D (clorsulon + ivermectin) displayed a low efficacy on either male or female rats at this time point (54 and 0%, respectively). Moreover, when administered 8 weeks postinfection, the Ivomec-D treatment proved highly efficient on male rats while it displayed little effect on the female population (100 and 53%, respectively). This unexpected result has been related to an overexpression of a P4503A isoform that is observed only in females that have been treated with Ivomec-D. The influence of this P4503A cytochrome on drug metabolism and the need for the incorporation of both genders in clinical trials are discussed.

  20. The geographic distribution of onchocerciasis in the 20 participating countries of the African Programme for Onchocerciasis Control: (1) priority areas for ivermectin treatment.

    PubMed

    Noma, Mounkaila; Zouré, Honorat G M; Tekle, Afework H; Enyong, Peter A I; Nwoke, Bertram E B; Remme, Jan H F

    2014-07-22

    The African Programme for Onchocerciasis Control (APOC) was created to control onchocerciasis as a public health problem in 20 African countries. Its main strategy is community directed treatment with ivermectin. In order to identify all high risk areas where ivermectin treatment was needed, APOC used Rapid Epidemiological Mapping of Onchocerciasis (REMO). REMO has now been virtually completed and we report the results in two articles. The present article reports the mapping of high risk areas where onchocerciasis was a public health problem. The companion article reports the results of a geostatistical analysis of the REMO data to map endemicity levels and estimate the number infected. REMO consists of three stages: exclusion of areas that are unsuitable for the vector, selection of sample villages to be surveyed in each river basin, and examination of 30 to 50 adults for the presence of palpable onchocercal nodules in each selected village. The survey results and other relevant information were processed in a geographical information system. A panel of experts interpreted the data taking the river-based sampling into account and delineated high risk areas where the prevalence of nodules is greater than 20%. Unsuitable areas were identified in eight countries. In the remaining areas surveys were done in a total of 14,473 sample villages in which more than half a million people were examined. High-risk areas were identified in 18 APOC countries, ranging from small isolated foci to a vast contiguous endemic area of 2 million km2 running across seven countries. In five countries the high risk area covered more than 48% of the total surface area, and 31% to 48% of the population. It is estimated that 86 million people live in high risk areas in the APOC countries. The REMO maps have played a significant role in onchocerciasis control in the 20 APOC countries. All high-risk areas where onchocerciasis used to be a serious public health problem have been clearly

  1. The geographic distribution of onchocerciasis in the 20 participating countries of the African Programme for Onchocerciasis Control: (1) priority areas for ivermectin treatment

    PubMed Central

    2014-01-01

    Background The African Programme for Onchocerciasis Control (APOC) was created to control onchocerciasis as a public health problem in 20 African countries. Its main strategy is community directed treatment with ivermectin. In order to identify all high risk areas where ivermectin treatment was needed, APOC used Rapid Epidemiological Mapping of Onchocerciasis (REMO). REMO has now been virtually completed and we report the results in two articles. The present article reports the mapping of high risk areas where onchocerciasis was a public health problem. The companion article reports the results of a geostatistical analysis of the REMO data to map endemicity levels and estimate the number infected. Methods REMO consists of three stages: exclusion of areas that are unsuitable for the vector, selection of sample villages to be surveyed in each river basin, and examination of 30 to 50 adults for the presence of palpable onchocercal nodules in each selected village. The survey results and other relevant information were processed in a geographical information system. A panel of experts interpreted the data taking the river-based sampling into account and delineated high risk areas where the prevalence of nodules is greater than 20%. Results Unsuitable areas were identified in eight countries. In the remaining areas surveys were done in a total of 14,473 sample villages in which more than half a million people were examined. High-risk areas were identified in 18 APOC countries, ranging from small isolated foci to a vast contiguous endemic area of 2 million km2 running across seven countries. In five countries the high risk area covered more than 48% of the total surface area, and 31% to 48% of the population. It is estimated that 86 million people live in high risk areas in the APOC countries. Conclusions The REMO maps have played a significant role in onchocerciasis control in the 20 APOC countries. All high-risk areas where onchocerciasis used to be a serious public

  2. Advantages of ivermectin at a single dose of 400 micrograms/kg compared with 100 micrograms/kg for community treatment of lymphatic filariasis in Polynesia.

    PubMed

    Nguyen, N L; Moulia-Pelat, J P; Glaziou, P; Martin, P M; Cartel, J L

    1994-01-01

    In April and October in 1991-1993, 5 supervised single doses of ivermectin were given to inhabitants aged > or = 3 years in a Polynesian district: the first 3 treatments were with 100 micrograms/kg and the 2 latter with 400 micrograms/kg. At each treatment, about 97% of the eligible population (899) were treated and blood samples were collected just before treatment from 96% of the 613 inhabitants aged > or = 15 years. Following the 5 successive treatments, adverse reactions were observed in, respectively, 23.8, 13, 6.2, 13.6 and 7.9% of the microfilariae (mf) carriers, and in less than 1% of amicrofilaraemic subjects. Neither the frequency nor the intensity of adverse reactions was significantly different between single doses of 100 micrograms/kg and 400 micrograms/kg. Although the geometric mean microfilaraemia (GMM) was reduced, the mf carrier prevalence remained unchanged before and after 3 mass treatments with 100 micrograms/kg (21.4 and 20.7% respectively), and the mf recurrence rate 6 months after each dose of 100 micrograms/kg was roughly stable (respectively, 34.3%, 21.6% and 31.2% of the initial GMM). In contrast, after one dose round of 400 micrograms/kg, the mf carrier prevalence decreased significantly to 14.9% (P < 10(-6)), and the mf recurrence rate dropped to 9.9% (P < 10(-3)) of the initial GMM. These results confirm the safety and the effectiveness of 400 micrograms/kg of ivermectin for lymphatic filariasis control.

  3. Ivermectin and onchocerciasis: is it all solved?

    PubMed

    Hopkins, A D

    2005-10-01

    The donation of ivermectin by Merck and Co. Inc. has led to one of the most effective private-public partnerships controlling a disease of major public health importance particularly in Africa. The up scaling of ivermectin distribution during the last 15 years has been remarkable with almost 40 million people treated in 2003, many already on their regular annual dose. The tools that have been developed particularly by the APOC programme have been instrumental in this increase. However, ivermectin is a microfilaricide and does not kill the adult worms. Distribution will be needed for at least 25 years and latest estimates indicate that 90 million people need annual treatment if onchocerciasis is to be eliminated as a public health problem. In spite of this incredible progress it is difficult to see how the programme will be sustained, especially after the closure of APOC in 2010. A macrofilaricide destroying adult worms and safe for mass distribution would solve the problem of onchocerciasis.

  4. Ivermectin: pharmacology and application in dermatology.

    PubMed

    Dourmishev, Assen L; Dourmishev, Lyubomir A; Schwartz, Robert A

    2005-12-01

    Ivermectin is a synthetic derivative of the antiparasitic class of compounds known as avermectins. It is a macrolide endectocide with activity against both endoparasites with cutaneous tropism (Strongyloides stercoralis, Ancylostoma braziliense, Cochliomyia hominivorax, Dermatobia hominis, Filaria bancrofti, Wucheria malayi, Onchocerca volvulus, Loa-loa) and ectoparasites such as Sarcoptes scabies, Pediculus humanus, Demodex folliculorum, and Cheyletiella sp. Ivermectin is of great interest in the treatment of patients with different forms of scabies, head lice, demodecidosis, cutaneous larva migrans, cutaneous larva currens, myiasis, and filariasis.

  5. The effects of ivermectin on transmission of Onchocerca volvulus.

    PubMed

    Cupp, E W; Bernardo, M J; Kiszewski, A E; Collins, R C; Taylor, H R; Aziz, M A; Greene, B M

    1986-02-14

    Ivermectin, given to onchocerciasis patients as a single oral dose of 200 micrograms per kilogram of body weight, substantially reduced the uptake of Onchocerca volvulus microfilariae by Simulium yahense, an efficient black fly vector of the parasite in the tropical rain forests of West Africa. Three months after treatment, patients given ivermectin infected flies at a significantly lower rate than those who had received diethylcarbamazine or placebo, thereby reducing the number of developing larvae in the vector population. This diminished rate of infectiousness was also evident 6 months after treatment. These results strongly suggest that ivermectin could be effective in interrupting transmission of Onchocerca volvulus for epidemiologically important periods of time.

  6. Effects of the veterinary pharmaceutical ivermectin in indoor aquatic microcosms.

    PubMed

    Boonstra, Harry; Reichman, Erik P; van den Brink, Paul J

    2011-01-01

    The effects of the parasiticide ivermectin were assessed in plankton-dominated indoor microcosms. Ivermectin was applied once at concentrations of 30, 100, 300, 1000, 3000, and 10,000 ng/l. The half-life (dissipation time 50%; DT₅₀) of ivermectin in the water phase ranged from 1.1 to 8.3 days. The lowest NOEC(community) that could be derived on an isolated sampling from the microcosm study by means of multivariate techniques was 100 ng/l. The most sensitive species in the microcosm study were the cladocerans Ceriodaphnia sp. (no observed effect concentration, NOEC = 30 ng/l) and Chydorus sphaericus (NOEC = 100 ng/l). The amphipod Gammarus pulex was less sensitive to ivermectin, showing consistent statistically significant reductions at the 1000-ng/l treatment level. Copepoda taxa decreased directly after application of ivermectin in the highest treatment but had already recovered at day 20 posttreatment. Indirect effects (e.g., increase of rotifers, increased primary production) were observed at the highest treatment level starting only on day 13 of the exposure phase. Cladocera showed the highest sensitivity to ivermectin in both standard laboratory toxicity tests as well as in the microcosm study. This study demonstrates that simple plankton-dominated test systems for assessing the effects of ivermectin can produce results similar to those obtained with large complex outdoor systems.

  7. Effects of the Veterinary Pharmaceutical Ivermectin in Indoor Aquatic Microcosms

    PubMed Central

    Boonstra, Harry; Reichman, Erik P.

    2010-01-01

    The effects of the parasiticide ivermectin were assessed in plankton-dominated indoor microcosms. Ivermectin was applied once at concentrations of 30, 100, 300, 1000, 3000, and 10,000 ng/l. The half-life (dissipation time 50%; DT50) of ivermectin in the water phase ranged from 1.1 to 8.3 days. The lowest NOECcommunity that could be derived on an isolated sampling from the microcosm study by means of multivariate techniques was 100 ng/l. The most sensitive species in the microcosm study were the cladocerans Ceriodaphnia sp. (no observed effect concentration, NOEC = 30 ng/l) and Chydorus sphaericus (NOEC = 100 ng/l). The amphipod Gammarus pulex was less sensitive to ivermectin, showing consistent statistically significant reductions at the 1000-ng/l treatment level. Copepoda taxa decreased directly after application of ivermectin in the highest treatment but had already recovered at day 20 posttreatment. Indirect effects (e.g., increase of rotifers, increased primary production) were observed at the highest treatment level starting only on day 13 of the exposure phase. Cladocera showed the highest sensitivity to ivermectin in both standard laboratory toxicity tests as well as in the microcosm study. This study demonstrates that simple plankton-dominated test systems for assessing the effects of ivermectin can produce results similar to those obtained with large complex outdoor systems. PMID:20422169

  8. [Bullous scabies responding to ivermectin therapy].

    PubMed

    Galvany Rossell, L; Salleras Redonnet, M; Umbert Millet, P

    2010-01-01

    Bullous scabies is a rare disease that is usually diagnosed in elderly patients. The clinical, histological, and immunological findings are identical to bullous pemphigoid. In a review of the literature, we found reports of 24 cases. We present a new case of bullous scabies in a 72-year-old man. The lesions responded to treatment with oral ivermectin.

  9. Clinical picture, epidemiology and outcome of Loa-associated serious adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon

    PubMed Central

    Boussinesq, Michel; Gardon, Jacques; Gardon-Wendel, Nathalie; Chippaux, Jean-Philippe

    2003-01-01

    In August 2002, 65 cases of Loa-associated neurological Serious Adverse Events were reported after ivermectin treatment. The first signs, occurring within the 12–24 hours following treatment, included fatigue, generalized arthralgia, and sometimes agitation, mutism, and incontinence. Disorders of consciousness, including coma, generally appeared between 24 and 72 hours, and showed a rapid variation with time. The most frequent objective neurological signs were extrapyramidal. The patients presented with haemorrhages of the conjunctiva and of the retina. Biological examinations showed a massive Loa microfilaruria, the passage of Loa microfilariae into the cerebrospinal fluid, haematuria, and an increase in the C-reactive protein, all of which have been correlated with the high intensity of the initial Loa microfilaraemia. Eosinophil counts decreased dramatically within the first 24 hours, and then rose again rapidly. Electroencephalograms suggested the existence of a diffuse pathological process within the first weeks; the abnormalities disappearing after 3–6 months. Death may occur when patients are not properly managed, i.e. in the absence of good nursing. However, some patients who recovered showed sequelae such as aphasia, episodic amnesia, or extrapyramidal signs. The main risk factor for these encephalopathies is the intensity of the initial Loa microfilaraemia. The disorders of consciousness may occur when there are >50,000 Loa microfilariae per ml. The possible roles of co-factors, such as Loa strains, genetic predisposition of individuals, co-infestations with other parasites, or alcohol consumption, seem to be minor but they should be considered. The mechanisms of the post-ivermectin Loa-related encephalopathies should be investigated to improve the management of patients developing the condition. PMID:14975061

  10. Efficacy and safety of the mosquitocidal drug ivermectin to prevent malaria transmission after treatment: a double-blind, randomized, clinical trial.

    PubMed

    Ouédraogo, André Lin; Bastiaens, Guido J H; Tiono, Alfred B; Guelbéogo, Wamdaogo M; Kobylinski, Kevin C; Ouédraogo, Alphonse; Barry, Aïssata; Bougouma, Edith C; Nebie, Issa; Ouattara, Maurice San; Lanke, Kjerstin H W; Fleckenstein, Lawrence; Sauerwein, Robert W; Slater, Hannah C; Churcher, Thomas S; Sirima, Sodiomon B; Drakeley, Chris; Bousema, Teun

    2015-02-01

    Artemisinin combination therapy effectively clears asexual malaria parasites and immature gametocytes but does not prevent posttreatment malaria transmission. Ivermectin (IVM) may reduce malaria transmission by killing mosquitoes that take blood meals from IVM-treated humans. In this double-blind, placebo-controlled trial, 120 asymptomatic Plasmodium falciparum parasite carriers were randomized to receive artemether-lumefantrine (AL) plus placebo or AL plus a single or repeated dose (200 µg/kg) of ivermectin (AL-IVM1 and AL-IVM2, respectively). Mosquito membrane feeding was performed 1, 3, and 7 days after initiation of treatment to determine Anopheles gambiae and Anopheles funestus survival and infection rates. The AL-IVM combination was well tolerated. IVM resulted in a 4- to 7-fold increased mortality in mosquitoes feeding 1 day after IVM (P < .001). Day 7 IVM plasma levels were positively associated with body mass index (r = 0.57, P < .001) and were higher in female participants (P = .003), for whom An. gambiae mosquito mortality was increased until 7 days after a single dose of IVM (hazard rate ratio, 1.34 [95% confidence interval, 1.07-1.69]; P = .012). Although we found no evidence that IVM reduced Plasmodium infection rates among surviving mosquitoes, the mosquitocidal effect of AL-IVM1 and AL-IVM2 resulted in 27% and 35% reductions, respectively, in estimated malaria transmission potential during the first week after initiation of treatment. We conclude that IVM can be safely given in combination with AL and can reduce the likelihood of malaria transmission by reducing the life span of feeding mosquitoes. NCT0160325. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Comparison of ivermectin and benzyl benzoate lotion for scabies in Nigerian patients.

    PubMed

    Sule, Halima M; Thacher, Tom D

    2007-02-01

    Few studies have compared ivermectin directly with topical agents in developing countries. We compared the effectiveness of oral ivermectin (200 microg/kg) with topical 25% benzyl benzoate and monosulfiram soap in 210 subjects of age 5 to 65 years with scabies. Subjects with persistent lesions after 2 weeks received a second course of treatment. All lesions had resolved after 2 weeks in 77 of 98 (79%) subjects treated with ivermectin and in 60 of 102 (59%) subjects treated topically (P = 0.003). The improvement in severity score was greater in the ivermectin group than in the topical treatment group (P < 0.001). The overall cure rate after 4 weeks was 95% in the ivermectin group and 86% in the topical treatment group (P = 0.04). Compared with topical benzyl benzoate and monosulfiram in the treatment of scabies, ivermectin was at least as effective and led to more rapid improvement.

  12. Prevalence of Lymphatic Filariasis and Treatment Effectiveness of Albendazole/ Ivermectin in Individuals with HIV Co-infection in Southwest-Tanzania

    PubMed Central

    Maganga, Lucas; Clowes, Petra; Maboko, Leonard; Hoerauf, Achim; Makunde, Williams H.; Haule, Antelmo; Mviombo, Prisca; Pitter, Bettina; Mgeni, Neema; Mabuye, Joseph; Kowuor, Dickens; Mwingira, Upendo; Malecela, Mwelecele N.; Löscher, Thomas; Hoelscher, Michael

    2016-01-01

    Background Annual mass treatment with ivermectin and albendazole is used to treat lymphatic filariasis in many African countries, including Tanzania. In areas where both diseases occur, it is unclear whether HIV co-infection reduces treatment success. Methodology In a general population study in Southwest Tanzania, individuals were tested for HIV and circulating filarial antigen, an indicator of Wuchereria bancrofti adult worm burden, before the first and after 2 consecutive rounds of anti-filarial mass drug administration. Principle Findings Testing of 2104 individuals aged 0–94 years before anti-filarial treatment revealed a prevalence of 24.8% for lymphatic filariasis and an HIV-prevalence of 8.9%. Lymphatic filariasis was rare in children, but prevalence increased in individuals above 10 years, whereas a strong increase in HIV was only seen above 18 years of age. The prevalence of lymphatic filariasis in adults above 18 years was 42.6% and 41.7% (p = 0.834) in HIV-negatives and–positives, respectively. Similarly, the HIV prevalence in the lymphatic filariasis infected (16.6%) and uninfected adult population (17.1%) was nearly the same. Of the above 2104 individuals 798 were re-tested after 2 rounds of antifilarial treatment. A significant reduction in the prevalence of circulating filarial antigen from 21.6% to 19.7% was found after treatment (relative drop of 8.8%, McNemar´s exact p = 0.036). Furthermore, the post-treatment reduction of CFA positivity was (non-significantly) larger in HIV-positives than in HIV-negatives (univariable linear regression p = 0.154). Conclusion/Significance In an area with a high prevalence for both diseases, no difference was found between HIV-infected and uninfected individuals regarding the initial prevalence of lymphatic filariasis. A moderate but significant reduction in lymphatic filariasis prevalence and worm burden was demonstrated after two rounds of treatment with albendazole and ivermectin. Treatment effects were

  13. Immunohistological and electron microscopic studies of microfilariae in skin and lymph nodes from onchocerciasis patients after ivermectin treatment.

    PubMed

    Darge, K; Lucius, R; Monson, M H; Behrendsen, J; Büttner, D W

    1991-12-01

    Microfilariae were studied in skin and lymph node biopsies from Liberian patients with generalised onchocerciasis 12-78 hours after administration of a single dose of 150 micrograms/kg body weight using histology, transmission electron microscopy and immunocytological staining with antibodies against an immunodominant antigen of Onchocerca volvulus. Most microfilariae in the skin appeared morphologically intact and beginning signs of degeneration were seen only on the ultrastructural level. The densities of microfilariae in the lymph nodes were about thousandfold higher in ivermectin treated patients. More than 90% of the microfilariae in the lymph nodes showed distinct signs of degeneration. Early changes were seen in the muscle cells. The disintegrating microfilariae in the lymph nodes were always encircled by eosinophils or macrophages or both cells. Immunohistological staining with antifilarial antibodies increased the detection of small and disintegrating pieces of microfilariae considerably.

  14. Treatment and prevention of natural heartworm (Dirofilaria immitis) infections in red pandas (Ailurus fulgens) with selamectin and ivermectin.

    PubMed

    Lan, Jingchao; Fu, Yan; Yang, Zhi; Zhang, Zhihe; Wang, Chengdong; Luo, Li; Liu, Li; Gu, Xiaobin; Wang, Shuxian; Peng, Xuerong; Yang, Guangyou

    2012-06-01

    Ten of the 48 red pandas in the Chengdu Research Base of Giant Panda Breeding, Sichuan province, China, died in 2006 after prolonged periods of depression, weight loss, and mucocutaneous membrane xanthochromia. During postmortem examination, live heartworms were found in the right cardiac ventricles and pulmonary arteries of all 10 animals. Selamectin and ivermectin were used for clinical prophylaxis in the remaining red pandas between December 2006 and November 2010. We observed a gradual decrease in morbidity and mortality during this period. As a consequence of our prophylaxis program, dirofilariosis did not occur in the remaining red pandas at Chengdu Research Base during 2010. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Use of ivermectin for the management of scabies in a nursing home.

    PubMed

    Dannaoui, E; Kiazand, A; Piens, M; Picot, S

    1999-09-01

    Ivermectin was used for the treatment of a scabies outbreak in a nursing home. Among the 128 residents, 42 presented pruritus or cutaneous lesions and scabies was parasitologically demonstrated in seven patients. All residents were treated with two 12 mg doses of ivermectin given two weeks apart. Ivermectin treatment associated with procedures for environmental disinfection led to the control of the outbreak. In only one case, was there a failure of the treatment. It is concluded that oral ivermectin is an effective and practical therapy for scabies in nursing homes.

  16. Twelve-month longitudinal parasitological assessment of lymphatic filariasis-positive individuals: impact of a biannual treatment with ivermectin and albendazole.

    PubMed

    Kanamitie, John N; Ahorlu, Collins S; Otchere, Joseph; Aboagye-Antwi, Fred; Kwansa-Bentum, Bethel; Boakye, Daniel A; Biritwum, Nana-Kwadwo; Wilson, Michael D; de Souza, Dziedzom K

    2017-09-11

    Mass drug administration (MDA) for the control of lymphatic filariasis (LF), in Ghana, started in the year 2000. While this had great success in many implementation units, there remain areas with persistent transmission, after more than 10 years of treatment. A closer examination of the parasite populations could help understand the reasons for persistent infections and formulate appropriate strategies to control LF in these areas of persistent transmission. In a longitudinal study, we assessed the prevalence of microfilaraemia (mf) in two communities with 12 years of MDA in Ghana. In baseline surveys 6 months after the National MDA in 2014, 370 consenting individuals were tested for antigenaemia using immunochromatographic test (ICT) cards and had their mf count determined through night blood surveys. 48 ICT positives, of whom, 17 were positive for mf, were treated with 400 μg/kg ivermectin + 400 mg albendazole and subsequently followed for parasitological assessment at 3-month intervals for 1 year. This overlapped with the National MDA in 2015. There was a 68% parasite clearance 3 months after treatment. The pre-treatment mf count differed significantly from the post-treatment mf counts at 3 months (P = 0.0023), 6 months (P = 0.0051), 9 months (P = 0.0113) and 12 months (P = 0.0008). In these settings with persistent LF transmission, twice-yearly treatment may help accelerate LF elimination. Further large-scale evaluations are required to ascertain these findings. © 2017 John Wiley & Sons Ltd.

  17. Toxicity and efficacy of ivermectin in chelonians.

    PubMed

    Teare, J A; Bush, M

    1983-12-01

    Five red-footed tortoises (Geochelone carbonaria) treated for intestinal nematode parasitism with a single IM injection of ivermectin (0.4 mg/kg) were found in a state of extreme paresis or flaccid paralysis. One tortoise recovered normal motor function over the next 7 to 10 days. The remaining tortoises died within 3 days of receiving the ivermectin. The only consistent postmortem finding was a marked fatty change in the liver. Studies in the red-footed tortoise showed that some paresis will occur with dosages as low as 0.05 mg/kg. At least 3 other species of chelonians were found to be susceptible to ivermectin toxicosis at similar dosages (0.1 mg/kg or less). The leopard tortoise (Geochelone pardalis) appeared to be the most susceptible of the species tested, consistently developing mild paresis with a dosage of 0.025 mg/kg. Death occurred with dosages as low as 0.3 mg/kg. A dosage of 0.05 mg/kg was found to be safe in red-footed tortoises, provided that treatment was not repeated at intervals of less than 7 days. Shedding of nematode larvae and eggs in the feces of parasitized red-footed tortoises was prevented with 2 to 6 weekly IM injections of ivermectin at a dosage of 0.05 mg/kg, but limited necropsy findings indicated that elimination of adult nematodes from the intestines was incomplete.

  18. [Safety of oral ivermectin in children].

    PubMed

    Chosidow, A; Gendrel, D

    2016-02-01

    Ivermectin is an antiparasitic drug, a derivate of avermectins, and a product of fermentation of an actinomycete, Streptomyces avermitilis. Its structure associates two avermectins. Ivermectin acts on the chloride-dependent channels of both glutamate and γ-aminobutyric acid, interrupting neurotransmission in invertebrates. In humans, several mechanisms of brain protection exist, including P-glycoprotein, present on the apical face of endothelial cells of the blood-brain barrier and coded by the MDR1 gene. Ivermectin is presently used in mass treatment of onchocerciasis, other filariasis, some intestinal nematode infections, but also in scabies, and more rarely in resistant head lice. The side effects described are related to the release of antigen and cause an inflammatory reaction. Studies conducted in children or infants have shown good tolerance of ivermectin. However, its use in infants who weigh less than 15kg is a problem because of the absence of marketing authorization for this age group. However, the risk of excessive and uncontrolled use in head lice requires close surveillance. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Searching for ivermectin resistance in Dutch horses.

    PubMed

    van Doorn, D C K; Eysker, M; Kooyman, F N J; Wagenaar, J A; Ploeger, H W

    2012-04-30

    A study was conducted to evaluate the occurrence of resistance against, in particular, ivermectin in cyathostomins in the Netherlands. Seventy horse farms were visited between October 2007 and November 2009. In initial screening, faecal samples were collected 2 weeks after deworming with either ivermectin, moxidectin or doramectin. Pooled faecal samples from a maximum of 10 horses were examined for worm eggs using a modified McMaster technique and for worm larvae after faecal larval cultures. In total 931 horses were involved. On 15 of 70 farms eggs and/or larvae were found. On 8 of these 15 farms a FECRT with ivermectin was performed on 43 horses. Efficacy of ivermectin against cyathostomins of 93% was found in one animal on one farm. Additionally, the strategies and efforts of the horse owners to control cyathostomins, as well as risk factors for the development of macrocyclic lactone resistance were evaluated with a questionnaire. Strikingly, many responders indicated that the control of cyathostomins in horses is achieved through very frequent deworming. Fourteen percent of these owners deworm seven times per year or more. On 34% of the 70 farms treatment was repeated within the Egg Reappearance Period of a product.

  20. Topical Ivermectin 10 mg/g and Oral Doxycycline 40 mg Modified-Release: Current Evidence on the Complementary Use of Anti-Inflammatory Rosacea Treatments.

    PubMed

    Steinhoff, Martin; Vocanson, Marc; Voegel, Johannes J; Hacini-Rachinel, Feriel; Schäfer, Gregor

    2016-09-01

    Rosacea is a common, chronic inflammatory skin disease that can present with a variety of signs and symptoms. The potentially simultaneous occurrence of different signs and symptoms is due to different underlying inflammatory pathways, emphasizing the need for complementary treatment approaches. Topical ivermectin cream (10 mg/g) and systemic, oral anti-inflammatory doxycycline (40 mg modified-release) are both approved for the treatment of papulopustular rosacea (PPR). Whether or not a combined therapeutic approach may be more beneficial than monotherapy for patients with PPR remains to be tested. Here, we summarize underlying inflammatory pathways implicated in rosacea and clarify the impact of these two agents on selective pathways during inflammation, due to specific characteristics of their individual mechanisms of action (MoA). Based on the complementary MoA of doxycycline modified-release and ivermectin, a scientific rationale for a combined therapy targeting inflammatory lesions in rosacea is given. We propose that topical ivermectin cream is a promising new candidate as first-line treatment to target the inflammatory lesions of rosacea, which can be used in combination with systemic doxycycline modified-release to provide an optimal treatment approach considering all inflammatory pathways involved in PPR. Funding Galderma.

  1. Double-blind study of ivermectin and diethylcarbamazine in African onchocerciasis patients with ocular involvement.

    PubMed

    Lariviere, M; Vingtain, P; Aziz, M; Beauvais, B; Weimann, D; Derouin, F; Ginoux, J; Schulz-Key, H; Gaxotte, P; Basset, D

    1985-07-27

    In a randomised double-blind study, ivermectin was compared with diethylcarbamazine (DEC) and placebo in the treatment of onchocerciasis in 30 male patients from Mali with moderate to heavy Onchocerca volvulus infections and ocular involvement. 10 patients received a single oral dose of ivermectin, 12 mg, 10 received DEC daily for eight days (total dose 1.3 g), and 10 received matching placebo. Patients were examined periodically for twelve months. Punctate keratitis disappeared in 6 of 7 ivermectin patients but increased in DEC patients. Numbers of O volvulus microfilariae (mf) in the anterior chamber decreased slowly and eventually disappeared in most ivermectin patients during the six months following treatment; anterior chamber mf disappeared more rapidly in some patients after DEC, but reappeared within six months of stopping treatment. Both ivermectin and DEC caused a prompt decrease in mean skin mf density; density then increased in both groups over the twelve month observation period, reaching 9% of pretreatment values in ivermectin patients and 45% in the DEC group. Analysis of adult O volvulus from nodules excised at three and twelve months post treatment showed no effect of either drug on viability; however, there was evidence of degeneration of intra-uterine developing mf in the ivermectin group. Side-effects were less frequent and less severe in ivermectin patients than in DEC patients. Ivermectin as a single oral dose appears to be a more effective microfilaricidal drug than DEC in onchocerciasis.

  2. Ventilating Air-Conditioner

    NASA Technical Reports Server (NTRS)

    Dinh, Khanh

    1994-01-01

    Air-conditioner provides ventilation designed to be used alone or incorporated into cooling or heating system operates efficiently only by recirculating stale air within building. Energy needed to operate overall ventilating cooling or heating system slightly greater than operating nonventilating cooling or heating system. Helps to preserve energy efficiency while satisfying need for increased forced ventilation to prevent accumulation of undesired gases like radon and formaldehyde. Provides fresh treated air to variety of confined spaces: hospital surgeries, laboratories, clean rooms, and printing shops and other places where solvents used. In mobile homes and portable classrooms, eliminates irritant chemicals exuded by carpets, panels, and other materials, ensuring healthy indoor environment for occupants.

  3. Ventilating Air-Conditioner

    NASA Technical Reports Server (NTRS)

    Dinh, Khanh

    1994-01-01

    Air-conditioner provides ventilation designed to be used alone or incorporated into cooling or heating system operates efficiently only by recirculating stale air within building. Energy needed to operate overall ventilating cooling or heating system slightly greater than operating nonventilating cooling or heating system. Helps to preserve energy efficiency while satisfying need for increased forced ventilation to prevent accumulation of undesired gases like radon and formaldehyde. Provides fresh treated air to variety of confined spaces: hospital surgeries, laboratories, clean rooms, and printing shops and other places where solvents used. In mobile homes and portable classrooms, eliminates irritant chemicals exuded by carpets, panels, and other materials, ensuring healthy indoor environment for occupants.

  4. Variable response of crusted scabies to oral ivermectin: report on eight Egyptian patients.

    PubMed

    Nofal, A

    2009-07-01

    Several reports have proved the efficacy of oral ivermectin in the treatment of crusted scabies. However, the response varied greatly between different studies. The aim of this study was to evaluate the response of crusted scabies to oral ivermectin in eight Egyptian patients. Eight patients with crusted scabies, diagnosed clinically and confirmed microscopically, were involved in this study. Patients received a single oral dose of ivermectin (200 microg/kg) and re-examined at 2, 4, 6 and 8 weeks. A second dose of ivermectin was given in case of treatment failure at the end of the second week. A third dose of ivermectin, combined with permethrin 5% and salicylic acid 5% was given at the end of the fourth week for the nonresponders to the second dose. Two patients were completely cured after a single dose of ivermectin, 4 patients required a second dose at a 2-week interval to achieve cure and 2 patients cleared from scabies after the combined therapy. No recurrence was reported at the end of 8 weeks. An inverse relation was observed between the response to ivermectin and the severity of immunosuppression, crust thickness and mite burden. Oral ivermectin is an effective alternative therapy for the treatment of crusted scabies. The response of crusted scabies to oral ivermectin is variable and combination therapy with topical scabicides and keratolytics seems to be the best choice.

  5. Ivermectin does not reduce the burden of itching in an onchocerciasis endemic community.

    PubMed

    Whitworth, J A; Luty, A J; Maude, G H; Morgan, D; Downham, M D; Taylor, D W

    1992-01-01

    Degrees of itching were estimated before and for 6 months after a fourth dose of ivermectin or placebo was given to 97 subjects in Sierra Leone. There was no reduction in itching attributable to ivermectin at any stage, but there were non-significant increases in the prevalence, severity and localization of itching within the first 2 months after ivermectin compared to placebo. We also found that cell-mediated immune responses to Onchocerca volvulus were significantly increased 4 weeks after a single dose of ivermectin compared to before treatment. A temporary reversal of the state of immunosuppression in people with onchocerciasis may counterbalance the reduction in skin microfilarial loads following ivermectin, with no consequent reduction in itching. The lack of effect of ivermectin on itching, a major symptom of onchocerciasis, while disappointing, need not detract from the success of mass distribution programmes.

  6. Changes in the structure of dung insect communities after ivermectin usage in a grassland ecosystem. I. Impact of ivermectin under drought conditions

    NASA Astrophysics Data System (ADS)

    Krüger, Kerstin; Scholtz, Clarke H.

    1998-10-01

    Changes in structure of dung insect communities after treatment of cattle with a single standard injection of ivermectin (200 μg·kg -1) were investigated in a large-scale field study under extensive farming conditions in South Africa. The study was carried out during a period of drought. Two herds of cattle were treated with ivermectin, whereas a further two herds remained untreated and served as controls. The four herds were kept in four paddocks of about 80 ha. Dung insect communities were monitored before and for three months after treatment. A range of community measures, including univariate, graphical and multivariate methods, were used to assess the effects of ivermectin. The results suggest that the use of ivermectin affected community structure through reduction in species diversity and an increase in species dominance. These effects appear to have lasted for three months after ivermectin treatment when experiments were terminated.

  7. Ivermectin and filariasis.

    PubMed

    Richard-Lenoble, Dominique; Chandenier, Jacques; Gaxotte, Philippe

    2003-04-01

    Ivermectin, a parasiticide that long ago proved its worth in veterinary medicine, became one of the most effective tools for control programs against human filarial diseases in the 1980s. It is provided at no cost, is effective against microfilariae (blocking their transmission) and can be administered annually as a single oral dose with virtually no side-effects: these considerations led the WHO to officially declare eradicable two endemic filarial diseases (among the major endemic diseases worldwide), onchocerciasis and lymphatic filariasis.

  8. Concurrent ivermectin and Solanum spp. toxicosis in a herd of horses.

    PubMed

    Norman, T E; Chaffin, M K; Norton, P L; Coleman, M C; Stoughton, W B; Mays, T

    2012-01-01

    Representatives from a herd of horses with acute onset of neurologic signs after administration of ivermectin presented for evaluation and treatment. Describe clinical signs of horses intoxicated by ingestion of Solanum sp. and administered ivermectin. Six of 11 affected unrelated horses presented for evaluation and treatment. The remaining 5 affected horses were treated at the farm. Four additional horses, housed separately, were unaffected. Case series is presented. Serum ivermectin concentrations were evaluated in the 6 hospitalized horses. The remnants of the tubes of ivermectin paste were analyzed for ivermectin concentration. The hay fed to the affected horses was analyzed for the presence of toxic plants. Serum ivermectin concentrations were higher than expected, given the dosage of ivermectin administered. The ivermectin concentration remaining in the administration tubes did not exceed specifications. The hay was heavily contaminated by 2 Solanum species. All horses returned to normal neurologic function with supportive care. Horses might exhibit signs of ivermectin toxicity after appropriate dosing of the drug if they concurrently consume toxic plants of the Solanum family. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  9. Situation analysis of parasitological and entomological indices of onchocerciasis transmission in three drainage basins of the rain forest of South West Cameroon after a decade of ivermectin treatment.

    PubMed

    Wanji, Samuel; Kengne-Ouafo, Jonas A; Esum, Mathias E; Chounna, Patrick W N; Tendongfor, Nicholas; Adzemye, Bridget F; Eyong, Joan E E; Jato, Isaac; Datchoua-Poutcheu, Fabrice R; Kah, Elvis; Enyong, Peter; Taylor, David W

    2015-04-02

    Community-Directed Treatment with Ivermectin (CDTI) is the main strategy adopted by the African Programme for Onchocerciasis control (APOC). Recent reports from onchocerciasis endemic areas of savannah zones have demonstrated the feasibility of disease elimination through CDTI. Such information is lacking in rain forest zones. In this study, we investigated the parasitological and entomological indices of onchocerciasis transmission in three drainage basins in the rain forest area of Cameroon [after over a decade of CDTI]. River basins differed in terms of river number and their flow rates; and were characterized by high pre-control prevalence rates (60-98%). Nodule palpation and skin snipping were carried out in the study communities to determine the nodule rates, microfilarial prevalences and intensity. Simulium flies were caught at capture points and dissected to determine the biting, parous, infection and infective rates and the transmission potential. The highest mean microfilaria (mf) prevalence was recorded in the Meme (52.7%), followed by Mungo (41.0%) and Manyu drainage basin (33.0%). The same trend was seen with nodule prevalence between the drainage basins. Twenty-three (23/39) communities (among which 13 in the Meme) still had mf prevalence above 40%. All the communities surveyed had community microfilarial loads (CMFL) below 10 mf/skin snip (ss). The infection was more intense in the Mungo and Meme. The intensity of infection was still high in younger individuals and children less than 10 years of age. Transmission potentials as high as 1211.7 infective larvae/person/month were found in some of the study communities. Entomological indices followed the same trend as the parasitological indices in the three river basins with the Meme having the highest values. When compared with pre-control data, results of the present study show that after over a decade of CDTI, the burden of onchocerciasis has reduced. However, transmission is still going on in this

  10. Amphidial structure of ivermectin-resistant and susceptible laboratory and field strains of Haemonchus contortus.

    PubMed

    Freeman, Andrea S; Nghiem, Catherine; Li, Jian; Ashton, Francis T; Guerrero, Jorge; Shoop, Wesley L; Schad, Gerhard A

    2003-01-02

    The development of anthelmintic resistance by nematode parasites is a growing problem for veterinarians, pet owners, and producers. The intensive use of the macrocyclic lactones for the treatment of a variety of parasitic diseases has hastened the development of resistance to this family of parasiticides. As a result, resistance to ivermectin, moxidectin, nemadectin, and doramectin by Haemonchus contortus has been documented throughout the world. Sensory neurons located in the cephalic end of nematodes are in close contact with the external environment. Through these neurons, important chemical and thermal cues are gathered by the parasite. Examination of serial electron micrographs of ivermectin-susceptible and ivermectin-resistant H. contortus allows for comparison of neuronal structure, arrangement of neurons within the amphidial channel, and distance of the tip of the dendritic processes to the amphidial pore. The latter of these characteristics provides a useful means by which to compare the association between the neurons and the external environment of the worm. Comparison of parental laboratory strains of ivermectin-susceptible strains of H. contortus with related selected, ivermectin-resistant strains and with a wild-type ivermectin-susceptible field strain of H. contortus from Louisiana reveal that the ivermectin-resistant worms examined have markedly shorter sensory cilia than their ivermectin-susceptible parental counterparts. Additionally, the amphidial neurons of ivermectin-resistant worms are characterized by generalized degeneration and loss of detail, whereas other neurons outside of the channels, such as the labial and cephalic neurons, are normal in structure. These findings raise a number of questions regarding the relationship between amphidial structure and ivermectin resistance as well as the role of amphids as a means of entry for ivermectin. While shortened amphidial sensilla are associated with ivermectin resistance, it remains unclear if

  11. Intermittent preventive treatment of malaria in pregnancy (IPTp): participation of community-directed distributors of ivermectin for onchocerciasis improves IPTp access in Ugandan rural communities.

    PubMed

    Ndyomugyenyi, Richard; Tukesiga, Ephraim; Katamanywa, James

    2009-12-01

    Access and compliance to sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria in pregnancy (IPTp) when delivered by community-directed drug distributors (CDDs) of ivermectin for onchocerciasis control (intervention arm) and through delivery of SP-IPTp during antenatal care visit (control arm) was investigated in western Uganda. Every woman in both arms who delivered during the study period was interviewed on access and compliance to SP-IPT during her previous pregnancy. Overall, 926 women participated in the study (473 and 453 in the intervention and control arms, respectively). There were 467 (98.7%) women who accessed SP-IPTp at least once in the intervention arm and 401 (88.5%) in the control arm (P<0.001), and 424 (89.6%) women accessed at least two doses of SP-IPTp in the intervention arm compared with 237 (52.3%) in the control arm (P<0.001). The findings of this study suggest that a strategy using community resource people such as CDDs is an effective and feasible option to deliver SP-IPTp, because it uses existing community structures and volunteers, which creates easy access of the intervention, and should complement SP-IPTp access during antenatal care visit.

  12. Impact of Eighteen-Year Varied Compliance to Onchocerciasis Treatment with Ivermectin in Sentinel Savannah Agrarian Communities in Kaduna State of Nigeria

    PubMed Central

    Osue, Hudu O.; Inabo, Helen I.; Yakubu, Sabo E.; Audu, Patrick A.; Galadima, Musa; Odama, Lillian E.; Musa, Danjuma; Ado, Saleh A.; Mamman, Mohammed

    2013-01-01

    Baseline and impact assessment data were generated in 1994 (n = 532) and 2011 (n = 593) from 6 sentinel villages with generalized onchocerciasis. Only volunteers and a cohort (n = 445, 75%) were screened at both visits. Each village had received 11 (64.7%) annual treatments and 92.6%, range 88.7–100%, treatment compliance. Overall mean number of treatment was 2.9 ± 1.6 with a range 2.0 ± 1.2–3.3 ± 0.6. Significant decreases in skin microfilaria prevalence from 201 (38%) to 0 (0%), palpable nodule from 77 (15%) to 4 (0.7%), dermal changes from 51 (9.6%) to 2 (0.04%), optic nerve disease from 24 (4.5%) to 4 (2.0%), and onchocercal inducible ocular lesions from 31 (5.8%) to 12 (2.0%) were recorded, P < 0.05, (t-test of unpaired data). Cases of glaucoma, 8 (1.4%), and blindness, 6 (1.05%), remained unchanged. Visual acuity ≥6/24 in one or both eyes, 198 (33.45%); cataract, 169 (28.5%); pterygium 157 (26.5%); and acute senilis, 165 (27.9%), were significantly increased and positively correlated with increase in age (R 2 = 0.898 − 0.949). Dissected parous Simulium damnosum caught (n = 222) were without infective third stage larva. Active onchocerciasis transmission seems halted despite varied compliance to long-term ivermectin treatment. We recommend continued surveillance and targeted treatment of controlled and hypoendemic areas. PMID:27398386

  13. Attenuator And Conditioner

    SciTech Connect

    Anderson, Gene R.; Armendariz, Marcelino G.; Carson, Richard F.; Bryan, Robert P.; Duckett, III, Edwin B.; Kemme, Shanalyn Adair; McCormick, Frederick B.; Peterson, David W.

    2006-04-04

    An apparatus and method of attenuating and/or conditioning optical energy for an optical transmitter, receiver or transceiver module is disclosed. An apparatus for attenuating the optical output of an optoelectronic connector including: a mounting surface; an array of optoelectronic devices having at least a first end; an array of optical elements having at least a first end; the first end of the array of optical elements optically aligned with the first end of the array of optoelectronic devices; an optical path extending from the first end of the array of optoelectronic devices and ending at a second end of the array of optical elements; and an attenuator in the optical path for attenuating the optical energy emitted from the array of optoelectronic devices. Alternatively, a conditioner may be adapted in the optical path for conditioning the optical energy emitted from the array of optoelectronic devices.

  14. Preclinical Study of Single-Dose Moxidectin, a New Oral Treatment for Scabies: Efficacy, Safety, and Pharmacokinetics Compared to Two-Dose Ivermectin in a Porcine Model

    PubMed Central

    Bernigaud, Charlotte; Aho, Ludwig Serge; Dreau, Dominique; Kelly, Andrew; Sutra, Jean-François; Moreau, Francis; Lilin, Thomas; Botterel, Françoise; Guillot, Jacques; Chosidow, Olivier

    2016-01-01

    Background Scabies is one of the commonest dermatological conditions globally; however it is a largely underexplored and truly neglected infectious disease. Foremost, improvement in the management of this public health burden is imperative. Current treatments with topical agents and/or oral ivermectin (IVM) are insufficient and drug resistance is emerging. Moxidectin (MOX), with more advantageous pharmacological profiles may be a promising alternative. Methodology/Principal Findings Using a porcine scabies model, 12 pigs were randomly assigned to receive orally either MOX (0.3 mg/kg once), IVM (0.2 mg/kg twice) or no treatment. We evaluated treatment efficacies by assessing mite count, clinical lesions, pruritus and ELISA-determined anti-S. scabiei IgG antibodies reductions. Plasma and skin pharmacokinetic profiles were determined. At day 14 post-treatment, all four MOX-treated but only two IVM-treated pigs were mite-free. MOX efficacy was 100% and remained unchanged until study-end (D47), compared to 62% (range 26–100%) for IVM, with one IVM-treated pig remaining infected until D47. Clinical scabies lesions, pruritus and anti-S. scabiei IgG antibodies had completely disappeared in all MOX-treated but only 75% of IVM-treated pigs. MOX persisted ~9 times longer than IVM in plasma and skin, thereby covering the mite’s entire life cycle and enabling long-lasting efficacy. Conclusions/Significance Our data demonstrate that oral single-dose MOX was more effective than two consecutive IVM-doses, supporting MOX as potential therapeutic approach for scabies. PMID:27732588

  15. Preclinical Study of Single-Dose Moxidectin, a New Oral Treatment for Scabies: Efficacy, Safety, and Pharmacokinetics Compared to Two-Dose Ivermectin in a Porcine Model.

    PubMed

    Bernigaud, Charlotte; Fang, Fang; Fischer, Katja; Lespine, Anne; Aho, Ludwig Serge; Dreau, Dominique; Kelly, Andrew; Sutra, Jean-François; Moreau, Francis; Lilin, Thomas; Botterel, Françoise; Guillot, Jacques; Chosidow, Olivier

    2016-10-01

    Scabies is one of the commonest dermatological conditions globally; however it is a largely underexplored and truly neglected infectious disease. Foremost, improvement in the management of this public health burden is imperative. Current treatments with topical agents and/or oral ivermectin (IVM) are insufficient and drug resistance is emerging. Moxidectin (MOX), with more advantageous pharmacological profiles may be a promising alternative. Using a porcine scabies model, 12 pigs were randomly assigned to receive orally either MOX (0.3 mg/kg once), IVM (0.2 mg/kg twice) or no treatment. We evaluated treatment efficacies by assessing mite count, clinical lesions, pruritus and ELISA-determined anti-S. scabiei IgG antibodies reductions. Plasma and skin pharmacokinetic profiles were determined. At day 14 post-treatment, all four MOX-treated but only two IVM-treated pigs were mite-free. MOX efficacy was 100% and remained unchanged until study-end (D47), compared to 62% (range 26-100%) for IVM, with one IVM-treated pig remaining infected until D47. Clinical scabies lesions, pruritus and anti-S. scabiei IgG antibodies had completely disappeared in all MOX-treated but only 75% of IVM-treated pigs. MOX persisted ~9 times longer than IVM in plasma and skin, thereby covering the mite's entire life cycle and enabling long-lasting efficacy. Our data demonstrate that oral single-dose MOX was more effective than two consecutive IVM-doses, supporting MOX as potential therapeutic approach for scabies.

  16. Changes in the structure of dung insect communities after ivermectin usage in a grassland ecosystem. II. Impact of ivermectin under high-rainfall conditions

    NASA Astrophysics Data System (ADS)

    Krüger, Kerstin; Scholtz, Clarke H.

    1998-10-01

    A large-scale field study was carried out to assess the ecotoxicological effect of ivermectin, a broad-spectrum veterinary agent, on dung insect communities under normal extensive farming conditions in South Africa. Dung insect communities were monitored: i) one year after a first treatment of entire herds with a single standard injection of ivermectin (200 μ·kg -1) in the 1992/93 season; and ii) for three months after a second single standard injection in the 1993/94 season. Two herds were treated with a single standard injection of ivermectin while two herds remained untreated as controls. Each herd was held in a paddock of about 80 ha. Field work was carried out in the rainy season of 1993/94, when the study area received above-average rainfall. The impact of ivermectin was examined using a variety of community measures, including univariate, graphical and multivariate methods. No effect of ivermectin on dung insect communities was observable one year after the 1992/93 treatment. Seven days after treatment in the 1993/94 season, fewer hydrophilid larvae, and scarabaeid and dipteran pupae were present in pats from treated animals in comparison with untreated controls. One and three months after treatment, there were no effects that could be attributed directly to the treatment with ivermectin. The results of the study indicate that the seriousness of the impact of ivermectin depends on several factors, including climatic conditions, spatial scale of treatment and number of animals treated in a herd.

  17. Micromorphology of pelletized soil conditioners

    NASA Astrophysics Data System (ADS)

    Hirsch, Florian; Dietrich, Nils; Knoop, Christine; Raab, Thomas

    2017-04-01

    Soil conditioners produced by anaerobic digestion and subsequent composting of organic household waste, bear the potential to improve unproductive farmland together with a reduced input risk of unwanted pollutants into the soils. Within the VeNGA project (http://www.biogas-network.de/venga), soil conditioners from anaerobically digested organic household waste are tested for their potential to increase plant growth in glasshouse and field experiments. Because the production techniques of these soil conditioners may influence their physical and chemical behaviour in the soil, two different techniques for pelletizing the soil conditioners where applied. We present findings from a pot experiment with cereal that has been sampled after two months for micromorphological analyses. We visualize the decomposition and the physical behaviour of the soil conditioners. Pellets produced in an agglomeration mixer result in dense balls, that are only slightly decomposed after the trial. But the soil conditioners created under pressure in a screw extruder are rich in voids and have the potential of retaining more soil water.

  18. Decreased strongyle egg re-appearance period after treatment with ivermectin and moxidectin in horses in Belgium, Italy and The Netherlands.

    PubMed

    Geurden, Thomas; van Doorn, Deborah; Claerebout, Edwin; Kooyman, Frans; De Keersmaecker, Sofie; Vercruysse, Jozef; Besognet, Bruno; Vanimisetti, Bindu; di Regalbono, Antonio Frangipane; Beraldo, Paola; Di Cesare, Angela; Traversa, Donato

    2014-08-29

    The objective of the present study was to evaluate the efficacy of an oral treatment with ivermectin (IVM) or moxidectin (MOX) against gastro-intestinal strongyles in naturally infected horses by performing a faecal egg count reduction test (FECRT) and by monitoring the egg reappearance period (ERP) after treatment. Therefore, a field efficacy study with a randomised complete block design for each study site was conducted, with the individual animal as the experimental unit. At least 10 study sites in Italy, Belgium and The Netherlands were selected and animals were allocated to one of the two treatment groups based on the pre-treatment faecal egg counts (FEC). Animals were treated on Day 0 with an oral paste containing either IVM (at 0.2mg/kg bodyweight) or MOX (at 0.4 mg/kg bodyweight). After treatment, faecal samples were collected at least every fortnight during 56 days after treatment with IVM and during 84 days after MOX treatment. In total, 320 horses on 32 farms were examined. The FECRT on Day 14 indicated a 100% efficacy in 59 of the 64 treatment groups and >92% efficacy in the remaining 5 groups. The ERP was decreased for at least one of the anthelmintics on 17 out of 32 study sites (15 sites or 47% for MOX and 17 sites or 53% for IVM) and on 9 sites (28%) the ERP was decreased for both anthelmintics. On some of these study sites the efficacy declined at the end of the expected ERP, often with good efficacy 2 weeks earlier. Nevertheless, on 1, 3 and 5 study sites in Italy, Belgium and The Netherlands respectively, an efficacy below 90% for IVM and MOX was identified as soon as Day 42 or Day 56. In The Netherlands, the efficacy of IVM was below 90% from Day 28 or Day 35 after treatment on 1 site each. The present study reports a high efficacy of MOX and IVM in a FECRT 14 days after treatment, yet does indicate a shortened ERP for these treatments in more than half of the selected study sites.

  19. Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection

    PubMed Central

    Henriquez-Camacho, Cesar; Gotuzzo, Eduardo; Echevarria, Juan; White, A Clinton; Terashima, Angelica; Samalvides, Frine; Pérez-Molina, José A; Plana, Maria N

    2016-01-01

    , Southeast Asia, America, and Europe). Four trials assessed the effectiveness of ivermectin compared with albendazole and three trials assessed the effectiveness of ivermectin compared with thiabendazole. Comparison ivermectin versus albendazole Treatment with ivermectin probably cures more people than albendazole (moderate quality evidence), and may be equally or better tolerated (low quality evidence). The included trials did not report serious adverse events or death. Comparison ivermectin versus thiabendazole Treatment with ivermectin and thiabendazole may cure similar numbers of people with strongyloides infection (low quality evidence), but ivermectin is probably better tolerated (moderate quality evidence). The included trials did not report serious adverse events or death. PMID:26778150

  20. Anthelmintic drug ivermectin inhibits angiogenesis, growth and survival of glioblastoma through inducing mitochondrial dysfunction and oxidative stress.

    PubMed

    Liu, Yingying; Fang, Shanshan; Sun, Qiushi; Liu, Bo

    2016-11-18

    Glioblastoma is one of the most vascular brain tumour and highly resistant to current therapy. Targeting both glioblastoma cells and angiogenesis may present an effective therapeutic strategy for glioblastoma. In our work, we show that an anthelmintic drug, ivermectin, is active against glioblastoma cells in vitro and in vivo, and also targets angiogenesis. Ivermectin significantly inhibits growth and anchorage-independent colony formation in U87 and T98G glioblastoma cells. It induces apoptosis in these cells through a caspase-dependent manner. Ivermectin significantly suppresses the growth of two independent glioblastoma xenograft mouse models. In addition, ivermectin effectively targets angiogenesis through inhibiting capillary network formation, proliferation and survival in human brain microvascular endothelial cell (HBMEC). Mechanistically, ivermectin decreases mitochondrial respiration, membrane potential, ATP levels and increases mitochondrial superoxide in U87, T98G and HBMEC cells exposed to ivermectin. The inhibitory effects of ivermectin are significantly reversed in mitochondria-deficient cells or cells treated with antioxidants, further confirming that ivermectin acts through mitochondrial respiration inhibition and induction of oxidative stress. Importantly, we show that ivermectin suppresses phosphorylation of Akt, mTOR and ribosomal S6 in glioblastoma and HBMEC cells, suggesting its inhibitory role in deactivating Akt/mTOR pathway. Altogether, our work demonstrates that ivermectin is a useful addition to the treatment armamentarium for glioblastoma. Our work also highlights the therapeutic value of targeting mitochondrial metabolism in glioblastoma. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Intravenous lipid emulsion therapy in 20 cats accidentally overdosed with ivermectin.

    PubMed

    Jourdan, Geraldine; Boyer, Guillaume; Raymond-Letron, Isabelle; Bouhsira, Emilie; Bedel, Benjamin; Verwaerde, Patrick

    2015-01-01

    To describe the outcome of 20 cats treated with intravenous lipid emulsion (IVLE) after an accidental parenteral ivermectin overdose. Twenty adult cats presented after receiving a 4 mg/kg accidental subcutaneous overdose of ivermectin. After admission, two IVLE treatments were initiated in asymptomatic cats: a single bolus (1.5 mL/kg; n = 16) versus a bolus followed by a 30-minute constant rate infusion (0.25 mL/kg/min; n = 4). Six out of the 16 cats that received only the single bolus developed clinical signs of ivermectin intoxication. Based on the severity of the clinical signs and their duration (approximately 48 hours), these 6 cats were retrospectively considered either moderately (n = 3) or severely (n = 3) intoxicated by ivermectin. Cats with a low body condition score (BCS) had more severe signs of ivermectin toxicity. Additional IVLE was administered until clinical resolution was complete. Median (min to max) cumulative dose of IVLE per cat was 4.5 (3.0-4.5) mL/kg for 36 (12-36) hours and 19.5 (7.5-37.5) mL/kg for 96 (72-168) hours for moderately and severely intoxicated cats, respectively. Our series describes the treatment of accidental ivermectin parenteral overdose in 20 cats with early initiation of IVLE therapy. An early bolus followed by a 30-minute constant rate infusion of IVLE appeared to mitigate the signs of ivermectin toxicosis in cats compared to a single treatment bolus. Our observations also suggest that cats with a low BCS given only a bolus of IVLE treatment were more likely to develop signs of ivermectin intoxication and require a greater amount of IVLE for the resolution of clinical signs. Based on our observations, BCS appears to influence the severity of ivermectin toxicity with a low BCS being associated with more severe signs of ivermectin toxicity. © Veterinary Emergency and Critical Care Society 2015.

  2. Knowledge, attitude and practice of community drug distributors' about onchocerciasis and community directed treatment with ivermectin in Quara district, North Western Ethiopia.

    PubMed

    Weldegebreal, Fitsum; Medhin, Girmay; Weldegebriel, Zemichael; Legesse, Mengistu

    2016-04-06

    Onchocerciasis is one of the most important public health problems over large areas of tropical Africa countries including Ethiopia. The African Program for Onchocerciasis Control (APOC) has been working with ultimate goal of reducing the public health and socio-economic problems of onchocerciasis through administration of the tablet for continuous 12-15 years using the strategy of yearly community-directed treatment with ivermectin (CDTI) in endemic areas of Africa to kill the microfilariae that invade the eyes and are present in the skin to be transported to another victim by the black fly. The objective of this study was to assess knowledge, attitude and practice of community drug distributors (CDDs) towards onchocerciasis and CDTI in Quara district. Of all the study participating CDD 11.4% (9/79) said that they knew about the etiology of the disease, 35.4% (28/79) had good level of knowledge, 19 (24.1%) had good level of positive attitude and 18 (22.8%) had good level of positive practice about onchocerciasis. Similarly, 45.6% (36/79), 81.0% (64/79) and 29.1% (23/79) had good level of knowledge, attitude and practice about CDTIP, respectively. Being a female CDD (adjusted OR 7.246, P = 0.035, 95% CI 1.147, 45.455) and being older than 35 years (adjusted OR 8.435, P = 0.001, 95% CI 4.53, 9.003) were significantly associated with the likelihood of having good level of knowledge about the disease. Although onchocerciasis is endemic in Quara district, large proportion of the CDDs had misconceptions about its causation, transmission and prevention. Therefore, CDTIP for onchocerciasis control need to be supported by proper and continuous training, and health education about different aspects of the disease.

  3. Treatment of Rosacea With Concomitant Use of Topical Ivermectin 1% Cream and Brimonidine 0.33% Gel: A Randomized, Vehicle-controlled Study.

    PubMed

    Gold, Linda Stein; Papp, Kim; Lynde, Charles; Lain, Edward; Gooderham, Melinda; Johnson, Sandra; Kerrouche, Nabil

    2017-09-01

    There is currently a lack of data on the simultaneous treatment of different features of rosacea. Individually, ivermectin 1% (IVM) cream and brimonidine 0.33% (BR) gel have demonstrated efficacy on inflammatory lesions and persistent erythema, respectively. To evaluate the efficacy, safety, patient satisfaction, and optimal timing of administration of IVM associated with BR (IVM+BR) versus their vehicles in rosacea (investigator global assessment [IGA] ≥3). Multicenter, randomized, double-blind study including subjects with rosacea characterized by moderate to severe persistent erythema and inflammatory lesions. The active treatment group included the IVM+BR/12 weeks subgroup (once-daily BR and once-daily IVM for 12 weeks), and the IVM+BR/8 weeks subgroup (once-daily BR vehicle for 4 weeks followed by once-daily BR for the remaining 8 weeks and once-daily IVM for 12 weeks). The vehicle group received once-daily BR vehicle and once-daily IVM vehicle for 12 weeks. The association showed superior efficacy (IGA success [clear/almost clear]) for erythema and inflammatory lesions in the total active group (combined active subgroups) compared to vehicle (55.8% vs. 36.8%, P=0.007) at week 12. The success rate increased from 32.7% to 61.2% at hour 0 and hour 3, respectively, in the IVM+BR/12 weeks subgroup, and from 28.3% to 50% in the IVM+BR/8 weeks subgroup. Reductions in erythema and inflammatory lesion counts confirmed the additive effect of BR to IVM treatment. Subjects reported greater improvement in the active subgroups than in the vehicle group, and similar rates for facial appearance satisfaction after the first 4 weeks of treatment in both active subgroups. All groups showed similar tolerability profiles. Concomitant administration of IVM cream with BR gel demonstrated good efficacy and safety, endorsing the comprehensive approach to this complex disease. Early introduction of BR, along with a complete daily skin care regimen may accelerate treatment success

  4. Role of antifungal medicaments added to tissue conditioners: A systematic review.

    PubMed

    Iqbal, Zahid; Zafar, Muhammad Sohail

    2016-10-01

    The aim of this review is to investigate the current state of knowledge on the incorporation of antifungal agents into the tissue conditioners for the treatment of denture induced stomatitis. Studies reporting the incorporation of antifungal/antimicrobial agents in to tissue conditioners were included in the review. In order to search the studies on the topic "incorporation of antifungal agents in tissue conditioners for the treatment of denture induced stomatitis" ISI web of science, PubMed/MEDLINE, and Google-Scholar databases were searched from 1970 up to and including July 2015 using various keywords such as antifungal agents, tissue conditioners, Candida albicans, denture stomatitis, etc. Various studies reported the efficacy and effectiveness of adding conventional organic antifungal medicines (nystatin, azole group derivatives and chlorhexidine, antimicrobials/antifungals other than organic (silver zeolite, silver nano-particles, photo-catalysts and metallic oxides) and natural and herbal antimicrobials (tea tree oil, lemongrass essential oil and origanum oil) into various tissue conditioners. The review literature reported that incorporation of antifungal agents into tissue conditioners is effective with minimal or no effects on physical and mechanical properties of tissue conditioners. Incorporation of different antifungal medicaments to commercially available tissue conditioners can be recommended for the management of denture induced stomatitis. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  5. Re-evaluation of ivermectin efficacy against equine gastrointestinal parasites.

    PubMed

    Klei, T R; Rehbein, S; Visser, M; Langholff, W K; Chapman, M R; French, D D; Hanson, P

    2001-07-27

    Two trials were conducted to confirm the efficacy of ivermectin paste against endoparasites of horses. In these trials, 20 ponies were treated with ivermectin oral paste at 200 mcg x kg body weight once on Day 0, and 20 ponies served as unmedicated controls. The animals carried naturally acquired parasite infections as confirmed by pretrial fecal examination. The animals were necropsied for worm recovery on Days 14, 15 or 16. Parasites recovered were identified to species. Horses treated with ivermectin had significantly (P<0.05) fewer (>99.0% reduction) adult small strongyles (Coronocyclus spp including C. coronatus, C. labiatus, C. labratus; Cyathostomum spp including C. catinatum, C. pateratum; Cylicocyclus spp including C. ashworthi, C. elongatus, C. insigne, C. leptostomum, C. nassatus, C. radiatus; Cylicodontophorus bicoronatus; Cylicostephanus spp including C. asymetricus, C. bidentatus, C. calicatus, C. goldi, C. longibursatus, C. minutus; Gyalocephalus capitatus; Parapoteriostomum spp including P. euproctus, P. mettami; Petrovinema poculatum; Poteriostomum spp including P. imparidentatum, P. ratzii) and adult large strongyles (Strongylus edentatus, S. vulgaris; Triodontophorus spp including T. brevicauda, T. serratus; Craterostomum acuticaudatum) than the controls. Ivermectin was also highly effective (94% to >99%, P<0.05-0.01) against Gasterophilus intestinalis larvae, Habronema spp., Oxyuris equi, Parascaris equorum. The data from these two trials confirm that ivermectin paste administered to horses orally at 200mcg x kg(-1) continues to be highly effective for treatment and control of a broad range of small and large strongyle species as well as other species of gastrointestinal parasites.

  6. Post-ivermectin encephalopathy in Senegal: a case report.

    PubMed

    Massi, Daniel Gams; Mansare, Mohamed Lelouma; Traoré, Mariétou; Ndiaye, Moustapha; Diop, Amadou Gallo; Ndiaye, Mouhamadou Mansour

    2017-01-01

    Ivermectin is an ant parasitic drug used for combating onchocerciasis and lymphatic filariasis. It works by inhibiting the function of neurons and muscles, thus causing paralysis of microfilariae. Side effects of this drug have been reported including post-ivermectin encephalopathy requiring emergency care in hospital. We report the case of a 35 years old patient living in rural areas of Senegal who presented two days after a mistake in administration of a second dose of ivermectin, headaches, altered consciousness and bilateral blindness. The workup revealed brain white matter lesions, abnormal liver function tests and biological inflammation without evidence of Loa loa microfilariae in blood and cerebrospinal fluid. Corticosteroid treatment was administered in emergency and patient recovered despite the persistence of bilateral blindness. Inflammatory process seems to have an important role in the pathophysiology of this encephalopathy. We should therefore carefully control the administration of this drugs.

  7. The lack of influence of food and local alcoholic brew on the blood level of Mectizan(®) (ivermectin).

    PubMed

    Homeida, Mamoun M; Malcolm, Stephen B; ElTayeb, A Z; Eversole, Rob R; Elassad, Asma S; Geary, Timothy G; Ali, Magdi M; Mackenzie, Charles D

    2013-08-01

    There is concern that extraneous factors, such as food and drink, may alter the pharmacodynamics of Mectizan(®) (ivermectin) in patients receiving this important anti-parasitic drug, and thus might put such individuals in danger of serious adverse events. The effects of a common local alcohol-containing beverage and a local food on plasma levels of ivermectin were studied in Sudanese volunteers after administration of the standard dose used in mass drug administration programs for onchocerciasis and filariasis. Plasma levels of ivermectin at various time points (0-48h) after administration of ivermectin were ascertained by HPLC assay in ten volunteers given 150μgkg(-1) ivermectin together with either a local sorghum-based food ('assida'), or a locally brewed alcoholic beverage ('arangi' made from sorghum grain) or in those who were fasting. Maximum mean (±SD) plasma levels of ivermectin (67±49ngml(-1)) were reached within 2h in fasting patients, and had dropped to 26±20ngml(-1) after 30h. The coadministration of local food or alcoholic beverage did not cause an increase in ivermectin plasma levels above those observed in people who were fasting. However, at 2h after ivermectin administration, patients given alcohol had significantly lower plasma ivermectin levels than fed patients or fasting patients. There were no significant differences among treatments for AUC0-30, Cmax, or tmax, and so the coadministration of local food or alcoholic beverage did not cause any change in pharmacokinetic parameters of ivermectin in the plasma in comparison with fasting. None of the measured levels of plasma ivermectin were greater than those reported in previous studies with this compound. These findings do not support the hypothesis that acute intake of alcohol is an important factor in the development of the serious adverse reactions that can occur during the treatment of loaisis patients with ivermectin (Mectizan(®)).

  8. 21 CFR 520.1192 - Ivermectin paste.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Ivermectin paste. 520.1192 Section 520.1192 Food... DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.1192 Ivermectin paste. (a... ivermectin. (b) Sponsors. See sponsors in § 510.600(c) of this chapter for use as in paragraph (e) of this...

  9. Hybrid respiration-signal conditioner

    NASA Technical Reports Server (NTRS)

    Rinard, G. A.; Steffen, D. A.; Sturm, R. E.

    1979-01-01

    Hybrid impedance-pneumograph and respiration-rate signal conditioner element of hand-held vital signs monitor measures changes in impedance of chest during breathing cycle and generates analog respiration signal as output along with synchronous square wave that can be monitored by breath-rate processor.

  10. Assessment of community's knowledge, attitude and practice about onchocerciasis and community directed treatment with Ivermectin in Quara District, north western Ethiopia.

    PubMed

    Weldegebreal, Fitsum; Medhin, Girmay; Weldegebriel, Zemichael; Legesse, Mengistu

    2014-03-10

    The African Program for Onchocerciasis Control (APOC) has been working with ultimate goal of reducing the public health and socio-economic problems associated with onchocerciasis within a period of 12-15 years. Although dedicated community engagement is crucial for the success of the program, there is little/no information on the levels of community's knowledge, attitude and practice about onchocerciasis as well as about the ongoing control program in Ethiopia. In this study, we have assessed the level of knowledge, attitude and practice of Quara district residents about onchocerciasis and the current control strategies in the area. This community-based cross-sectional study was conducted between October 2012 and January 2013 in Quara District, Amhara Regional State, North West of Ethiopia. The study participants were recruited from randomly selected kebeles (small administrative units) of the study area and were interviewed about onchocerciasis and about community directed treatment with ivermectin (CDTI) using structured questionnaire. The collected data were double entered into a data entry file using EpiData software, V.3.1. The data were transferred to SPSS soft-ware V.16 and analyzed according to the different variables. Out of 418 respondents, 401 (95.9%) of the respondents have heard about onchocerciasis (locally known as 'wara') and 11.2% said that they knew about the etiology of the disease, which was named as filarial worm. However, 356 (88.8%) had at least one misconception about the causative agent of onchocerciasis. More than half (69.4%) knew that the transmission of the disease is related to black fly biting. Overall, 93.3% participants believed that onchocerciasis is preventable, of whom 49.5% indicated use of drug as the means of preventing the disease. Majority (95.5%) of the participants perceived CDTI as very useful program. Although onchocerciasis is endemic disease in the study area, large proportion of the community had conspicuous

  11. Assessment of community’s knowledge, attitude and practice about onchocerciasis and community directed treatment with Ivermectin in Quara District, north western Ethiopia

    PubMed Central

    2014-01-01

    Background The African Program for Onchocerciasis Control (APOC) has been working with ultimate goal of reducing the public health and socio-economic problems associated with onchocerciasis within a period of 12–15 years. Although dedicated community engagement is crucial for the success of the program, there is little/no information on the levels of community’s knowledge, attitude and practice about onchocerciasis as well as about the ongoing control program in Ethiopia. In this study, we have assessed the level of knowledge, attitude and practice of Quara district residents about onchocerciasis and the current control strategies in the area. Methods This community-based cross-sectional study was conducted between October 2012 and January 2013 in Quara District, Amhara Regional State, North West of Ethiopia. The study participants were recruited from randomly selected kebeles (small administrative units) of the study area and were interviewed about onchocerciasis and about community directed treatment with ivermectin (CDTI) using structured questionnaire. The collected data were double entered into a data entry file using EpiData software, V.3.1. The data were transferred to SPSS soft-ware V.16 and analyzed according to the different variables. Results Out of 418 respondents, 401 (95.9%) of the respondents have heard about onchocerciasis (locally known as ‘wara’) and 11.2% said that they knew about the etiology of the disease, which was named as filarial worm. However, 356 (88.8%) had at least one misconception about the causative agent of onchocerciasis. More than half (69.4%) knew that the transmission of the disease is related to black fly biting. Overall, 93.3% participants believed that onchocerciasis is preventable, of whom 49.5% indicated use of drug as the means of preventing the disease. Majority (95.5%) of the participants perceived CDTI as very useful program. Conclusion Although onchocerciasis is endemic disease in the study area, large

  12. Topical application of ivermectin for human ectoparasites.

    PubMed

    Youssef, M Y; Sadaka, H A; Eissa, M M; el-Ariny, A F

    1995-12-01

    Ivermectin is used in veterinary practice against many ectoparasites and endoparasites and is the drug of choice for treatment of human onchocerciasis. This study was carried out to investigate the effect of topical application of this drug against human ectoparasites (Sarcoptes scabiei and Pediculus humanus capitis). Ivernectin was found to have a curative effect on head lice after a single topical application. In patients with scabies, the drug was also found to be effective after a single application. However, in 50% of the cases, another application was needed five days later.

  13. [The use of ivermectin in the control of onchocerciasis].

    PubMed

    Chippaux, J P; Boussinesq, M; Prod'hon, J

    1995-01-01

    Onchocerciasis is an infection with the nematode Onchocerca volvulus. The main clinical symptoms are caused by the microfilariae. They include ocular lesions leading to blindness. Onchocerciasis is widely distributed in Africa from the Sahara to the southern tip, and is also found in some areas of South and Central America. Ivermectin was shown to be an effective treatment in the early 1980's, and is safe and better tolerated than diethylcarbamazine. We report the results of ivermectin treatment of onchocerciasis, and various features of the control obtained by large-scale ivermectin treatment programs. In large-scale programs, ivermectin (150 micrograms/kg) is administered once a year. This dose paralyses the microfilariae, such that they are carried away by the lymph to the lymph nodes where they are destroyed. This dose thereby reduces the load of microfilaria by 90%. The effects of a dose of ivermectin last about two or three years, and the lesions in the anterior segment of the eye can be cured or substantially reduced. Regular treatment prevents severe lesions of the posterior segment of the eye. The effects of repeated treatment on lesions of the retina are currently under investigation. Frequent doses of ivermectin prevent the development of embryo parasites in the females, and reduces the number of adults by attrition. Large-scale treatment programs reduce the transmission of the parasite by its vectors. There are several problems impeding large-scale treatment programs. Choosing patients for priority treatment requires expensive and sometimes aggressive methods of diagnosis. Thus new techniques for the identification of communities in which onchocerciasis is a serious public health problem are required. The choice of strategies for distribution, to optimize the cost, benefit ratio and feasibility, remain controversial. Wide distribution by mobile teams is effective, but expensive. Active distribution by trained community distributors is a cheaper

  14. Resistance to ivermectin by Haemonchus contortus in goats and calves.

    PubMed

    DeVaney, J A; Craig, T M; Rowe, L D

    1992-05-01

    Efficacy of ivermectin on susceptible or resistant populations of the parasitic nematode Haemonchus contortus was determined in cattle and goats held in a barn. Goats were each infected with 3000 infective, ivermectin-susceptible or -resistant H. contortus larvae on day 0 and reinfected with 2000 infective larvae on day 24. Goats were treated orally with 600 micrograms kg-1 ivermectin on day 31. No significant differences were detected in blood packed cell volume (PCV) or total protein (TP), prepatent period, or epg among the four groups of goats that were each infected with one of four parasite strains (one susceptible, three resistant). There were no differences among the four parasite strains in the numbers of infective larvae that developed to the third larval stage from fecal cultures or in the viability of cultured infective larvae when held in the laboratory at 27 +/- 1 degrees C for 14 weeks. After treatment with ivermectin, there were significant differences among the parasite strains in PCV, TP, and epg. Total worm counts were reduced by 94 to 97% with three times the recommended dose. Immature and adult Skrjabinema ovis were also present in two treated goats. In a second test, one goat infected once with 10,000 infective larvae of a resistant strain of H. contortus and then treated with nine doses of ivermectin, increasing from 500 to 2000 micrograms kg-1 over a period of 133 days, had 35 adult worms at necropsy. In a third test, three calves were readily infected with an ivermectin-resistant strain of H. contortus from goats.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Clearance of plasma ivermectin with single pass lipid dialysis in 2 dogs.

    PubMed

    Londoño, Leonel A; Buckley, Gareth J; Bolfer, Luiz; Bandt, Carsten

    2017-03-01

    To describe the use of single pass lipid dialysis (SPLD) for treatment of ivermectin toxicosis in 2 Australian Shepherd dogs with the ABCB1-1Δ gene mutation. Two Australian Shepherd dogs were presented for treatment of ivermectin toxicosis. Dogs were initially treated with intravenous lipid emulsion and supportive care, without improvement of clinical signs. They both developed respiratory paralysis and required mechanical ventilation. In order to increase the clearance of circulating ivermectin, SPLD was performed using dialysate containing 5% lipid. Blood samples were obtained immediately before and after dialysis and analyzed for serum ivermectin concentration. Ivermectin reduction ratio was calculated at 29% and 39% for each dog, respectively. When compared to intrinsic total body ivermectin clearance, only the second dog had a relative improvement of plasma clearance following SPLD. Both dogs were confirmed to be homozygous for ABCB1-1Δ gene mutations. Both dogs remained ventilator dependent for several days and ultimately made a full recovery. SPLD may be an adjunctive detoxification strategy for highly lipophilic toxins such as ivermectin. © Veterinary Emergency and Critical Care Society 2017.

  16. Effects of repeated doses of ivermectin on ocular onchocerciasis: community-based trial in Sierra Leone.

    PubMed

    Whitworth, J A; Gilbert, C E; Mabey, D M; Maude, G H; Morgan, D; Taylor, D W

    1991-11-02

    Ivermectin seems to be a safe and effective treatment for onchocerciasis when given in a single dose, but less is known about the effects of repeated doses. Also, there seem to be differences in its effectiveness in anterior and posterior segment ocular disease. The ocular effects of ivermectin were studied in 586 villagers who were taking part in a double-blind, placebo-controlled, randomised trial in Sierra Leone. Only those who had received four doses, with 6-month intervals, of ivermectin or placebo were eligible. The 296 ivermectin-treated subjects and the 272 who received placebo were comparable with respect to age, sex, Onchocerca infection, blindness, and visual impairment before treatment. After treatment, the ivermectin group had less anterior segment disease than the placebo group, with significantly lower prevalences of microfilariae in the anterior chamber and cornea, and punctate keratitis (all p less than 0.001), and iritis (p less than 0.05). There was no significant difference in the prevalence of sclerosing keratitis, optic atrophy, or chorioretinitis between the groups. Visual acuities tended to be better in the ivermectin group, but the difference was not significant. There was a small but significant (p less than 0.01) excess of vascular sheathing in the ivermectin group. These differences persisted when subjects who were blind or visually impaired at baseline were excluded from analysis. The long-term effects of ivermectin, particularly on posterior segment disease, need further evaluation. In the mean time, the mass distribution of ivermectin should be promoted for all communities with hyperendemic onchocerciasis at risk of anterior segment disease.

  17. Ivermectin - Old Drug, New Tricks?

    PubMed

    Laing, Roz; Gillan, Victoria; Devaney, Eileen

    2017-03-09

    Ivermectin is one of the most important drugs in veterinary and human medicine for the control of parasitic infection and was the joint focus of the 2015 Nobel Prize in Physiology or Medicine, some 35 years after its remarkable discovery. Although best described for its activity on glutamate-gated chloride channels in parasitic nematodes, understanding of its mode of action remains incomplete. In the field of veterinary medicine, resistance to ivermectin is now widespread, but the mechanisms underlying resistance are unresolved. Here we discuss the history of this versatile drug and its use in global health. Based on recent studies in a variety of systems, we question whether ivermectin could have additional modes of action on parasitic nematodes.

  18. Ivermectin is better than benzyl benzoate for childhood scabies in developing countries.

    PubMed

    Brooks, P A; Grace, R F

    2002-08-01

    To compare single dose oral ivermectin with topical benzyl benzoate for the treatment of paediatric scabies. An observer-blinded randomized controlled trial was undertaken at Vila Central Hospital, Vanuatu. One hundred and ten children aged from 6 months to 14 years were randomized to receive either ivermectin 200 micro g/kg orally or 10% benzyl benzoate topically. Follow up was at 3 weeks post-treatment. Primary outcome measures were the number of scabies lesions, the itch visual analogue score and nocturnal itch. Secondary outcome measures were the skin's reaction to treatment, the passage of worms in stool and other side effects. Eighty patients completed the study protocol. There was no significant difference between the two treatments; both produced a significant decrease in the number of scabies lesions seen at follow up. Ivermectin cured 24 out of 43 patients (56%), and benzyl benzoate 19 out of 37 patients (51%) at 3 weeks post-treatment. No serious side effects were noted with either treatment, but benzyl benzoate was more likely to produce local skin reactions (P = 0.004, OR 6.4, 95% CI 1.6-25.0) Ivermectin is cheap and effective in the treatment of paediatric scabies. Ivermectin has minimal observed toxicity and has the additional beneficial effects of antiparasitic action in onchocerciasis, filariasis and strongyloidiasis. Ivermectin is better than benzyl benzoate for the treatment of paediatric scabies in developing countries.

  19. Ivermectin inhibits porcine reproductive and respiratory syndrome virus in cultured porcine alveolar macrophages.

    PubMed

    Lee, Yoo Jin; Lee, Changhee

    2016-02-01

    Porcine reproductive and respiratory syndrome virus (PRRSV) is a devastating viral pathogen of swine that causes huge financial losses in the pig industry worldwide. Ivermectin is known to be a potent inhibitor of importin α/β-mediated nuclear transport and exhibits antiviral activity towards several RNA viruses by blocking the nuclear trafficking of viral proteins. Although PRRSV replication occurs exclusively in the cytoplasm of infected cells, the nucleocapsid (N) protein has been shown to distinctly localize in the nucleus and nucleolus throughout infection. Here, we sought to assess whether ivermectin suppresses PRRSV replication in cultured porcine alveolar macrophage (PAM) cells and to investigate the effect of ivermectin on the subcellular localization of the PRRSV N protein. Our data demonstrate that ivermectin treatment inhibits PRRSV infection in PAM-pCD163 cells in a dose-dependent manner. The antiviral activity of ivermectin on PRRSV replication was most effective when cells were treated during the early stage of infection. Treatment of PRRSV-infected cells with ivermectin significantly suppressed viral RNA synthesis, viral protein expression, and progeny virus production. However, immunofluorescence and cell fractionation assays revealed that ivermectin was incapable of disrupting the nuclear localization of the N protein, both in PRRSV-infected PAM-pCD163 cells and in PAM cells stably expressing the PRRSV N protein. This finding suggests that an alternative mechanism of action accounts for the ability of ivermectin to diminish PRRSV replication. Taken together, our results suggest that ivermectin is an invaluable therapeutic or preventative agent against PRRSV infection.

  20. Comparative cost-effectiveness of ivermectin versus topical organophosphate in feedlot calves

    PubMed Central

    Bauck, Stewart W.; Jim, G. Kee; Guichon, P. Tim; Newcomb, Kathleen M.; Cox, James L.; Barrick, Ruth-Ann

    1989-01-01

    A study was conducted in a commercial feedlot in western Canada to evaluate the impact of treatment with ivermectin versus a topical organophosphate on growth rate and feed efficiency in calves entering a feedlot at an average 275 kg liveweight. A total of 9527 head of cattle was used. Variables measured included average daily gain, average days occupation, and feed conversion. Ivermectin treated animals gained an average 0.08 kg per day more than those treated with topical organophosphate. In addition, they required an average 0.23 kg less feed/kg gain. Based on an average 227 kg of gain, this would result in 11 fewer days occupation and 52.3 kg less feed for ivermectin treated animals. This equaled a net benefit of $7.04 per head over treatment costs for ivermectin treatment versus topical organophosphate. PMID:17423237

  1. Maintaining compliance to ivermectin in communities in two West African countries.

    PubMed

    Whitworth, J A; Alexander, N D; Seed, P; Thomas, W; Abiose, A; Jones, B R

    1996-09-01

    We have investigated various aspects related to managing wide-scale ivermectin distribution schemes within randomized controlled trials in communities where onchocerciasis is endemic. Multiple logistic regression analysis of determinants of compliance to five doses of ivermectin in 589 people in Sierra Leone showed independent significant associations with leopard skin depigmentation, the severity of side effects of treatment, fulfilling the exclusion criteria for treatment, and long-term residence in the community. These results are useful for tailoring health promotion messages in Sierra Leone, but the associations may differ in other West African societies. In Nigeria 1847 people were interviewed about various subjective responses, including itching. None of these showed clear improvement after three years of ivermectin treatment. Positive comments about treatment were generally non-specific and similar in the placebo and ivermectin groups. Negative comments were usually related to adverse reactions, especially itching and rash, and were more common after ivermectin. The lack of any benefit attributable to ivermectin that is discernible to its recipients may make it difficult to maintain the high compliance rates needed for long periods if mass dosing programmes are to have a lasting impact on onchocerciasis. In addition, no consistent effects of ivermectin were found by measuring visual acuity, height, weight or haematocrit in comparison with placebo. This may indicate that evidence of clinical impact is very slow to develop and is hard to measure using simple objective methods after only three doses of treatment. At present it seems that parasitological, entomological and detailed ophthalmological or dermatological methods are required to demonstrate the impact of ivermectin treatment in the medium-term.

  2. Shuttle APS propellant thermal conditioner study

    NASA Technical Reports Server (NTRS)

    Pearson, W. E.

    1971-01-01

    A study program was performed to allow selection of thermal conditioner assemblies for superheating O2 and H2 at supercritical pressures. The application was the auxiliary propulsion system (APS) for the space shuttle vehicle. The O2/H2 APS propellant feed system included propellant conditioners, of which the thermal conditioner assemblies were a part. Cryogens, pumped to pressures above critical, were directed to the thermal conditioner assembly included: (1) a gas generator assembly with ignition system and bipropellant valves, which burned superheated O2 and H2 at rich conditions; (2) a heat exchanger assembly for thermal conditioning of the cryogenic propellant; and (3) a dump nozzle for heat exchanger exhaust.

  3. Anthelmintic resistance of intestinal nematodes to ivermectin and pyrantel in Estonian horses.

    PubMed

    Lassen, B; Peltola, S-M

    2015-11-01

    There is evidence of resistance in horses to anthelmintic treatment using ivermectin and pyrantel. However, little information is available about the parasites, treatment practices or anthelmintic resistance in the horse population in Estonia. In the present study, we examined 41 trotting and riding horses aged < 3 years from four stables in Estonia. Faecal samples were collected, and horses were selected for treatment if the nematode egg count per gram faeces exceeded 200. Horses (n= 32) that shed strongyle-type eggs were treated with pyrantel, whereas Parascaris equorum-positive animals received ivermectin. Up to 78% of horses required anthelmintic treatment and the efficiency of the anthelmintics was evaluated using a faecal egg count reduction test. Resistance of P. equorum was observed in 50% of horses treated with ivermectin and of strongyles in 27% of horses treated with pyrantel. Ivermectin treatment resulted in a mean reduction of 100% for strongyle eggs and an 89% reduction in P. equorum, and pyrantel-treated horses exhibited an 88% reduction in strongyle eggs. These results are considered to be the first indication of resistance to pyrantel, but further studies of ivermectin resistance are required. According to questionnaires completed by the owners of horses, resistance might be explained by a lack of evidence-based strategies, a strong preference for using ivermectin and possibly a subjective evaluation of the body weight of horses.

  4. Oral ivermectin for head lice: a comparison with 0.5 % topical malathion lotion.

    PubMed

    Nofal, Ahmad

    2010-12-01

    Reports of treatment failure of head lice have become increasingly common. Oral ivermectin has been proposed as a potential alternative for the treatment of head lice infestation. The aim of this study was to compare the efficacy of oral ivermectin with topical malathion lotion in the treatment of head lice. Eighty apparently healthy children with head lice infestation were randomly assigned to 2 groups, with 40 patients in each. The first group received oral ivermectin as a single dose of 200 μg/kg and the second group received single topical application of malathion lotion 0.5%. Follow up visits were done at days 8, 15 and 29. A second dose of either drug was given at day 8 in case of treatment failure. After a single dose, complete cure was achieved in 77.5% and 87.5% of ivermectin and malathion groups respectively. After the second dose for nonresponders, the cure rate increased to 92.5% in the ivermectin group and 95% in the malathion group. No major adverse effects were observed in either group. Oral ivermectin is a promising effective approach for the treatment of head lice and could be an ideal substitute for conventional pediculicides. © The Author • Journal compilation © Blackwell Verlag GmbH, Berlin.

  5. Demodicosis Treatment with Systemic Ivermectin.

    PubMed

    da Rocha, Manuel Coelho; Travassos, Ana Rita; Uva, Luís; Sequeira, Hortênsia; Filipe, Paulo

    2017-01-01

    A 23-year-old white man presented to our dermatology department complaining of pruriginous and erythematous papulopustules on the right cheek that had developed 6 months previously. He had a history of chronic blepharitis, complicated by a recurrent hordeolum that had been treated with warm compresses and topical antibiotic ointment (chloramphenicol) for approximately 2 years. The patient had oily skin and atopy (allergic rhinitis) and did not experience photosensitivity or flushing or have previous exposure to immunosuppressants or topical/systemic corticosteroids.

  6. Ivermectin reduces sexual behavior in female rats.

    PubMed

    Moreira, N; Bernardi, M M; Spinosa, H S

    2014-01-01

    Ivermectin (IVM) is an antiparasitic drug that is widely used in domestic animals. In mammals, IVM acts as a γ-aminobutyric acid (GABA) receptor agonist. This neurotransmitter plays an important role in the regulation of female sexual behavior. The present study investigated the effects of therapeutic (0.2 mg/kg) and high (1.0 mg/kg) IVM doses on female sexual behavior in physiological and pharmacological conditions. Female rats in estrus or treated with estradiol valerate to induce sexual behavior 24 h before the experiments were used. Ivermectin was administered 15 min before the sexual observations. The number of lordosis events in 10 mounts was recorded to calculate the lordosis quotient. The intensity of lordosis (0 [no lordosis], 1 [low lordosis], 2 [normal lordosis] and 3 [exaggerated lordosis]) was scored. In estrus and hormonal treated female rats, both IVM doses decreased the intensity of the lordosis reflex and the percentage of females that presented high levels of lordosis (exaggerated lordosis). However, the number of females that presented lordosis was unaltered. We conclude that in both hormonal conditions, 0.2mg/kg IVM treatment reduced female sexual behavior and the execution of the lordosis reflex. The present results may be useful for avoiding the side effects of this drug in veterinary practice. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Failure of ivermectin and eprinomectin to control Amblyomma parvum in goats: characterization of acaricidal activity and drug pharmacokinetic disposition.

    PubMed

    Lifschitz, A; Nava, S; Guglielmone, A A; Imperiale, F; Farias, C; Mangold, A J; Lanusse, C

    2008-10-01

    The therapeutic efficacies of ivermectin (subcutaneous injection) and eprinomectin (topical treatment) given at two different dosage levels to goats naturally infested with Amblyomma parvum were assessed. Treatments included subcutaneous injection of ivermectin at 0.2 and 0.4mg/kg and extra-label pour-on administration of eprinomectin at 0.5 and 1mg/kgb.w. Ivermectin and eprinomectin failed to control Amblyomma parvum on goats. Treatment with ivermectin resulted in a low number of engorged female ticks in relation to untreated control goats and, at the highest dose rate (0.4mg/kg), the female engorgement weights were significantly lower and the pre-oviposition period significantly longer than those observed in ticks recovered from untreated control goats. The tick efficacy assessment was complemented in a separate group of tick-free goats with a pharmacokinetic characterization of eprinomectin (topically administered at 0.5, 1.0 and 1.5mg/kg) and ivermectin (subcutaneous treatment given at (0.2 and 0.4mg/kg) in goats. Heparinized blood samples were taken between 0 and 21 days post-treatment. Higher and more persistent drug plasma concentrations were recovered after the subcutaneous treatment with ivermectin compared to those obtained for eprinomectin topically administered. The understanding of the relationship among the pattern of drug absorption, the kinetic disposition and the resultant clinical efficacy is relevant to improve the poor performance observed for ivermectin and eprinomectin against A. parvum on goats.

  8. Ivermectin failure in the control of Oxyuris equi in a herd of ponies in France.

    PubMed

    Sallé, Guillaume; Cortet, Jacques; Koch, Christine; Gascogne, Thierry; Reigner, Fabrice; Cabaret, Jacques

    2016-10-15

    Drug resistance in equine gastro-intestinal parasitic nematodes has been reported throughout the world. While the focus is usually put on cyathostomins, observations of macrocylic lactone failure against Oxyuris equi have accumulated over the last decade. Here we report the failure of ivermectin in the control of O. equi in an experimental Welsh pony herd. In a first trial, 6 ponies previously drenched with moxidectin and showing patent O. equi infections were administered ivermectin and subsequently monitored for O. equi egg excretion over one month. This trial demonstrated a failure of ivermectin to control O. equi egg excretion as half of ponies demonstrated recurrent egg excretion in the peri-anal region during 21days after treatment. One year later, six female Welsh ponies drenched with moxidectin demonstrated signs of itching and scratching in their peri-anal region with worms being found transiently in fecal materials three weeks later. Ponies were allocated to three treatment groups, i.e. ivermectin, pyrantel embonate and fenbendazole and monitored for egg excretion over five weeks. Fenbendazole and pyrantel embonate broke ivermectin suboptimal efficacy as soon as 8 and 14days respectively after treatment, while egg excretion remained constant throughout the 41-day long trial in the ivermectin-treated ponies. This is the first report of ivermectin failure against O. equi in France. In the absence of critical efficacy test, it remains unclear whether true resistance is at stake or if these observations confound a constitutive suboptimal efficacy of ivermectin against O. equi. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Crusted scabies in an adult T-cell leukemia/lymphoma patient successfully treated with oral ivermectin.

    PubMed

    Yonekura, Kentaro; Kanekura, Takuro; Kanzaki, Tamotsu; Utsunomiya, Atae

    2006-02-01

    We report an adult T-cell leukemia/lymphoma (ATL) patient whose crusted scabies was successfully treated with oral ivermectin. This 63-year-old man had previously been treated with oral prednisolone, sobuzoxane and etoposide for approximately 1 year. When he developed crusted scabies, he received two doses of oral ivermectin (200 microg/kg) 10 days apart and the concomitant topical application of crotamiton containing 30% benzyl benzoate. This produced remarkable results, suggesting that oral ivermectin should be considered for the treatment of crusted scabies even in immunocompromised patients. While ivermectin may be useful for treating intractable scabies, attention must be paid to the possible appearance of ivermectin-resistant mites.

  10. 7 CFR 3201.92 - Fuel conditioners.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Fuel conditioners. 3201.92 Section 3201.92... Designated Items § 3201.92 Fuel conditioners. (a) Definition. Products formulated to improve the performance... fuel system. (b) Minimum biobased content. The Federal preferred procurement product must have...

  11. 7 CFR 3201.92 - Fuel conditioners.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Fuel conditioners. 3201.92 Section 3201.92... Designated Items § 3201.92 Fuel conditioners. (a) Definition. Products formulated to improve the performance... fuel system. (b) Minimum biobased content. The Federal preferred procurement product must have...

  12. Ivermectin-induced immunopotentiation in onchocerciasis: recognition of selected antigens following a single dose of ivermectin.

    PubMed

    Akuffo, H; Maasho, K; Lavebratt, C; Engström, K; Britton, S

    1996-02-01

    Onchocerciasis is associated with blindness and gross skin changes, believed to be a consequence of the immune response to antigens released from the offspring of the female worm of Onchocerca volvulus, the microfilariae (mf). An effective microfilaricidal drug is now available which quickly reduces the mf burden without affecting the adult worm. There exist foci in onchocerciasis endemic areas where some of the patients have many mf in their skin but relatively few clinical symptoms. This state of hyposensitivity is believed to be due to immunosuppression. The aim of this study was to address the question of the basis of, and the effect of ivermectin treatment on this immunosuppression. Female adult worms of O. volvulus were used as whole or fractionated antigens to stimulate peripheral blood mononuclear cells. Microfilariae are found in the reproduction tract of the female worms, and thus an antigen preparation of the female adult O. volvulus contains both exclusive adult antigens as well as antigens from microfilariae. Cells were obtained from onchocerciasis patients, individuals of similar socio-economic status living in the same Ghanaian village, but who showed no parasitological or clinical evidence of onchocerciasis (exposed endemic controls), healthy Ghanaians living in areas where transmission of onchocerciasis does not seem to occur (non-exposed endemic controls) and unexposed healthy Swedish donors. As a group, cells from onchocerciasis patients proliferated to a lesser degree than cells from the exposed endemic control and the non-exposed endemic control groups to the whole worm antigen, whereas the phytohaemagglutinin (PHA) response was strongest in the patients. Proliferative responses of above 1000 ct/min to fractions of the worm extract were only evident in the cells from a few individuals in each of the various groups. However, 28 days following ivermectin treatment, cells from all onchocerciasis patients were able to mount significantly enhanced

  13. Ivermectin: does P-glycoprotein play a role in neurotoxicity?

    PubMed Central

    Edwards, Geoffrey

    2003-01-01

    The macrocyclic lactone ivermectin (Mectizan®) is widely used for the control of human filarial infections, particularly as a donated product for onchocerciasis and lymphatic filariasis. In the case of control of lymphatic filariasis in Africa, it is used in combination with donated albendazole. In areas co-endemic for Onchocerciasis and Loa loa, serious adverse reactions have been observed in patients with apparently high microfilaria counts of Loa loa. Recent findings suggest that the severe central nervous system side effects seen in various vertebrates following ivermectin treatment may be due to an absence of, or functional deficiency in P-glycoprotein. P-glycoprotein is expressed in the apical membrane of brain capillary epithelial cells and is responsible for limiting the brain penetration of a range of compounds. Toxicity of ivermectin in some collie dogs may be explained by a 4-bp deletion mutation of the mdr1 gene resulting in a frame shift, generating stop codons that prematurely terminate synthesis of P-glycoprotein. Additionally, sub-populations of CF-1 identified as expressing reduced levels of P-glycoprotein exhibit increased toxicity to substrates of this transporter. Furthermore, while the traditional view of drug-drug interactions is alteration in drug clearance mediated through a change in hepatic drug metabolism, some of these changes may arise through competition for binding sites on P-glycoprotein in the blood-brain barrier, resulting in reduced extracellular efflux and enhanced CNS toxicity. In conclusion, P-glycoprotein is an integral component of the human blood brain barrier and plays a central role in limiting drug uptake into the brain. Altered expression or function of p-glycoprotein could conceivably allow elevation of brain concentrations of ivermectin and produce severe neurotoxicity. This might arise through a genetic polymorphism in p-glycoprotein or co-administration of ivermectin with a drug or foodstuff that might inhibit this

  14. Space shuttle aps propellant thermal conditioner study

    NASA Technical Reports Server (NTRS)

    Fulton, D. L.

    1973-01-01

    An analytical and experimental effort was completed to evaluate a baffle type thermal conditioner for superheating O2 and H2 at supercritical pressures. The thermal conditioner consisted of a heat exchanger and an integral reactor (gas generator) operating on O2/H2 propellants. Primary emphasis was placed on the hydrogen conditioner with some effort on the oxygen conditioner and a study completed of alternate concepts for use in conditioning oxygen. A hydrogen conditioner was hot fire tested under a range of conditions to establish ignition, heat exchange and response parameters. A parallel technology task was completed to further evaluate the integral reactor and heat exchanger with the side mounted electrical spark igniter.

  15. Conditioner for a helically transported electron beam

    SciTech Connect

    Wang, C.

    1992-05-01

    The kinetic theory is developed to investigate a conditioner for a helically imported electron beam. Linear expressions for axial velocity spread are derived. Numerical simulation is used to check the theoretical results and examine nonlinear aspects of the conditioning process. The results show that in the linear regime the action of the beam conditioner on a pulsed beam mainly depends on the phase at which the beam enters the conditioner and depends only slightly on the operating wavelength. In the nonlinear regime, however, the action of the conditioner strongly depends on the operating wavelength and only slightly upon the entrance phase. For a properly chosen operating wavelength, a little less than the electron's relativistic cyclotron wavelength, the conditioner can decrease the axial velocity spread of a pulsed beam down to less than one-third of its initial value.

  16. Conditioner for a helically transported electron beam

    SciTech Connect

    Wang, C.

    1992-05-01

    The kinetic theory is developed to investigate a conditioner for a helically imported electron beam. Linear expressions for axial velocity spread are derived. Numerical simulation is used to check the theoretical results and examine nonlinear aspects of the conditioning process. The results show that in the linear regime the action of the beam conditioner on a pulsed beam mainly depends on the phase at which the beam enters the conditioner and depends only slightly on the operating wavelength. In the nonlinear regime, however, the action of the conditioner strongly depends on the operating wavelength and only slightly upon the entrance phase. For a properly chosen operating wavelength, a little less than the electron`s relativistic cyclotron wavelength, the conditioner can decrease the axial velocity spread of a pulsed beam down to less than one-third of its initial value.

  17. Host ABC transporter proteins may influence the efficacy of ivermectin and possibly have broader implications for the development of resistance in parasitic nematodes.

    PubMed

    Dooley, L A; Froese, E A; Chung, Y T; Burkman, E J; Moorhead, A R; Ardelli, B F

    2015-10-01

    ABC transporter proteins function to extrude compounds from the cell. These proteins present an obstacle for treatment and for overcoming drug resistance as they are expressed by both host and parasite, and function similarly. The contribution of host ABC proteins to drug efficacy was examined using ivermectin and a Brugia malayi model system. Parallel in vitro and in vivo experiments were conducted using equal concentrations of ivermectin. The motilities and fecundity of B. malayi exposed to ivermectin in vitro were significantly lower than those treated in vivo. The higher motilities were correlated with low concentrations of ivermectin in worms extracted from treated hosts. The expression of ABC proteins was significantly higher in worms treated in vitro compared to those treated in vivo as well as in gerbils treated with ivermectin than in non-treated controls. The results suggest that host ABC transporters may influence the efficacy of ivermectin. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Low-noise pulse conditioner

    DOEpatents

    Bird, David A.

    1983-01-01

    A low-noise pulse conditioner is provided for driving electronic digital processing circuitry directly from differentially induced input pulses. The circuit uses a unique differential-to-peak detector circuit to generate a dynamic reference signal proportional to the input peak voltage. The input pulses are compared with the reference signal in an input network which operates in full differential mode with only a passive input filter. This reduces the introduction of circuit-induced noise, or jitter, generated in ground referenced input elements normally used in pulse conditioning circuits, especially speed transducer processing circuits.

  19. Relationship between oral declaration on adherence to ivermectin treatment and parasitological indicators of onchocerciasis in an area of persistent transmission despite a decade of mass drug administration in Cameroon.

    PubMed

    Wanji, Samuel; Kengne-Ouafo, Jonas A; Esum, Mathias E; Chounna, Patrick W N; Adzemye, Bridget F; Eyong, Joan E E; Jato, Isaac; Datchoua-Poutcheu, Fabrice R; Abong, Raphael A; Enyong, Peter; Taylor, David W

    2015-12-30

    Onchocerciasis control for years has been based on mass drug administration (MDA) with ivermectin (IVM). Adherence to IVM repeated treatment has recently been shown to be a confounding factor for onchocerciasis elimination precisely in rain forest areas where transmission continues and Loa loa co-exists with Onchocerca volvulus. In this study, participants' oral declarations were used as proxy to determine the relationship between adherence to IVM treatment and parasitological indicators of onchocerciasis in the rain forest area of Cameroon with more than a decade of MDA. Participants were recruited based on their IVM intake profile with the aid of a semi-structured questionnaire. Parasitological examinations (skin sniping and nodule palpation) were done on eligible candidates. Parasitological indicators were calculated and correlated to IVM intake profile. Of 2,364 people examined, 15.5% had never taken IVM. The majority (40.4%) had taken the drug 1-3 times while only 18% had taken ≥ 7 times. Mf and nodule prevalence rates were still high at 47%, 95% CI [44.9-49.0%] and 36.4%, 95% CI [34.4-38.3%] respectively. There was a treatment-dependent reduction in microfilaria prevalence (rs =-0.986, P = 0.01) and intensity (rs =-0.96, P = 0.01). The highest mf prevalence (59.7%) was found in the zero treatment group and the lowest (33.9%) in the ≥ 7 times treatment group (OR = 2.8; 95% CI [2.09-3.74]; P < 0.001). Adults with ≥ 7 times IVM intake were 2.99 times more likely to have individuals with no microfilaria compared to the zero treatment group (OR = 2.99; 95% CI [2.19-4.08], P < 0.0001). There was no clear correlation between treatment and nodule prevalence and intensity. Adherence to ivermectin treatment is not adequate in this rain forest area where L. loa co-exists with O. volvulus. The prevalence and intensity of onchocerciasis remained high in individuals with zero IVM intake after more than a decade of MDA. Our

  20. Ivermectin Induces Cytostatic Autophagy by Blocking the PAK1/Akt Axis in Breast Cancer.

    PubMed

    Dou, Qianhui; Chen, Hai-Ning; Wang, Kui; Yuan, Kefei; Lei, Yunlong; Li, Kai; Lan, Jiang; Chen, Yan; Huang, Zhao; Xie, Na; Zhang, Lu; Xiang, Rong; Nice, Edouard C; Wei, Yuquan; Huang, Canhua

    2016-08-01

    Breast cancer is the most common cancer among women worldwide, yet successful treatment remains a clinical challenge. Ivermectin, a broad-spectrum antiparasitic drug, has recently been characterized as a potential anticancer agent due to observed antitumor effects. However, the molecular mechanisms involved remain poorly understood. Here, we report a role for ivermectin in breast cancer suppression by activating cytostatic autophagy both in vitro and in vivo Mechanistically, ivermectin-induced autophagy in breast cancer cells is associated with decreased P21-activated kinase 1 (PAK1) expression via the ubiquitination-mediated degradation pathway. The inhibition of PAK1 decreases the phosphorylation level of Akt, resulting in the blockade of the Akt/mTOR signaling pathway. In breast cancer xenografts, the ivermectin-induced cytostatic autophagy leads to suppression of tumor growth. Together, our results provide a molecular basis for the use of ivermectin to inhibit the proliferation of breast cancer cells and indicate that ivermectin is a potential option for the treatment of breast cancer. Cancer Res; 76(15); 4457-69. ©2016 AACR. ©2016 American Association for Cancer Research.

  1. Autoantibody induced by experimental Onchocerca infection. Effect of different routes of administration of microfilariae and of treatment with diethylcarbamazine citrate and ivermectin.

    PubMed

    Donnelly, J J; Xi, M S; Haldar, J P; Hill, D E; Lok, J B; Khatami, M; Rockey, J H

    1988-05-01

    Hartley guinea pigs were injected with microfilariae (Mf) of Onchocerca lienalis as a model for acute inflammatory responses to Mf in human Onchocerca volvulus infection. IgG autoantibody reactive with a 3 M KCl extract of guinea pig cornea was detected by ELISA in the serum of guinea pigs injected with O. lienalis Mf three or more times sub-conjunctivally, or two or more times subcutaneously. Administration of the microfilaricides diethylcarbamazine citrate and ivermectin did not alter the proportion of animals expressing autoantibody or the mean autoantibody titer. The severity of acute corneal inflammatory reactions to Mf was similar in animals with and without circulating autoantibody. Although autoantibody responses did not correlate with acute corneal inflammatory reactions to dead Mf, the ability of Mf to induce formation of an antibody reactive with a component of autologous cornea suggests that autoimmune mechanisms might participate in chronic onchocercal lesions in the cornea, eg, sclerosing keratitis.

  2. A randomized, double-blind, multicenter clinical trial on the efficacy of ivermectin against intestinal nematode infections in China.

    PubMed

    Wen, Li-Yong; Yan, Xiao-Lan; Sun, Feng-Hua; Fang, Yue-Yi; Yang, Ming-Jin; Lou, Lei-Jun

    2008-06-01

    To assess the efficacy of ivermectin against intestinal nematode infections, a randomized, double-blind, multicenter clinical trial was carried out in a total of 816 human individuals infected with different nematodes from three counties in China. The subjects were randomly assigned into experimental and control groups and orally given a single dose of 0.1, 0.2, 0.2 and 0.2mg/kg ivermectin against Ascaris lumbricoides, hookworm, Trichuris trichiura and Enterobius vermicularis, respectively. Parallel control groups to each of the ivermectin groups were given a single oral dose of 6.7 mg/kg albendazole. The cure rates with ivermectin and albendazole were 100% (102/102) and 99.0% (101/102) for Ascaris, and 66.7% (68/102) and 67.7% (69/102) for Trichuris, respectively, with no significant difference (P>0.05) between the two treatments. The parasitological cure rates of albendazole were 69.6% (71/102) for hookworm and 94.1% (96/102) for Enterobius, which were significantly higher than ivermectin (33.3% and 52.9%, respectively, P<0.0001). The expulsion of worm in the feces reached its peak 1-2 days after ivermectin treatment. The study showed that ivermectin, with few side effects, could be used as an additional treatment tool for intestinal nematodes, especially for the treatment of Ascaris and Trichuris infections in China.

  3. Effect of ivermectin on the larvae of Anopheles gambiae and Culex quinquefasciatus.

    PubMed

    Derua, Yahya A; Malongo, Bernard B; Simonsen, Paul E

    2016-03-08

    Ivermectin is used extensively globally for treatment of helminthic and ectoparasitic infections in animals and humans. The effect of excreted ivermectin on non-target organisms in aquatic and terrestrial environments has been increasingly reported. Due to its low water solubility and adsorption to sediments, the ivermectin exposure-risk to aquatic organisms dwelling in different strata of water bodies varies. This study assessed the survival of larvae of Anopheles gambiae Giles and Culex quinquefasciatus Say, when exposed to low concentrations of ivermectin under laboratory conditions. A total of 1800 laboratory reared mosquito larvae of each species were used in the bioassays. Twelve replicates were performed, each testing 6 concentrations of ivermectin (0.0, 0.001, 0.01, 0.1, 1.0 and 10.0 parts per million (ppm)) against third instar larvae of An. gambiae and Cx. quinquefasciatus. Larval mortality was recorded at 24 and 48 h post addition of ivermectin. Survival declined markedly with increase in ivermectin concentration in both species. While mean survival of An. gambiae at 24 h of exposure was 99.6 %, 99.2 % and 61.6 % in 0.001, 0.01 and 0.1 ppm of ivermectin, respectively, the mean survival of Cx. quinquefasciatus at the same dosage and time was 89.2 %, 47.2 % and 0.0 %. A similar pattern, but with higher mortality, was observed after 48 h of exposure. Comparison between the species revealed that Cx. quinquefasciatus larvae were significantly more affected by ivermectin than those of An. gambiae, both at 24 and 48 h. Low concentrations of ivermectin in the aquatic environment reduced the survival of larvae of An. gambiae and Cx. quinquefasciatus, with the effect being more marked in the latter species. It is suggested that this difference may be due to the different water strata occupied by the two species, with ivermectin adsorbed in food that sediment being more readily available to the bottom feeding Cx. quinquefasciatus than the surface feeding An

  4. 21 CFR 520.1199 - Ivermectin, pyrantel, and praziquantel tablets.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... micrograms (mcg) ivermectin, 28.5 milligrams (mg) pyrantel pamoate, and 28.5 mg praziquantel; (2) 68 mcg ivermectin, 57 mg pyrantel pamoate, and 57 mg praziquantel; (3) 136 mcg ivermectin, 114 mg pyrantel pamoate, and 114 mg praziquantel; or (4) 272 mcg ivermectin, 228 mg pyrantel pamoate, and 228 mg...

  5. 21 CFR 520.1199 - Ivermectin, pyrantel, and praziquantel tablets.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... micrograms (mcg) ivermectin, 28.5 milligrams (mg) pyrantel pamoate, and 28.5 mg praziquantel; (2) 68 mcg ivermectin, 57 mg pyrantel pamoate, and 57 mg praziquantel; (3) 136 mcg ivermectin, 114 mg pyrantel pamoate, and 114 mg praziquantel; or (4) 272 mcg ivermectin, 228 mg pyrantel pamoate, and 228 mg...

  6. A new ivermectin formulation topically kills permethrin-resistant human head lice (Anoplura: Pediculidae).

    PubMed

    Strycharz, Joseph P; Yoon, Kyong Sup; Clark, J Marshall

    2008-01-01

    This study examines the effectiveness of a new ivermectin formulation for the topical treatment of the human head louse, Pediculus humanus capitis De Geer (Anoplura: Pediculidae). Permethrin-resistant lice originally obtained from south Florida and maintained on an in vitro rearing system were 100% susceptible to ivermectin formulations by using a semiclinical hair tuft bioassay. The formulation was 100% effective at killing lice using 1, 0.5, and 0.25% ivermectin concentrations after 10-min exposures. As judged by the lethal time (LT)50 and LT95 values, 0.5% formulated ivermectin was 3.8 and 3.2 times faster at killing lice, respectively, than 0.5% nonformulated ivermectin, indicating that the formulation may facilitate the penetration of ivermectin into the louse. The hair tuft-based bioassay in conjunction with the in vitro rearing system provides a standardized method to assess the comparative efficacy of pediculicide formulations in a reproducible format that mimics the exposure scenario that occurs on the human scalp.

  7. How long do the effects of ivermectin on adult Onchocerca volvulus persist?

    PubMed

    Kläger, S; Whitworth, J A; Post, R J; Chavasse, D C; Downham, M D

    1993-12-01

    The persistence of the effects of ivermectin on the viability, morphology and reproductivity of adult Onchocerca volvulus was examined eighteen months after treatment with a single or five six-monthly doses of ivermectin and compared with untreated controls. Treated nodules were removed from patients participating in a randomised controlled trial of ivermectin in Sierra Leone. Adult filariae, 545 females and 348 males, were isolated by collagenase digestion. The nodules were significantly smaller, contained fewer young worms and supported lower microfilarial production in those treated with five doses of ivermectin. The productivity index, a measure of the reproductive potential of a worm population, was still reduced by 83% eighteen months after five doses and by 63% after a single dose compared to controls. These results show that worms recover their fertility even after multiple doses of ivermectin, but do so slowly compared to standard dosage intervals. In addition ivermectin may have a partial chemoprophylactic effect which contributes to the maintenance of low microfilarial production in conditions of on-going transmission.

  8. The embryogenesis of Onchocerca volvulus over the first year after a single dose of ivermectin.

    PubMed

    Duke, B O; Zea-Flores, G; Muñoz, B

    1991-09-01

    Adult Onchocerca volvulus, extracted from nodules before, and at intervals of two weeks to 12 months after, a single 150 micrograms/kg dose of ivermectin, were examined longitudinally and by sequential transverse sections. The mean number of male worms per nodule fell, and the proportion of nodules with no male worm rose, within two weeks of ivermectin and remained so for 12 months. In female worms, at intervals after ivermectin, the percentages of the length of the lower genital tracts occupied by embryos at each stage of development, or by degenerating ova, embryos and microfilariae (mfs), were recorded: (a) in un(re-)inseminated worms whose original embryogenesis was continuing and in those in which it was completed; and (b) in worms, reinseminated post-ivermectin, in which a new embryogenesis had begun. The results indicated that: (a) the time needed for the zygotes of O. volvulus to develop to mfs is 8-12 weeks; (b) nearly 40 percent of females had not resumed mf production by 12 months after treatment; (c) many intrauterine mfs had not degenerated within the first two weeks of ivermectin; (d) some of the last embryos to mature to mfs did not degenerate but accumulated temporarily in the anterior uteri 8-16 weeks after ivermectin.

  9. Double-blind controlled trial of a single dose of the combination ivermectin 400 micrograms/kg plus diethylcarbamazine 6 mg/kg for the treatment of bancroftian filariasis: results at six months.

    PubMed

    Glaziou, P; Moulia-Pelat, J P; Nguyen, L N; Chanteau, S; Martin, P M; Cartel, J L

    1994-01-01

    In 1993, a three-arm double-blind controlled trial was implemented in French Polynesia to compare the tolerance and efficacy of a single dose of the combination ivermectin (IVR) 400 micrograms/kg plus diethylcarbamazine (DEC) 6 mg/kg vs. IVR 400 micrograms/kg alone vs. DEC 6 mg/kg alone, for treatment of Wuchereria bancrofti carriers. Of the 57 treated male patients in whom microfilaria (mf) densities ranged from 22 to 4709 mg/mL, 3 groups of 19 were randomly selected and allocated to one of the 3 treatments. Side effects were experienced by 34 patients (60%), but none suffered a severe reaction. Grade of reaction did not differ between treatment group, but was significantly correlated with the pretreatment mf density. Six months after treatment, 26%, 32% and 53% of patients were amicrofilaraemic in the DEC, IVR and IVR+DEC groups, respectively. Mf levels were 6.3%, and 3.1% and 1.0% of the pretreatment level, respectively, significantly lower in the IVR+DEC group than in both the IVR and DEC comparison groups. The combination IVR+DEC showed promise in term of sustained mf decrease, and could be an effective alternative for lymphatic filariasis control programmes.

  10. Effect of ivermectin on allergy-type manifestations in occult strongyloidiasis.

    PubMed

    Rampur, Lahari; Jariwala, Sunit P; Hudes, Golda; Rosenstreich, David L; de Vos, Gabriele

    2016-10-01

    The immunomodulatory effects of helminths have been well described. However, there is a relative lack of literature regarding the link between parasites and allergic diseases. A number of patients with allergic symptoms have positive serologic test results for Strongyloides stercoralis. To identify patients with allergy-type symptoms and coexisting Strongyloides infection and to analyze the effect of Strongyloides eradication therapy with ivermectin on these symptoms. The medical records of our allergy clinic sites were reviewed for Strongyloides test results between January 2011 and October 2014. Each allergy-type symptom was assessed separately with regard to improvement after ivermectin therapy. Among the 1,446 patients who had Strongyloides serologic tests ordered, 127 (8.8%) had positive test results. Eighty-four patients had follow-up data regarding allergy-type symptoms after ivermectin treatment. Among these, 52 patients (61.9%) reported skin-related problems (pruritus, urticaria, angioedema, and/or rash). Forty-nine patients (58.3%) had asthma, and 73.8% had allergic rhinoconjunctivitis. Although respiratory symptoms typically did not respond to ivermectin treatment, 24 of 48 patients (50%) with skin symptoms reported a significant subjective improvement of symptoms after ivermectin treatment. Peripheral eosinophil counts significantly decreased after ivermectin treatment from 450 to 200/μL (P < .001). Serologic testing for strongyloides may be indicated for patients with allergy-type symptoms and a suggestive exposure history. Patients with strongyloidiasis and primarily cutaneous symptoms experienced significant symptomatic improvement after ivermectin therapy. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Low-noise pulse conditioner

    DOEpatents

    Bird, D.A.

    1981-06-16

    A low-noise pulse conditioner is provided for driving electronic digital processing circuitry directly from differentially induced input pulses. The circuit uses a unique differential-to-peak detector circuit to generate a dynamic reference signal proportional to the input peak voltage. The input pulses are compared with the reference signal in an input network which operates in full differential mode with only a passive input filter. This reduces the introduction of circuit-induced noise, or jitter, generated in ground referenced input elements normally used in pulse conditioning circuits, especially speed transducer processing circuits. This circuit may be used for conditioning the sensor signal from the Fidler coil in a gas centrifuge for separation of isotopic gaseous mixtures.

  12. High efficiency laser spectrum conditioner

    DOEpatents

    Greiner, Norman R.

    1980-01-01

    A high efficiency laser spectrum conditioner for generating a collinear parallel output beam containing a predetermined set of frequencies from a multifrequency laser. A diffraction grating and spherical mirror are used in combination, to disperse the various frequencies of the input laser beam and direct these frequencies along various parallel lines spatially separated from one another to an apertured mask. Selection of the desired frequencies is accomplished by placement of apertures at locations on the mask where the desired frequencies intersect the mask. A recollimated parallel output beam with the desired set of frequencies is subsequently generated utilizing a mirror and grating matched and geometrically aligned in the same manner as the input grating and mirror.

  13. Chemokines in onchocerciasis patients after a single dose of ivermectin

    PubMed Central

    Fendt, J; Hamm, DM; Banla, M; Schulz-Key, H; Wolf, H; Helling-Giese, G; Heuschkel, C; Soboslay, PT

    2005-01-01

    Ivermectin treatment will effectively diminish microfilariae (Mf) of Onchocerca volvulus in the skin of patients, but therapy is associated with adverse host inflammatory responses. To investigate the association of proinflammatory chemokines with the intensity of infection and clinical adverse reactions, chemokine serum levels were measured in patients following ivermectin treatment (100 µg/kg, 150 µg/kg or 200 µg/kg) or placebo. The density of O. volvulus Mf per mg skin decreased by 85%, 97%, 97% and 90% at day 3, at month 3, month 6 and at 1 year post-ivermectin. The cutaneous T cell-attracting chemokine (CTACK/CCL27) was found highly elevated in onchocerciasis patients compared to infection-free European controls (P = 0·0004) and it did not change following ivermectin or placebo to 1 year post-therapy. The chemokine RANTES/CCL5 (regulated on activated and normally T cell-expressed) was similarly high in onchocerciasis patients and infection-free European controls; the RANTES/CCL5 levels did not change following treatment until 6 months post-therapy but were slightly elevated at 1 year post-therapy (P < 0·02). In contrast, the Th2-type chemoattractants, thymus and activation regulated chemokine (TARC/CCL17) and macrophage-derived chemokine (MDC/CCL22), were activated at 3 days post-ivermectin (P < 0·0001) to return to pretreatment or lower levels thereafter. The Th1-type chemoattractants, macrophage inflammatory protein (MIP)-1α/CCL3 and MIP-1β/CCL4 were low before ivermectin treatment, but following clearance of microfilariae of O. volvulus their levels increased from 6 months post-therapy onwards (for both at 12 months post-therapy, P < 0·0001). The adverse reaction scores (RS) in treated patients increased significantly on day 3 (P < 0·02) while it remained unchanged in those who received placebo (P = 0·22); RS interacted with the microfilarial density (P = 0·01), but not with the dose of ivermectin or with the serum levels of MIP-1α/CCL3, MIP-1

  14. Chemokines in onchocerciasis patients after a single dose of ivermectin.

    PubMed

    Fendt, J; Hamm, D M; Banla, M; Schulz-Key, H; Wolf, H; Helling-Giese, G; Heuschkel, C; Soboslay, P T

    2005-11-01

    Ivermectin treatment will effectively diminish microfilariae (Mf) of Onchocerca volvulus in the skin of patients, but therapy is associated with adverse host inflammatory responses. To investigate the association of proinflammatory chemokines with the intensity of infection and clinical adverse reactions, chemokine serum levels were measured in patients following ivermectin treatment (100 microg/kg, 150 microg/kg or 200 microg/kg) or placebo. The density of O. volvulus Mf per mg skin decreased by 85%, 97%, 97% and 90% at day 3, at month 3, month 6 and at 1 year post-ivermectin. The cutaneous T cell-attracting chemokine (CTACK/CCL27) was found highly elevated in onchocerciasis patients compared to infection-free European controls (P = 0.0004) and it did not change following ivermectin or placebo to 1 year post-therapy. The chemokine RANTES/CCL5 (regulated on activated and normally T cell-expressed) was similarly high in onchocerciasis patients and infection-free European controls; the RANTES/CCL5 levels did not change following treatment until 6 months post-therapy but were slightly elevated at 1 year post-therapy (P < 0.02). In contrast, the Th2-type chemoattractants, thymus and activation regulated chemokine (TARC/CCL17) and macrophage-derived chemokine (MDC/CCL22), were activated at 3 days post-ivermectin (P < 0.0001) to return to pretreatment or lower levels thereafter. The Th1-type chemoattractants, macrophage inflammatory protein (MIP)-1alpha/CCL3 and MIP-1beta/CCL4 were low before ivermectin treatment, but following clearance of microfilariae of O. volvulus their levels increased from 6 months post-therapy onwards (for both at 12 months post-therapy, P < 0.0001). The adverse reaction scores (RS) in treated patients increased significantly on day 3 (P < 0.02) while it remained unchanged in those who received placebo (P = 0.22); RS interacted with the microfilarial density (P = 0.01), but not with the dose of ivermectin or with the serum levels of MIP-1alpha

  15. Efficacy and tolerance of ivermectin in human onchocerciasis.

    PubMed

    Aziz, M A; Diallo, S; Diop, I M; Lariviere, M; Porta, M

    1982-07-24

    Initial clinical studies in 32 Senegalese subjects have demonstrated the efficacy of ivermectin in Onchocerca volvulus infection (river blindness). Although O. volvulus microfilariae in skin snips were not reduced in number after single oral doses of 5 micrograms or 10 micrograms/kg body-weight, they were greatly reduced in all subjects after single oral doses of 30 micrograms or 50 micrograms/kg and were eliminated completely in 6 of th 8 subjects who received the 50 micrograms/kg dose. All subjects tolerated the drug well. Transient pruritus which did not require treatment was observed on the day the dose was given in 2 of the 8 subjects after the 30 micrograms/kg dose and in 4 of the 8 who received the 50 micrograms/kg dose. Ivermectin produced no abnormal laboratory results.

  16. Anthelmintic Resistance of Strongyle Nematodes to Ivermectin and Fenbendazole on Cart Horses in Gondar, Northwest Ethiopia

    PubMed Central

    Zewdu, Alemu; Dagnachew, Shimelis; Bogale, Basazinew

    2017-01-01

    A study was conducted from November 2015 to April 2016 to determine fenbendazole and ivermectin resistance status of intestinal nematodes of cart horses in Gondar, Northwest Ethiopia. Forty-five strongyle infected animals were used for this study. The animals were randomly allocated into three groups (15 horses per group). Group I was treated with fenbendazole and Group II with ivermectin and Group III was left untreated. Faecal samples were collected from each cart horse before and after treatment. Accordingly, the reduction in the mean fecal egg count at fourteen days of treatment for ivermectin and fenbendazole was 97.25% and 79.4%, respectively. It was significantly different in net egg count between treatment and control groups after treatment. From the study, resistance level was determined for fenbendazole and suspected for ivermectin. In addition, a questionnaire survey was also conducted on 90 selected cart owners to assess their perception on anthelmintics. In the survey, the most available drugs in the study area used by the owners were fenbendazole and ivermectin. Most respondents have no knowledge about drug management techniques. Hence, animal health extension services to create awareness regarding anthelmintic management that plays a key role in reducing the anthelmintic resistance parasites. PMID:28265572

  17. [Ivermectin or diethylcarbamazine in spaced dosages in Bancroft's filariasis: which protocol?].

    PubMed

    Cartel, J L; Moulia-Pelat, J P; Nguyen, L N; Martin, P M; Roux, J F; Spiegel, A

    1992-06-01

    58 apparently healthy Polynesian Wuchereria bancrofti carriers were randomly allocated to 5 treatment groups: 1) two annual doses of ivermectin 100 mcg/kg, 2) three semi-annual doses of ivermectin 100 mcg/kg, 3) two annual doses of diethylcarbamazine (DEC) 3 mg/kg, 4) semi-annual doses of DEC 3 mg/kg, 5) two annual doses of DEC 6 mg/kg. Results observed during the 12-month period which followed last treatment have confirmed that efficacy of ivermectin is higher than that of DEC in terms of immediate clearance or complete negativation of microfilaremia, but not in terms of sustained reduction and that efficacy of repeated single doses of either DEC 3 mg/kg or ivermectin 100 mcg/kg is much higher when given semi-annually than annually. They also have indicated that (i) 6 months after last treatment: 3 semi-annual doses of 100 mcg/kg of ivermectin have resulted in high reduction of microfilaremia (85%) and, 2 annual doses of 6 mg/kg and 3 semi-annual doses of 3 mg/kg of DEC have resulted in even greater reduction (96 and 98% respectively) and (ii): 12 months after last treatment, the greatest reductions of microfilaremia (95 and 92%) have been observed in carriers treated, respectively, with 3 semi-annual doses of 3 mg/kg or with 2 annual doses of 6 mg/kg of DEC.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Effect of ivermectin on Trypanosoma brucei brucei in experimentally infected mice.

    PubMed

    Udensi, Udensi K; Fagbenro-Beyioku, A F

    2012-09-01

    Human and livestock African trypanosomiasis, otherwise known as sleeping sickness, is a neglected tropical disease of public health importance in west and central Africa. In view of the adverse side effects of the antitrypanosomal drugs, the relatively few side effects observed in ivermectin use, and because both onchocerciasis and typanosomiasis occur in overlapping foci in Africa, it would be desirable if the ivermectin that has been used successfully on onchocerciasis management could also be used in the control and treatment of trypanosomiasis. In this study, prophylactic and therapeutic effects of ivermectin (Mectizan) were investigated in albino mice infected with a Nigerian strain of Trypanosoma brucei brucei. A 300 μg/ml/kg dose had the most effective impact because it showed the highest mean survival time of 12 days in both the treatment and prophylactic groups of mice. This dose also enhanced the defence capacity of the treated groups. It also had positive influence on the packed cell volume (PCV) and the state of anaemia in the trypanosome infected mice, hence, improving their survivability. Our report indicates that using the 300 μg/ml/kg dose of ivermectin increases the mean survival period from 5 to 12 days. This suggests that ivermectin could be possibly used in the treatment of trypanosomiasis. Further studies will be required to show whether proper treatment may entail a single dose, as used in this study; an increased number of doses, or combinations with other drugs.

  19. Anthelmintic Resistance of Strongyle Nematodes to Ivermectin and Fenbendazole on Cart Horses in Gondar, Northwest Ethiopia.

    PubMed

    Seyoum, Zewdu; Zewdu, Alemu; Dagnachew, Shimelis; Bogale, Basazinew

    2017-01-01

    A study was conducted from November 2015 to April 2016 to determine fenbendazole and ivermectin resistance status of intestinal nematodes of cart horses in Gondar, Northwest Ethiopia. Forty-five strongyle infected animals were used for this study. The animals were randomly allocated into three groups (15 horses per group). Group I was treated with fenbendazole and Group II with ivermectin and Group III was left untreated. Faecal samples were collected from each cart horse before and after treatment. Accordingly, the reduction in the mean fecal egg count at fourteen days of treatment for ivermectin and fenbendazole was 97.25% and 79.4%, respectively. It was significantly different in net egg count between treatment and control groups after treatment. From the study, resistance level was determined for fenbendazole and suspected for ivermectin. In addition, a questionnaire survey was also conducted on 90 selected cart owners to assess their perception on anthelmintics. In the survey, the most available drugs in the study area used by the owners were fenbendazole and ivermectin. Most respondents have no knowledge about drug management techniques. Hence, animal health extension services to create awareness regarding anthelmintic management that plays a key role in reducing the anthelmintic resistance parasites.

  20. The effect of a single dose of oral ivermectin on pruritus in the homeless.

    PubMed

    Badiaga, Sékéné; Foucault, Cédric; Rogier, Christophe; Doudier, Barbara; Rovery, Clarisse; Dupont, Hervé Tissot; Castro, Pierre; Raoult, Didier; Brouqui, Philippe

    2008-08-01

    Homeless people commonly present with ectoparasite-based pruritus. We evaluated the efficacy of a single dose of ivermectin to reduce the pruritus prevalence in a homeless population. We conducted a randomized, double-blind, placebo-controlled trial from January 2006 to April 2006 in two homeless shelters in the city of Marseille, France. Homeless people complaining of pruritus were randomized to receive either ivermectin (24 mg) or placebo. Follow-up visits were planned at day 14 and day 28 after the inclusion to assess the outcome of pruritus. Forty-two subjects with pruritus were randomized to the ivermectin group and 40 to the placebo group. On day 14, pruritus was reported by significantly more subjects in the placebo group than those in the ivermectin group for both the per-protocol (PP) population (91.42% versus 68.57%, P = 0.014) and the intention-to-treat (ITT) population (92.5% versus 73.80%, P = 0.038). No significant effect was observed at day 28. Ivermectin was the only independent factor associated with the absence of pruritus at day 14 in both PP population [OR: 4.60 (95% CI:1.13; 18.73), P = 0.033] and ITT population [OR: 4.38 (95% CI: 1.07; 17.77), P = 0.039]. A single dose of oral ivermectin has a transient beneficial effect on the reduction of the prevalence of pruritus in the homeless population. More studies are required to assess the efficacy of multiple repeated treatments with ivermectin to reduce scabies and body lice endemic among homeless people with pruritus and the impact of such treatment on this population.

  1. Crusted scabies and multiple dosages of ivermectin.

    PubMed

    Ortega-Loayza, Alex G; McCall, Calvin O; Nunley, Julia R

    2013-05-01

    We present the case of a bone marrow transplant patient who was diagnosed with crusted scabies but did not respond to the usual approach with topical permethrin and ivermectin. The Centers for Disease Control and Prevention were contacted and suggested a 7-dose regimen of ivermectin. The patient started to improve remarkably after the third dose, and the skin eruption was resolved after 7 doses. This case supports the use of a more prolonged course of oral ivermectin for crusted scabies in those who fail the conventional approach.

  2. Control of bancroftian filariasis in an endemic area of Polynesia by ivermectin 400 micrograms/kg.

    PubMed

    Nguyen, N L; Moulia-Pelat, J P; Cartel, J L

    1996-01-01

    Community treatment with ivermectin was implemented in Opoa, French Polynesia from April 1991 to October 1993. All consenting inhabitants aged 3 years or more were treated with twice-yearly single doses of ivermectin, pregnant women excepted. A dosage of 100 microgram/kg was used for the 3 first treatments and then abandoned because it did not reduce the prevalence of microfilariae (mf) carriers. With a dosage of 400 micrograms/kg dosage, this prevalence decreased dramatically from 21% to 7%, and the mf level in carriers dropped to only 0.5% of its initial value after 3 treatments. The 400 micrograms/kg dosage was well tolerated and compliance was excellent. The twice-yearly single dose strategy with ivermectin at 400 micrograms/kg is safe and highly effective for filariasis control in an endemic area.

  3. Lack of effect of ivermectin on prepatent guinea-worm: a single-blind, placebo-controlled trial.

    PubMed

    Issaka-Tinorgah, A; Magnussen, P; Bloch, P; Yakubu, A

    1994-01-01

    The effect of ivermectin on prepatent guinea-worm was tested in a single-blind placebo-controlled trial; 400 adults were randomly allocated to a single dose of ivermectin (150 micrograms/kg) or placebo. Fifty-four of the 385 participants who were followed for 15 months developed a total of 69 emergent guinea-worms. There was no significant difference in the proportion of persons with emergent guinea-worms between the 2 treatment groups; 58% appeared in males. 80% of emergent guinea-worms were located below the knee. Migration of guinea-worms in the tissues was not affected. It is concluded that ivermectin has no effect on prepatent guinea-worms nor does it disturb their migration pattern. No adverse reaction to treatment was seen. It appears that ivermectin can be used safely as mass chemotherapy against onchocerciasis and lymphatic filariasis in areas where guinea-worm is also endemic.

  4. Reduction in incidence of optic nerve disease with annual ivermectin to control onchocerciasis.

    PubMed

    Abiose, A; Jones, B R; Cousens, S N; Murdoch, I; Cassels-Brown, A; Babalola, O E; Alexander, N D; Nuhu, I; Evans, J; Ibrahim, U F

    1993-01-16

    The safety and efficacy of ivermectin in the prevention of blindness from onchocerciasis have been established in many studies that have addressed the drug's effects on the front of the eye. We undertook a study with sufficient statistical power to detect an effect on optic nerve disease (OND), probably the main cause of blindness in the disorder. The trial was based in 34 mesoendemic communities in Kaduna State, Nigeria. Villagers aged 5 years and older were randomly assigned annual dosing with ivermectin or placebo for 3 years. Participants underwent medical and ophthalmological examinations before the first, third, and fourth treatments. 3522 villagers aged 15 and older were re-examined at least once. Skin-snip samples were taken at baseline for calculation of microfilarial load. The outcome measure was development of disc pallor accompanied by objective evidence of deterioration in visual function; 116 subjects (45 ivermectin-treated, 71 placebo-treated) showed such changes during the trial. The incidence rate ratio (ivermectin vs placebo) was 0.90 (95% CI 0.54-1.51) for subjects with loads of 0-10 mf (microfilariae) per mg skin and 0.52 (0.29-0.93) for subjects with more than 10 mf/mg. The incidence rate ratio varied little when account was taken of age, sex, presence of pre-existing disc pallor in one eye, previous use of diethylcarbamazine citrate, or doses of ivermectin or placebo received. There was evidence that ivermectin reduced the incidence of OND in subjects with microfilarial loads above 10 mf/mg but had little effect in those with lower loads. Sustained annual delivery of ivermectin could prevent a substantial proportion of onchocercal blindness in mesoendemic communities.

  5. Assessment of the environmental fate and effects of ivermectin in aquatic mesocosms.

    PubMed

    Sanderson, Hans; Laird, Brian; Pope, Louise; Brain, Richard; Wilson, Christian; Johnson, David; Bryning, Gareth; Peregrine, Andrew S; Boxall, Alistair; Solomon, Keith

    2007-12-30

    Pharmaceuticals in the environment have been subject to increasing public concern and scientific investigation over the past years. More than 100 active pharmaceutical ingredients have been detected in surface waters worldwide at the ng to microg L(-1) range. At these low levels it is commonly assumed that only chronic and/or mixture toxic effects will be discernible in aquatic ecosystems and that there are orders of magnitude between exposure and effect concentrations. Assessment of potential ecosystem risk of pharmaceuticals are recommended but rarely performed in mesocosms, so for most risk assessments the final tier to reduce extrapolation uncertainty is missing. This paper describes the fate and effects of the anthelmintic drug ivermectin for a 265-day period following treatment (nominal concentration levels of 0, 30, 100, 1000 ng L(-1) (or parts per trillion (ppt)) in fifteen 12,000 L outdoor aquatic mesocosms. Although it is established that ivermectin is highly toxic towards invertebrates, it has been believed that ivermectin does not present notable risks to aquatic systems due to the rapid dissipation of the compound and binding to the sediment. Hence, fate and exchange of ivermectin between water and sediment were evaluated in this study. The ivermectin DT(50aqueous) in water was found to be 3-5 days, but concentrations increased and appeared to be stabile in the sediment at 20-30 ng kg(-1) with no assessable DT(50sed). Acute effects (first week) following ivermectin exposure were identified and cladocerans were particularly sensitive (nom. 100 ppt). Chronic responses (229 days) were identified for more sediment-active organisms (e.g. Chydoriae and Ephemeroptera) (nom. 1000 ppt). This is the first study to demonstrate the potential environmental risk of ivermectin at or below the predicted environmental concentration using a standardized test methodology

  6. Ivermectin detection in serum of onchocerciasis patients: relationship to adverse reactions.

    PubMed

    Njoo, F L; Beek, W M; Keukens, H J; van Wilgenburg, H; Oosting, J; Stilma, J S; Kijlstra, A

    1995-01-01

    Ivermectin treatment of onchocerciasis patients can be accompanied by adverse reactions. Not much is known concerning the pathogenesis of these reactions. Previous studies have demonstrated that the occurrence and extent of adverse reactions are related to infection intensity. However, some severely infected patients experience relatively few adverse effects. The aim of the present study was to investigate whether this seeming discrepancy could be due to diminished ivermectin absorption. Ivermectin concentrations one and two days after treatment were measured by high-performance liquid chromatography in sera of 71 skin snip-positive onchocerciasis patients (21 without reactions, 25 with mild reactions, 14 with moderate reactions, and 11 with severe reactions). The overall mean +/- SD ivermectin concentrations one and two days after a single oral dose (150 micrograms/kg) were 16.4 +/- 6.4 and 6.6 +/- 3.1 ng/ml, respectively. The overall mean +/- SD half-life was estimated to be 19.9 +/- 8.6 hr. The data presented did not show a relationship between ivermectin concentrations and the grade of adverse reactions.

  7. Ivermectin influence on the mast cell activity in nodules of onchocerciasis patients.

    PubMed

    Wildenburg, G; Korten, S; Mainuka, P; Büttner, D W

    1998-11-01

    Onchocercal nodules were stained immunohistochemically using antibodies specific for human mast cells and IgE to elucidate the localization and frequency of mast cells after a single oral dose of 150 microg/kg ivermectin. Tryptase-and chymase-positive mast cells occurred predominantly in mixed inflammatory infiltrates and perivascularly, and never adhered to adult worms or microfilariae. Up to three days after ivermectin, mast cells and IgE-positive cells were markedly increased in the capsular area of nodules containing female worms with embryos and microfilariae compared to untreated nodules. In the centre of these nodules, around the adult Onchocerca volvulus, we found many tryptase-positive cells. More mast cells were IgE-positive than in untreated nodules, equalling the number of tryptase-positive mast cells. There was a clear correlation between the appearance of mast cells and the attacks on damaged microfilariae by eosinophils and macrophages and in the vicinity of adult worms by neutrophils that occur soon after ivermectin treatment. Onchocercomata harbouring female worms with oocytes only revealed, after all treatment intervals, the same mast cell numbers as untreated nodules. In conclusion, during the first three days after administration, ivermectin produces increased numbers of mast cells in nodules harbouring females with embryos and microfilariae, probably as part of an allergic reaction to the attacked microfilariae. Four to 19 days after ivermectin the number of mast cells in the entire nodule is no longer elevated.

  8. Ivermectin uptake and distribution in the plasma and tissue of Sudanese and Mexican patients infected with Onchocerca volvulus.

    PubMed

    Elkassaby, M H

    1991-06-01

    Ten Sudanese patients with Onchocerca volvulus infection were treated with a single oral dose of 150 micrograms/kg of ivermectin. Plasma samples were collected before treatment, 0.5, 1, 3, 4, 6, 12 hours and 1, 2, 3, 7, and 30 days. Four patients were selected for nodulectomies and skin biopsies at 6, 18 and 30 hours and 3 days post treatment. Using these samples O. volvulus worm fragments were dissected free of host nodular tissues for ivermectin extraction. Ivermectin was present in the nodular tissue at 6 hr and persisted for 3 days. It was also detected in an individual worm tissue extract at a concentration similar to the nodule, but in subcutaneous fascial tissue higher concentrations were sometimes found. Ivermectin was detected by radioimmunoassay in the plasma of all patients at 1 hr and peak concentrations were reached in an average of 5.6 hr. The drug persisted at detectable levels for 7 days in 70% of the studied patients. Plasma samples were also collected from 16 treated Mexican onchocerciasis patients before ivermectin treatment and 4 hr treatment and from six individuals who served as controls. The Mexican patients had concentrations of ivermectin in their plasma similar to those in the Sudanese patients.

  9. Doxycycline Leads to Sterility and Enhanced Killing of Female Onchocerca volvulus Worms in an Area With Persistent Microfilaridermia After Repeated Ivermectin Treatment: A Randomized, Placebo-Controlled, Double-Blind Trial

    PubMed Central

    Debrah, Alexander Yaw; Specht, Sabine; Klarmann-Schulz, Ute; Batsa, Linda; Mand, Sabine; Marfo-Debrekyei, Yeboah; Fimmers, Rolf; Dubben, Bettina; Kwarteng, Alexander; Osei-Atweneboana, Mike; Boakye, Daniel; Ricchiuto, Arcangelo; Büttner, Marcelle; Adjei, Ohene; Mackenzie, Charles D.; Hoerauf, Achim

    2015-01-01

    Background. Ivermectin (IVM) has been the drug of choice for the treatment of onchocerciasis. However, there have been reports of persistent microfilaridermia in individuals from an endemic area in Ghana after many rounds of IVM, raising concerns of suboptimal response or even the emergence of drug resistance. Because it is considered risky to continue relying only on IVM to combat this phenomenon, we assessed the effect of targeting the Onchocerca volvulus Wolbachia endosymbionts with doxycycline for these individuals with suboptimal response. Methods. One hundred sixty-seven patients, most of them with multiple rounds of IVM, were recruited in areas with IVM suboptimal response and treated with 100 mg/day doxycycline for 6 weeks. Three and 12 months after doxycycline treatment, patients took part in standard IVM treatment. Results. At 20 months after treatment, 80% of living female worms from the placebo group were Wolbachia positive, whereas only 5.1% in the doxycycline-treated group contained bacteria. Consistent with interruption of embryogenesis, none of the nodules removed from doxycycline-treated patients contained microfilariae, and 97% of those patients were without microfilaridermia, in contrast to placebo patients who remained at pretreatment levels (P < .001). Moreover, a significantly enhanced number of dead worms were observed after doxycycline. Conclusions. Targeting the Wolbachia in O. volvulus is effective in clearing microfilariae in the skin of onchocerciasis patients with persistent microfilaridermia and in enhanced killing of adult worms after repeated standard IVM treatment. Strategies can now be developed that include doxycycline to control onchocerciasis in areas where infections persist despite the frequent use of IVM. Clinical Trials Registration. ISRCTN 66649839. PMID:25948064

  10. 21 CFR 556.344 - Ivermectin.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... residues of ivermectin is 1 microgram per kilogram of body weight per day. (b) Tolerances—(1) Liver. A tolerance is established for 22,23-dihydroavermectin B1a (marker residue) in liver (target tissue)...

  11. 21 CFR 556.344 - Ivermectin.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... residues of ivermectin is 1 microgram per kilogram of body weight per day. (b) Tolerances—(1) Liver. A tolerance is established for 22,23-dihydroavermectin B1a (marker residue) in liver (target tissue)...

  12. 21 CFR 556.344 - Ivermectin.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... residues of ivermectin is 1 microgram per kilogram of body weight per day. (b) Tolerances—(1) Liver. A tolerance is established for 22,23-dihydroavermectin B1a (marker residue) in liver (target tissue)...

  13. Locally produced natural conditioners for dewatering of faecal sludge

    PubMed Central

    Gold, Moritz; Dayer, Pauline; Faye, Marie Christine Amie Sene; Clair, Guillaume; Seck, Alsane; Niang, Seydou; Morgenroth, Eberhard; Strande, Linda

    2016-01-01

    ABSTRACT In urban areas of low-income countries, treatment of faecal sludge (FS) is insufficient or non-existent. This results in large amounts of FS being dumped into the environment. Existing treatment technologies for FS, such as settling-thickening tanks and drying beds, are land intensive which is limiting in urban areas. Enhanced settling and dewatering by conditioning was evaluated in order to reduce the treatment footprint (or increase treatment capacity). Conventional wastewater conditioners, such as commercially available lime and polymers, are expensive, and commonly rely on complex supply chains for use in low-income countries. Therefore, the treatment performance of five conditioners which could be produced locally was evaluated: Moringa oleifera seeds and press cake, Jatropha curcas seeds, Jatropha Calotropis leaves and chitosan. M. oleifera seeds and press cake, and chitosan improved settling and dewatering and had a similar performance compared to lime and polymers. Optimal dosages were 400–500 kg M. oleifera/t TS, 300–800 kg lime/t TS and 25–50 kg polymer solution/t TS. In comparison, chitosan required 1.5–3.75 kg/t TS. These dosages are comparable to those recommended for wastewater (sludge). The results indicate that conditioning of FS can reduce total suspended solids (TSS) in the effluent of settling-thickening tanks by 22–81% and reduce dewatering time with drying beds by 59–97%. This means that the area of drying beds could be reduced by 59–97% with end-use as soil conditioner, or 9–26% as solid fuel. Least expensive options and availability will depend on the local context. In Dakar, Senegal, chitosan produced from shrimp waste appears to be most promising. PMID:26984372

  14. Locally produced natural conditioners for dewatering of faecal sludge.

    PubMed

    Gold, Moritz; Dayer, Pauline; Faye, Marie Christine Amie Sene; Clair, Guillaume; Seck, Alsane; Niang, Seydou; Morgenroth, Eberhard; Strande, Linda

    2016-11-01

    In urban areas of low-income countries, treatment of faecal sludge (FS) is insufficient or non-existent. This results in large amounts of FS being dumped into the environment. Existing treatment technologies for FS, such as settling-thickening tanks and drying beds, are land intensive which is limiting in urban areas. Enhanced settling and dewatering by conditioning was evaluated in order to reduce the treatment footprint (or increase treatment capacity). Conventional wastewater conditioners, such as commercially available lime and polymers, are expensive, and commonly rely on complex supply chains for use in low-income countries. Therefore, the treatment performance of five conditioners which could be produced locally was evaluated: Moringa oleifera seeds and press cake, Jatropha curcas seeds, Jatropha Calotropis leaves and chitosan. M. oleifera seeds and press cake, and chitosan improved settling and dewatering and had a similar performance compared to lime and polymers. Optimal dosages were 400-500 kg M. oleifera/t TS, 300-800 kg lime/t TS and 25-50 kg polymer solution/t TS. In comparison, chitosan required 1.5-3.75 kg/t TS. These dosages are comparable to those recommended for wastewater (sludge). The results indicate that conditioning of FS can reduce total suspended solids (TSS) in the effluent of settling-thickening tanks by 22-81% and reduce dewatering time with drying beds by 59-97%. This means that the area of drying beds could be reduced by 59-97% with end-use as soil conditioner, or 9-26% as solid fuel. Least expensive options and availability will depend on the local context. In Dakar, Senegal, chitosan produced from shrimp waste appears to be most promising.

  15. Aeroacoustic Characteristics of Model Jet Test Facility Flow Conditioners

    NASA Technical Reports Server (NTRS)

    Kinzie, Kevin W.; Henderson, Brenda S.; Haskin, Harry H.

    2005-01-01

    An experimental investigation of flow conditioning devices used to suppress internal rig noise in high speed, high temperature experimental jet facilities is discussed. The aerodynamic and acoustic characteristics of a number of devices including pressure loss and extraneous noise generation are measured. Both aerodynamic and acoustic characteristics are strongly dependent on the porosity of the flow conditioner and the closure ratio of the duct system. For unchoked flow conditioners, the pressure loss follows conventional incompressible flow models. However, for choked flow conditioners, a compressible flow model where the duct and flow conditioner system is modeled as a convergent-divergent nozzle can be used to estimate pressure loss. Choked flow conditioners generate significantly more noise than unchoked conditioners. In addition, flow conditioners with small hole diameters or sintered metal felt material generate less self-noise noise compared to flow conditioners with larger holes.

  16. A community trial of ivermectin for onchocerciasis in Sierra Leone: clinical and parasitological responses to the initial dose.

    PubMed

    Whitworth, J A; Morgan, D; Maude, G H; Downham, M D; Taylor, D W

    1991-01-01

    A double-blind placebo-controlled trial of ivermectin was started in 1987 in 6 villages in southern Sierra Leone. 1625 villagers, 93% of the total population, were surveyed before treatment and allocated at random to the trial. Onchocerciasis was hyperendemic and of moderate intensity in the area. Typical onchocerciasis skin lesions were seen in most cases; the blindness rate was 1.5% and a further 4.3% had visual impairment. Six months after treatment 988 subjects (80%) were reassessed and microfilarial loads in the ivermectin group were found to be 10% of control levels. Additionally, blood eosinophil concentrations were reduced by one-quarter. The severity, but not the prevalence, of skin lesions was significantly reduced in the ivermectin group, with a particularly marked effect on papular eruptions. There had been no reduction in the prevalence of itching, nor had markers of general health shown improvement after ivermectin. Ivermectin is an effective microfilaricidal agent and may improve Onchocerca-related skin lesions after a single dose. However, the lack of obvious benefit to a target population after the first dose of ivermectin may reduce compliance with subsequent doses. This has implications for planned mass treatment initiatives in onchocerciasis endemic regions.

  17. The chemotherapy of onchocerciasis. XI. A double-blind comparative study of ivermectin, diethylcarbamazine and placebo in human onchocerciasis in northern Ghana.

    PubMed

    Awadzi, K; Dadzie, K Y; Schulz-Key, H; Gilles, H M; Fulford, A J; Aziz, M A

    1986-08-01

    Fifty-nine onchocerciasis patients with ocular involvement were randomly assigned to receive either 12 mg of ivermectin in a single dose or 1300 mg of diethylcarbamazine over eight days or matching placebo capsules. Detailed standardized follow-up examination was carried out for one year. Both ivermectin and diethylcarbamazine rapidly reduced skin microfilarial counts to a similar extent over six months, after which counts increased significantly more with diethylcarbamazine. Diethylcarbamazine rapidly eliminated microfilariae from the eye, while ivermectin did so over six months. Reactions to treatment were more severe with diethylcarbamazine, which also produced clinical ocular deficiency in two patients. Ivermectin produced intra-uterine sequestration and degeneration of microfilariae in adult worms, which may account for its ability to produce prolonged suppression of skin microfilariae. Ivermectin proved superior to diethylcarbamazine in safety, tolerance and efficacy, but further work is needed to assess fully its effects in patients with heavy intraocular microfilarial loads.

  18. Cross-resistance to moxidectin and ivermectin on a meat sheep farm in France.

    PubMed

    Paraud, C; Marcotty, T; Lespine, A; Sutra, J F; Pors, I; Devos, I

    2016-08-15

    Resistance to ivermectin and moxidectin was explored by a faecal egg count reduction test in two sheep flocks with suspected anthelmintic resistance. The FECRT confirmed one suspicion, with a mean percentage of reduction in egg excretion within the treated groups of 0% for ivermectin (CI 95%: -228 to 58) and 13% for moxidectin (CI 95%: -152 to 70). This was further explored by a controlled efficacy test. An experimental infection of 18 naïve lambs was set up using infective larvae isolated from this flock (5000 L3/lamb). Compared to the control group, abomasal worm burdens (Teladorsagia circumcincta) were reduced by 90% [CI 95%: 81.5-94.8] and 85% [CI 95%: 72.4-92.2] after ivermectin (p<0.05) and moxidectin (p<0.05) treatment respectively. Again, compared to the control group, there was a reduction for intestinal strongyles (Trichostrongylus colubriformis) of 100% and 99% [CI 95%: 97.5-99.7] for ivermectin and moxidectin respectively. No difference was found between the efficacy of moxidectin and ivermectin. Pharmacokinetic values indicated that the strongyles were submitted to anthelmintic concentrations usually lethal to them. This trial demonstrated the first multiple resistance of ovine strongyles in France. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. 21 CFR 882.1845 - Physiological signal conditioner.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... signal conditioner. (a) Identification. A physiological signal conditioner is a device such as an integrator or differentiator used to modify physiological signals for recording and processing. (b... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Physiological signal conditioner. 882.1845...

  20. 21 CFR 882.1845 - Physiological signal conditioner.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... signal conditioner. (a) Identification. A physiological signal conditioner is a device such as an integrator or differentiator used to modify physiological signals for recording and processing. (b... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Physiological signal conditioner. 882.1845...

  1. 21 CFR 882.1845 - Physiological signal conditioner.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... signal conditioner. (a) Identification. A physiological signal conditioner is a device such as an integrator or differentiator used to modify physiological signals for recording and processing. (b... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Physiological signal conditioner. 882.1845...

  2. 21 CFR 882.1845 - Physiological signal conditioner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... signal conditioner. (a) Identification. A physiological signal conditioner is a device such as an integrator or differentiator used to modify physiological signals for recording and processing. (b... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Physiological signal conditioner. 882.1845...

  3. 21 CFR 882.1845 - Physiological signal conditioner.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... signal conditioner. (a) Identification. A physiological signal conditioner is a device such as an integrator or differentiator used to modify physiological signals for recording and processing. (b... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Physiological signal conditioner. 882.1845...

  4. Influence of varnish application on a tissue conditioner: analysis of biofilm adhesion.

    PubMed

    Boscato, Noéli; Delavi, Julian Delarozieri; Muller, Leonardo; Pereira-Cenci, Tatiana; Imanishi, Soraia Watanabe

    2010-09-01

    The aim of this study was to evaluate if the use of a varnish on a tissue conditioner would affect biofilm adhesion. After the surgery has been performed, before the delivery of a complete denture, it is often necessary to use materials such as tissue conditioners on the surgical wound. However, these materials present deficient physico-mechanical properties, which allow biofilm development. Forty elderly volunteers wearing complete maxillary dentures were selected. They were randomly allocated into two groups (n = 20), G1 and G2. In both groups, a silicone-based tissue conditioner was placed in a recess created at the base of the denture, according to the manufacturer's guidelines. In group G1, a varnish was applied to the tissue conditioner, while in group G2, no treatment was applied. All volunteers performed daily hygiene of the prosthesis with a soft toothbrush, and toothpaste. Quantification of the mean score values of biofilm formed at different time points (baseline, 1 week and 3 weeks) was statistically analysed using anova (alpha = 0.05). Group G2 (1.6 +/- 1.2) showed the lowest mean score values of biofilm formation and there was a statistical difference between the groups (p = 0.03). The highest mean score values were found after 3 weeks (2.7 +/- 1.4) and were statistically different from the other time points studied (baseline and 1 week). The use of a varnish had a detrimental effect on the tissue conditioner studied, allowing higher biofilm formation.

  5. On noise indices for domestic air conditioners

    NASA Astrophysics Data System (ADS)

    Tang, S. K.; Wong, M. Y.

    2004-07-01

    A survey was carried out in the present study to determine the noise indices which are capable of describing the nuisance caused by exposure to air-conditioner noise inside residential apartments. This survey consisted of a questionnaire, which asked the respondents to rate their feelings of annoyance and loudness on the air-conditioner noise and to give their preference of a change in the noise levels. Physical noise measurements were also carried out. A total of 57 noise spectra and 399 respondents were involved in the survey. Results show that the Zwicker's loudness level and the percentile level of 90% exceedence are the two major indices for air-conditioner noise assessment. Tonality appears not to be a good indicator for such a purpose.

  6. Stirling Air Conditioner for Compact Cooling

    SciTech Connect

    2010-09-01

    BEETIT Project: Infinia is developing a compact air conditioner that uses an unconventional high efficient Stirling cycle system (vs. conventional vapor compression systems) to produce cool air that is energy efficient and does not rely on polluting refrigerants. The Stirling cycle system is a type of air conditioning system that uses a motor with a piston to remove heat to the outside atmosphere using a gas refrigerant. To date, Stirling systems have been expensive and have not had the right kind of heat exchanger to help cool air efficiently. Infinia is using chip cooling technology from the computer industry to make improvements to the heat exchanger and improve system performance. Infinia’s air conditioner uses helium gas as refrigerant, an environmentally benign gas that does not react with other chemicals and does not burn. Infinia’s improvements to the Stirling cycle system will enable the cost-effective mass production of high-efficiency air conditioners that use no polluting refrigerants.

  7. Shuttle APS propellant thermal conditioner study

    NASA Technical Reports Server (NTRS)

    Fulton, D. L.

    1971-01-01

    The conditioner design concept selected for evaluation consists of an integral reactor and baffle-type heat exchanger. Heat exchange is accomplished by flowing reactor hot gases past a series of slotted and formed plates, through which the conditioned propellant flows. Heat transfer analysis has resulted in the selection of a reactor hot gas nominal mixture ratio of 1.0, giving a combustion temperature of 1560 F with a hydrogen inlet temperature of 275 R. Worst case conditions result in a combustion gas temperature of 2060 F, satisfying the condition of no damage to the conditioner in case of failure to flow cold fluid. In addition, evaluation of hot gas flow requirements and conditioner weight has resulted in the selection of a reactor hot gas exhaust temperature of 750 R.

  8. Photovoltaic array: Power conditioner interface characteristics

    NASA Technical Reports Server (NTRS)

    Gonzalez, C. C.; Hill, G. M.; Ross, R. G., Jr.

    1982-01-01

    The electrical output (power, current, and voltage) of flat plate solar arrays changes constantly, due primarily to changes in cell temperature and irradiance level. As a result, array loads such as dc-to-ac power conditioners must be capable of accommodating widely varying input levels while maintaining operation at or near the maximum power point of the array. The array operating characteristics and extreme output limits necessary for the systematic design of array load interfaces under a wide variety of climatic conditions are studied. A number of interface parameters are examined, including optimum operating voltage, voltage energy, maximum power and current limits, and maximum open circuit voltage. The effect of array degradation and I-V curve fill factor or the array power conditioner interface is also discussed. Results are presented as normalized ratios of power conditioner parameters to array parameters, making the results universally applicable to a wide variety of system sizes, sites, and operating modes.

  9. High Efficiency Room Air Conditioner

    SciTech Connect

    Bansal, Pradeep

    2015-01-01

    This project was undertaken as a CRADA project between UT-Battelle and Geberal Electric Company and was funded by Department of Energy to design and develop of a high efficiency room air conditioner. A number of novel elements were investigated to improve the energy efficiency of a state-of-the-art WAC with base capacity of 10,000 BTU/h. One of the major modifications was made by downgrading its capacity from 10,000 BTU/hr to 8,000 BTU/hr by replacing the original compressor with a lower capacity (8,000 BTU/hr) but high efficiency compressor having an EER of 9.7 as compared with 9.3 of the original compressor. However, all heat exchangers from the original unit were retained to provide higher EER. The other subsequent major modifications included- (i) the AC fan motor was replaced by a brushless high efficiency ECM motor along with its fan housing, (ii) the capillary tube was replaced with a needle valve to better control the refrigerant flow and refrigerant set points, and (iii) the unit was tested with a drop-in environmentally friendly binary mixture of R32 (90% molar concentration)/R125 (10% molar concentration). The WAC was tested in the environmental chambers at ORNL as per the design rating conditions of AHAM/ASHRAE (Outdoor- 95F and 40%RH, Indoor- 80F, 51.5%RH). All these modifications resulted in enhancing the EER of the WAC by up to 25%.

  10. Successful management of ivermectin-induced blindness in an African lion (Panthera leo) by intravenous administration of a lipid emulsion.

    PubMed

    Saqib, Muhammad; Abbas, Ghazanfar; Mughal, Mudassar Niaz

    2015-11-26

    Ivermectin is widely used in veterinary practice for the treatment of ecto- and endo-parasites. In wildlife, an extra-label use this parasiticide is sometimes associated with toxicity. Different treatment regimens have been used in ivermectin toxicosis. The present report describes a successful reversal of ivermectin toxicity by intravenous administration of a commercially available lipid emulsion in a captive African lion (Panthera leo). A 2-year old captive African lion (Panthera leo) weighing ~130 kg was presented with acute neurological impairment and bilateral blindness that had developed 24 h after ivermectin exposure. The animal was treated with a commercially available lipid emulsion along with supportive therapy and experienced complete recovery. To our knowledge, this is the first case report of the use of lipid emulsion in the management of ivermectin induced blindness in an African lion and it appears that intravenous lipid emulsion may be an effective therapy in ivermectin toxicity in lions. Further testing in expanded clinical trials is clearly warranted.

  11. Efficacy of ivermectin, closantel and fenbendazole against gastrointestinal nematodes of sheep in Kashmir valley.

    PubMed

    Tramboo, S R; Shahardar, R A; Allaie, I M; Wani, Z A; Abbas, Maria

    2017-06-01

    The present work was undertaken to evaluate the therapeutic efficacy of ivermectin, closantel and fenbendazole under field conditions against Gastrointestinal Nematodes (GIN) of cross bred merino sheep in Budgam area of Kashmir Valley. A total of 115 sheep having Egg per gram of faeces (EPG) greater than or equal to 150 (mean EPG 258.89) were selected. The animals were randomly divided into four groups comprising of 30 animals each in three treatment groups (ivermectin, closantel and fenbendazole) and twenty-five in fourth untreated infected control group. Faecal samples from the selected animals were collected on day '0' pre treatment and on days 8th and 14th post treatment. Based on Faecal Egg Count Reduction Test (FECRT), ivermectin was found to be 98.80 % effective against strongyles on 8th day post treatment, however an efficacy of 100 % was seen against strongyle worms on 14th day post treatment. 98.80 and 100 % efficacy was observed on day 8th post treatment against strongyles in case of closantel and fenbendazole respectively, however efficacy decreased to 97.60 and 98.8 % respectively on 14th day post treatment. There was no evidence of development of resistance by GIN of cross bred merino sheep in District Budgam of Kashmir Valley to ivermectin, closantel and fenbendazole.

  12. Mold contamination of automobile air conditioner systems.

    PubMed

    Kumar, P; Lopez, M; Fan, W; Cambre, K; Elston, R C

    1990-02-01

    Eight cars belonging to patients who were found to have exacerbation of allergic rhinitis and bronchial asthma after turning on the air conditioner in their cars were examined. Mold concentrations inside the passenger compartment with the a/c turned off and at different climate control settings were lower than concentrations in the outside air. After turning on the air conditioner to "Max", cultures obtained at various intervals revealed that mold concentrations decreased significantly with time. Furthermore, placement of a filter at the portal of entry of outside air significantly reduced the mold concentration in the passenger compartment.

  13. A comparison of the efficacy of single doses of albendazole, ivermectin, and diethylcarbamazine alone or in combinations against Ascaris and Trichuris spp.

    PubMed Central

    Belizario, V. Y.; Amarillo, M. E.; de Leon, W. U.; de los Reyes, A. E.; Bugayong, M. G.; Macatangay, B. J. C.

    2003-01-01

    OBJECTIVE: To determine the efficacy of single doses of albendazole, ivermectin and diethylcarbamazine, and of the combinations albendazole + ivermectin and albendazole + diethylcarbamazine against common intestinal helminthiases caused by Ascaris and Trichuris spp. METHODS: In a randomized, placebo-controlled trial, infected children were randomly assigned to treatment with albendazole + placebo, ivermectin + placebo, diethylcarbamazine + placebo, albendazole + ivermectin, or albendazole + diethylcarbamazine. The Kato-Katz method was used for qualitative and quantitative parasitological diagnosis. The chi2 test was used to determine the significance of cure rates, repeated measures analysis of variance for the comparison of mean log egg counts, the Newman-Keuls procedure for multiple comparison tests, and logistic regression for the comparison of infection rates at days 180 and 360 after treatment. FINDINGS: Albendazole, ivermectin and the drug combinations gave significantly higher cure and egg reduction rates for ascariasis than diethylcarbamazine. For trichuriasis, albendazole + ivermectin gave significantly higher cure and egg reduction rates than the other treatments: the infection rates were lower 180 and 360 days after treatment. CONCLUSION: Because of the superiority of albendazole + ivermectin against both lymphatic filariasis and trichuriasis, this combination appears to be a suitable tool for the integrated or combined control of both public health problems. PMID:12640474

  14. Endectocide activity of a pour-on formulation containing 1.5 per cent ivermectin +0.5 per cent abamectin in cattle

    PubMed Central

    Silva, Heloisa Cristina; Prette, Nancy; Lopes, Welber Daniel Zanetti; Sakamoto, Cláudio Alessandro M; Buzzulini, Carolina; dos Santos, Thais Rabelo; Cruz, Breno Cayeiro; Teixeira, Weslen F Pires; Felippelli, Gustavo; Carvalho, Rafael Silveira; Maciel, Willian Giquelin; Soares, Vando Edésio; da Costa, Alvimar José

    2015-01-01

    The present work aimed to evaluate, through ten different studies, the therapeutic efficacy of a new pour-on formulation, containing 1.5 per cent ivermectin +0.5 per cent abamectin, against parasites of cattle. Results obtained on trials against Rhipicephalus (Boophilus) microplus showed that the pour-on combination of 1.5 per cent ivermectin +0.5 per cent abamectin obtained superior efficacy indexes against this ectoparasite, when compared with formulations containing 0.5 per cent ivermectin, 1 per cent ivermectin and the combination of 1 per cent abamectin +20 per cent levamisole. The results of efficacy of the ivermectin+abamectin and the 0.5 per cent ivermectin against Haematobia irritans were similar. Against Cochliomyia hominivorax larvae, all pour-on formulations tested (1.5 per cent ivermectin +0.5 per cent abamectin, 0.5 per cent ivermectin and 0.5 per cent abamectin), as well as 1 per cent doramectin administered subcutaneously, were considered ineffective. Cattle medicated with 1.5 per cent ivermectin +0.5 per cent abamectin, pour-on, remained free from parasitism by Dermatobia hominis larvae during 42 days (96 per cent efficacy), while values superior to 90 per cent were obtained by 0.5 per cent ivermectin (92 per cent) and 0.5 per cent abamectin (93 per cent) until the 42nd and 35th days post treatment, respectively. Against Haemonchus placei and Oesophagostomum radiatum, the pour-on of ivermectin+abamectin showed better efficacy than the 0.5 per cent ivermectin and 0.5 per cent abamectin. As to Cooperia punctata, there was no difference regarding efficacy results obtained by the avermectins combination and abamectin. The pour-on combination of 1.5 per cent ivermectin +0.5 per cent abamectin obtained high efficacy against R. (B.) microplus, D. hominis and some species of cattle gastrointestinal helminths when compared with formulations of 0.5 per cent ivermectin and 0.5 per cent abamectin administered through the same route. PMID:26392893

  15. 21 CFR 520.1197 - Ivermectin sustained-release bolus.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Ivermectin sustained-release bolus. 520.1197... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.1197 Ivermectin sustained-release bolus. (a) Specifications. Each sustained-release bolus contains 1.72 grams of ivermectin...

  16. 21 CFR 520.1197 - Ivermectin sustained-release bolus.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Ivermectin sustained-release bolus. 520.1197... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.1197 Ivermectin sustained-release bolus. (a) Specifications. Each sustained-release bolus contains 1.72 grams of ivermectin...

  17. 21 CFR 520.1197 - Ivermectin sustained-release bolus.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Ivermectin sustained-release bolus. 520.1197... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.1197 Ivermectin sustained-release bolus. (a) Specifications. Each sustained-release bolus contains 1.72 grams of ivermectin...

  18. 21 CFR 524.1193 - Ivermectin topical solution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Ivermectin topical solution. 524.1193 Section 524... Ivermectin topical solution. (a) Specifications. Each milliliter (mL) of solution contains 5 milligrams of ivermectin. (b) Sponsors. See sponsors in § 510.600(c) of this chapter for use as in paragraph (e) of this...

  19. 21 CFR 524.1195 - Ivermectin otic suspension.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Ivermectin otic suspension. 524.1195 Section 524... Ivermectin otic suspension. (a) Specifications. Each tube contains 0.5 milliliter (mL) of a 0.01 percent suspension of ivermectin. (b) Sponsor. See No. 000010 in § 510.600(c) of this chapter. (c) Conditions of use...

  20. 21 CFR 520.1197 - Ivermectin sustained-release bolus.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Ivermectin sustained-release bolus. 520.1197... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.1197 Ivermectin sustained-release bolus. (a) Specifications. Each sustained-release bolus contains 1.72 grams of ivermectin...

  1. 21 CFR 524.1195 - Ivermectin otic suspension.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Ivermectin otic suspension. 524.1195 Section 524... Ivermectin otic suspension. (a) Specifications. Each tube contains 0.5 milliliter (mL) of a 0.01 percent suspension of ivermectin. (b) Sponsor. See No. 000010 in § 510.600(c) of this chapter. (c) Conditions of use...

  2. 21 CFR 524.1195 - Ivermectin otic suspension.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Ivermectin otic suspension. 524.1195 Section 524... Ivermectin otic suspension. (a) Specifications. Each tube contains 0.5 milliliter (mL) of a 0.01 percent suspension of ivermectin. (b) Sponsor. See No. 000010 in § 510.600(c) of this chapter. (c) Conditions of use...

  3. 21 CFR 522.1193 - Ivermectin and clorsulon.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Ivermectin and clorsulon. 522.1193 Section 522....1193 Ivermectin and clorsulon. (a) Specifications. Each milliliter (mL) of solution contains 10 milligrams (mg) (1 percent) ivermectin and 100 mg (10 percent) clorsulon. (b) Sponsors. See Nos. 050604...

  4. 21 CFR 524.1193 - Ivermectin topical solution.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Ivermectin topical solution. 524.1193 Section 524... Ivermectin topical solution. (a) Specifications. Each milliliter (mL) of solution contains 5 milligrams of ivermectin. (b) Sponsors. See sponsors in § 510.600(c) of this chapter for use as in paragraph (e) of this...

  5. 21 CFR 524.1193 - Ivermectin topical solution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Ivermectin topical solution. 524.1193 Section 524... Ivermectin topical solution. (a) Specifications. Each milliliter (mL) of solution contains 5 milligrams of ivermectin. (b) Sponsors. See sponsors in § 510.600(c) of this chapter for use as in paragraph (e) of this...

  6. 21 CFR 522.1193 - Ivermectin and clorsulon.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Ivermectin and clorsulon. 522.1193 Section 522....1193 Ivermectin and clorsulon. (a) Specifications. Each milliliter (mL) of solution contains 10 milligrams (mg) (1 percent) ivermectin and 100 mg (10 percent) clorsulon. (b) Sponsors. See Nos. 050604 and...

  7. 21 CFR 524.1195 - Ivermectin otic suspension.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Ivermectin otic suspension. 524.1195 Section 524... Ivermectin otic suspension. (a) Specifications. Each tube contains 0.5 milliliter (mL) of a 0.01 percent suspension of ivermectin. (b) Sponsor. See No. 000010 in § 510.600(c) of this chapter. (c) Conditions of use...

  8. 21 CFR 522.1193 - Ivermectin and clorsulon.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Ivermectin and clorsulon. 522.1193 Section 522....1193 Ivermectin and clorsulon. (a) Specifications. Each milliliter (mL) of solution contains 10 milligrams (mg) (1 percent) ivermectin and 100 mg (10 percent) clorsulon. (b) Sponsors. See Nos. 050604...

  9. 21 CFR 522.1193 - Ivermectin and clorsulon.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Ivermectin and clorsulon. 522.1193 Section 522....1193 Ivermectin and clorsulon. (a) Specifications. Each milliliter (mL) of solution contains 10 milligrams (mg) (1 percent) ivermectin and 100 mg (10 percent) clorsulon. (b) Sponsors. See Nos. 050604 and...

  10. 21 CFR 524.1195 - Ivermectin otic suspension.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Ivermectin otic suspension. 524.1195 Section 524... Ivermectin otic suspension. (a) Specifications. Each tube contains 0.5 milliliter (mL) of a 0.01 percent suspension of ivermectin. (b) Sponsor. See No. 000010 in § 510.600(c) of this chapter. (c) Conditions of use...

  11. 21 CFR 524.1193 - Ivermectin topical solution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Ivermectin topical solution. 524.1193 Section 524... Ivermectin topical solution. (a) Specifications. Each milliliter (mL) of solution contains 5 milligrams of ivermectin. (b) Sponsors. See sponsors in § 510.600(c) of this chapter for use as in paragraph (e) of this...

  12. 21 CFR 520.1200 - Ivermectin, fenbendazole, and praziquantel tablets.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...: (1) 68 micrograms (µg) ivermectin, 1.134 grams fenbendazole, and 57 milligrams (mg) praziquantel; or (2) 27 µg ivermectin, 454 mg fenbendazole, and 23 mg praziquantel. (b) Sponsor. See No. 000061 in... µg per kilogram (/kg) ivermectin, 100 mg/kg fenbendazole, and 5 mg/kg praziquantel. (2)...

  13. 21 CFR 520.1200 - Ivermectin, fenbendazole, and praziquantel tablets.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...: (1) 68 micrograms (µg) ivermectin, 1.134 grams fenbendazole, and 57 milligrams (mg) praziquantel; or (2) 27 µg ivermectin, 454 mg fenbendazole, and 23 mg praziquantel. (b) Sponsor. See No. 000061 in... µg per kilogram (/kg) ivermectin, 100 mg/kg fenbendazole, and 5 mg/kg praziquantel. (2)...

  14. Effects of Ivermectin with and without doxycycline on clinical symptoms of onchocerciasis.

    PubMed

    Masud, Hannan; Qureshi, Tausif Qadir; Dukley, Meimei

    2009-01-01

    To compare and analyze the effects of ivermectin with combined therapy of doxycycline and ivermectin on clinical symptoms of onchocerciasis. Randomized, comparative trial without blinding, a quasi-experimental study. Tubmenburg City (Bomy County) of Liberia, from March to December 2005. Two hundred and forty black local patients were included in clinical trial after recording their informed consent. Inclusion criteria was history of exposure to black fly in endemic area, symptoms of generalized and ocular itching, visual impairment associated with pannus and perilimbal pigmentation, punctuate/sclerosing keratitis, iridocyclitis, chorioretinitis, optic atrophy, lesions suggestive of onchodermatitis and subcutaneous nodules. Patients suffering from allergic conjunctivitis, history of measles and rubella, pregnant / breast-feeding women and children under 16 years of age were excluded from the study. The patients were randomly placed into two groups. Group I (120 patients) was treated with ivermectin in a single dose of 150 microg/kg orally. Group II (120 patients) was treated with combined therapy of doxycycline 100 mg/day for 6 weeks followed by ivermectin in a single dose of 150 microg/kg orally. Topical steroid-antibiotic combination was given to patients of both groups where indicated. Follow-up was carried out for 6 months. Improvement or progression of clinical features was recorded on each visit. Results were compiled and analysed by SPSS 10.0 using Chi-square test. Eighty four patients (70%) of group I and 117 (98%) patients of group II responded to treatment, with improvement in onchocerciasis clinical symptoms (p < 0.05). Pannus, punctuate keratitis and iridocyclitis healed in all patients, whereas irreversible eye lesions like sclerosing keratitis and optic atrophy did not respond to treatment in either group. There was a significantly greater relief in patients of group II treated with a combination of doxycycline and ivermectin as compared to those

  15. Ivermectin acts as a posteclosion nymphicide by reducing blood feeding of human head lice (Anoplura: Pediculidae) that hatched from treated eggs.

    PubMed

    Strycharz, Joseph P; Berge, Noah M; Alves, Anna-Maria; Clark, J Marshall

    2011-11-01

    The 0.5% ivermectin topical cream formulation was not directly ovicidal to treated eggs of head lice, as hatchability was not decreased. Nevertheless, the percent of hatched lice from treated eggs that took a blood meal significantly decreased (80-95%) compared with lice that hatched from untreated eggs and all treated lice died within 48 h of hatching, including those that fed. Dilutions of ivermectin formulation of 0.15 and 0.2 microg/ml, which were topically applied to 0-8 d old eggs, were not lethal to lice at 24 h posteclosion. However, 9 and 16% less lice fed when hatched from these treated eggs, respectively. Total [3H] inulin ingested by untreated first instars significantly increased over a 48 h feeding interval but was significantly less in instars that hatched from eggs receiving the 0.15 (36% less) and 0.2 (55% less) microg/ml ivermectin treatments compared with placebo. The reduced feeding that occurred after the 0.15 and 0.2 microg/ml ivermectin treatments occurred in the absence of mortality and suggests a unique mode of action of ivermectin on feeding that is separate from the mode of action of ivermectin leading to mortality. Failure of hatched instars to take a blood meal after egg treatments with formulated ivermectin is likely responsible for its action as a posteclosion nymphicide.

  16. Improvement in severe onchocercal skin disease after a single dose of ivermectin.

    PubMed

    Pacqué, M; Elmets, C; Dukuly, Z D; Muñoz, B; White, A T; Taylor, H R; Greene, B M

    1991-05-01

    Skin disease is the most common clinically important manifestation of onchocerciasis. Ivermectin, a newly available drug, is well tolerated and effective in Onchocerca volvulus infection. However, little information is available regarding its effect on onchocercal skin disease. The purpose of this study was to examine, in patients with well-characterized onchodermatitis, the effect of a single dose of ivermectin. Twenty-one persons with severe onchodermatitis were followed over a 6-month period. In order to evaluate the effect of ivermectin on their skin lesions, photographic transparencies were made before treatment and at 3 and 6 months after treatment. These were then evaluated in a blinded fashion. Following a single dose of 150 micrograms/kg, there was a significant improvement in dermatitis in the first 3 months after treatment. All 14 persons with the worst skin disease showed improvement. The drug had no demonstrable effect on depigmented lesions over the period of observation. Treatment was well tolerated. Single-dose ivermectin shows promise as the first acceptable treatment for severe onchocercal dermatitis.

  17. Residue depletion of ivermectin in broiler poultry.

    PubMed

    Mestorino, Nora; Buldain, Daniel; Buchamer, Andrea; Gortari, Lihuel; Daniele, Martín; Marchetti, María Laura

    2017-04-01

    Helminth infections are widespread in the poultry industry. There is evidence of extra-label use of some drugs, such as ivermectin (IVM), in broiler poultry. Pharmacokinetic and residual studies of IVM in poultry, however, are rather scarce. Our aim was to determine time restrictions for broiler chickens fed with balanced feed mixed with IVM for 21 days, and thus achieve acceptable residual levels for consumption as established by the European Union. Sixty 1-day-old chicks were fed with food supplemented with IVM at 5 mg kg(-1) feed for 21 days. Groups of six treated animals were sacrificed at 0, 1, 2, 4, 8, 10, 15, 20 and 28 days after treatment. Liver, skin/fat, kidney and muscle samples were obtained. IVM were determined by liquid chromatography with fluorescence detection after automatic solid-phase extraction with SPE C18 cartridges. The highest concentrations were measured in the liver, which is logical given that IVM is a drug that undergoes extensive hepatic metabolism. The optimal withdrawal time for edible tissues of these animals to stay within the permitted residual levels were: 12 days for liver, 8 days for skin/fat, 0 days for muscle and 10 days for kidney.

  18. Absence of an Association Between Plasmodium falciparum Infection and Post-Ivermectin Loa-Related Non-Neurologic Serious Adverse Events

    PubMed Central

    Fokom-Domgue, Joël; Pion, Sébastien D.; Gounoue, Raceline; Akame, Julie; Nguipdop-Djomo, Patrick; Twum-Danso, Nana A. Y.; Thylefors, Björn; Boussinesq, Michel; Kamgno, Joseph

    2014-01-01

    Although ivermectin treatment can induce serious adverse events (SAEs) in individuals harboring high Loa loa microfilaremia (mf), not all patients with high mf levels develop such reactions, suggesting that cofactors may be involved. A study was conducted in Cameroon to investigate the possible role of Plasmodium coinfection at the time of ivermectin treatment in the development of SAEs. Before their first ivermectin treatment, thick smears were obtained from 4,175 individuals to determine the burden of Plasmodium sp., L. loa, and Mansonella perstans. After treatment, 18 (4.3 per 1,000) patients developed a non-neurologic SAE. Logistic regression analysis, adjusting for age, sex, P. falciparum infection, and M. perstans infection intensities, confirmed that L. loa mf was the main risk factor for SAEs. We found no evidence that coinfection with P. falciparum at the time of ivermectin treatment was associated with the occurrence of Loa-related SAEs in this population. PMID:24420781

  19. ENERGY STAR Certified Room Air Conditioners

    EPA Pesticide Factsheets

    Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Room Air Conditioners that are effective as of October 26, 2015. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=roomac.pr_crit_room_ac

  20. 75 FR 26647 - Implantation or Injectable Dosage Form New Animal Drugs; Ivermectin

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... CFR Part 522 [Docket No. FDA-2010-N-0002] Implantation or Injectable Dosage Form New Animal Drugs... ivermectin injectable solution in cattle and swine for treatment and control of various internal and external...--IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS 0 1. The authority citation for 21 CFR part...

  1. Synergistic activity of antibiotics combined with ivermectin to kill body lice.

    PubMed

    Sangaré, Abdoul Karim; Rolain, Jean Marc; Gaudart, Jean; Weber, Pascal; Raoult, Didier

    2016-03-01

    Ivermectin and doxycycline have been found to be independently effective in killing body lice. In this study, 450 body lice were artificially fed on a Parafilm™ membrane with human blood associated with antibiotics (doxycycline, erythromycin, rifampicin and azithromycin) alone and in combination with ivermectin. Fluorescence in situ hybridisation and spectral deconvolution were performed to evaluate bacterial transcriptional activity following antibiotic intake by the lice. In the first series, a lethal effect of antibiotics on lice was observed compared with the control group at 18 days (log-rank test, P≤10(-3)), with a significant difference between groups in the production of nits (P=0.019, Kruskal-Wallis test). A high lethal effect of ivermectin alone (50ng/mL) was observed compared with the control group (log-rank test, P≤10(-3)). Fluorescence of bacteriocytes in lice treated with 20μg/mL doxycycline was lower than in untreated lice (P<0.0001, Kruskal-Wallis test). In the second series with antibiotic-ivermectin combinations, a synergistic lethal effect on treated lice (log-rank test, P<10(-6)) was observed compared with the control group at 18 days, associated with a significant decrease in the production of nits (P≤0.001, Kruskal-Wallis test). Additionally, survival of lice in the combination treatment groups compared with ivermectin alone was significant (log-rank test, P=0.0008). These data demonstrate that the synergistic effect of combinations of antibiotics and ivermectin could be used to achieve complete eradication of lice and to avoid selection of a resistant louse population. Copyright © 2016 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  2. The Effects of Ivermectin on Brugia malayi Females In Vitro: A Transcriptomic Approach.

    PubMed

    Ballesteros, Cristina; Tritten, Lucienne; O'Neill, Maeghan; Burkman, Erica; Zaky, Weam I; Xia, Jianguo; Moorhead, Andrew; Williams, Steven A; Geary, Timothy G

    2016-08-01

    Lymphatic filariasis and onchocerciasis are disabling and disfiguring neglected tropical diseases of major importance in developing countries. Ivermectin is the drug of choice for mass drug administration programs for the control of onchocerciasis and lymphatic filariasis in areas where the diseases are co-endemic. Although ivermectin paralyzes somatic and pharyngeal muscles in many nematodes, these actions are poorly characterized in adult filariae. We hypothesize that paralysis of pharyngeal pumping by ivermectin in filariae could result in deprivation of essential nutrients, especially iron, inducing a wide range of responses evidenced by altered gene expression, changes in metabolic pathways, and altered developmental states in embryos. Previous studies have shown that ivermectin treatment significantly reduces microfilariae release from females within four days of exposure in vivo, while not markedly affecting adult worms. However, the mechanisms responsible for reduced production of microfilariae are poorly understood. We analyzed transcriptomic profiles from Brugia malayi adult females, an important model for other filariae, using RNAseq technology after exposure in culture to ivermectin at various concentrations (100 nM, 300 nM and 1 μM) and time points (24, 48, 72 h, and 5 days). Our analysis revealed drug-related changes in expression of genes involved in meiosis, as well as oxidative phosphorylation, which were significantly down-regulated as early as 24 h post-exposure. RNA interference phenotypes of the orthologs of these down-regulated genes in C. elegans include "maternal sterile", "embryonic lethal", "larval arrest", "larval lethal" and "sick". These changes provide insight into the mechanisms involved in ivermectin-induced reduction in microfilaria output and impaired fertility, embryogenesis, and larval development.

  3. Confirmation of ivermectin resistance in Ostertagia ostertagi in cattle in New Zealand.

    PubMed

    Waghorn, Tania S; Miller, Chris M; Leathwick, Dave M

    2016-10-15

    Six suspected cases of ivermectin resistance in Ostertagia spp. in cattle were investigated after routine anthelmintic efficacy testing on commercial farms. On four farms a comprehensive faecal egg count reduction test (FECRT) was undertaken using oral formulations of ivermectin (0.2mg/kg), albendazole (10mg/kg) and levamisole (7.5mg/kg) while on two farms only ivermectin was tested. The proportions of Ostertagia spp. in the untreated control and post-treatment larval cultures were used to apportion egg counts to genera and determine efficacy against this genus. Isolates of Ostertagia spp. recovered from three of the farms were each used to infect 18 six month old calves. The efficacy of oral formulations of ivermectin and moxidectin, both at 0.2mg/kg, was determined against each isolate by slaughter and worm count. The efficacy of ivermectin against Ostertagia spp., based on differentiated FECRT for each of the farms varied from 0% to 88%. The efficacy of ivermectin based on worm counts in the slaughter trial varied from 13% to 75% but moxidectin was >99% effective against all isolates. In addition, in the FECRT albendazole, at a dose rate of 10mg/kg, failed to achieve 95% efficacy against Ostertagia spp. on two farms (82% and 85%). Levamisole consistently failed to achieve 95% efficacy against Ostertagia spp. which is consistent with its known lesser efficacy against this parasite. These results confirm the presence of macrocyclic lactone resistant O. ostertagi in cattle in New Zealand and the likely presence of dual resistance, to macrocyclic lactones and albendazole, in some isolates. Resistant populations of this highly pathogenic parasite are probably not uncommon in New Zealand and pose a significant threat to animal production and welfare in the future. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Ivermectin in loiasis and concomitant O. volvulus and M. perstans infections.

    PubMed

    Richard-Lenoble, D; Kombila, M; Rupp, E A; Pappayliou, E S; Gaxotte, P; Nguiri, C; Aziz, M A

    1988-11-01

    Two clinical studies were carried out in Gabon, Africa to evaluate the efficacy, safety, and tolerability of ivermectin in the treatment of patients with Loa loa infection. In the first study, 35 patients received single oral doses of ivermectin, 5-200 mcg/kg body weight. Blood microfilariae levels did not decrease after a single oral 5, 10, 30, or 50 mcg/kg dose of ivermectin, but levels did decrease after doses of 100, 150, and 200 mcg/kg. The most efficacious dose was 200 mcg/kg; mean blood microfilariae levels decreased to 12% of mean pretreatment values by day 15 and remained decreased for 28 days. A second study evaluated the safety and efficacy of ivermectin in patients with multifilarial infections. All 17 patients had concomitant Loa loa and O. volvulus infection. M. perstans affected 5 of the patients. Sixteen patients also had infections due to intestinal nematodes. The patients each received single oral doses of 200 mcg/kg ivermectin. Ten days later, the mean Loa loa blood microfilariae level had decreased to 20% of the mean pretreatment level. O. volvulus dermal microfilariae densities were reduced to 2% of the pretreatment levels. A minimal increase in blood microfilaria levels was observed on day 28. In contrast, dermal microfilariae levels remained near zero for the duration of the study. Intestinal infection due to Ascaris was eradicated in all of the affected patients by day 23; efficacy against Trichuris and hookworm infections, however, was poor. All patients tolerated ivermectin well including those with multiple infections.

  5. The Effects of Ivermectin on Brugia malayi Females In Vitro: A Transcriptomic Approach

    PubMed Central

    O’Neill, Maeghan; Burkman, Erica; Zaky, Weam I.; Xia, Jianguo; Moorhead, Andrew; Williams, Steven A.; Geary, Timothy G.

    2016-01-01

    Background Lymphatic filariasis and onchocerciasis are disabling and disfiguring neglected tropical diseases of major importance in developing countries. Ivermectin is the drug of choice for mass drug administration programs for the control of onchocerciasis and lymphatic filariasis in areas where the diseases are co-endemic. Although ivermectin paralyzes somatic and pharyngeal muscles in many nematodes, these actions are poorly characterized in adult filariae. We hypothesize that paralysis of pharyngeal pumping by ivermectin in filariae could result in deprivation of essential nutrients, especially iron, inducing a wide range of responses evidenced by altered gene expression, changes in metabolic pathways, and altered developmental states in embryos. Previous studies have shown that ivermectin treatment significantly reduces microfilariae release from females within four days of exposure in vivo, while not markedly affecting adult worms. However, the mechanisms responsible for reduced production of microfilariae are poorly understood. Methodology/Principal Findings We analyzed transcriptomic profiles from Brugia malayi adult females, an important model for other filariae, using RNAseq technology after exposure in culture to ivermectin at various concentrations (100 nM, 300 nM and 1 μM) and time points (24, 48, 72 h, and 5 days). Our analysis revealed drug-related changes in expression of genes involved in meiosis, as well as oxidative phosphorylation, which were significantly down-regulated as early as 24 h post-exposure. RNA interference phenotypes of the orthologs of these down-regulated genes in C. elegans include “maternal sterile”, “embryonic lethal”, “larval arrest”, “larval lethal” and “sick”. Conclusion/Significance These changes provide insight into the mechanisms involved in ivermectin-induced reduction in microfilaria output and impaired fertility, embryogenesis, and larval development. PMID:27529747

  6. Comparison of safety, efficacy, and cost effectiveness of benzyl benzoate, permethrin, and ivermectin in patients of scabies

    PubMed Central

    Bachewar, Narendra P.; Thawani, Vijay R.; Mali, Smita N.; Gharpure, Kunda J.; Shingade, Vaishali P.; Dakhale, Ganesh N.

    2009-01-01

    Objective: To compare three treatment modalities in scabies for safety, efficacy, and economy in a local population of Nagpur. Materials and Methods: This was a prospective, randomized, comparative clinical trial conducted in 103 participants, randomly allocated to three groups. First group received benzyl benzoate (BB) 25% lotion, second group received permethrin 5% cream, whereas third group received tablet ivermectin 200 μg/kg as a single dose. The participants were recalled after one week for follow-up evaluation. If there were no signs of cure, the same intervention was repeated. The participants were followed up for two weeks for cure rate, adverse drug reaction (ADR) monitoring, and postintervention observation. The follow-up was stopped after two weeks. Statistics: Fischer's exact test using Graph pad Instat v 3.05. Results: Ivermectin showed 100% cure rate after two weeks of treatment. Permethrin decreased pruritus by 76% at the end of one week and had significantly better cure rate than ivermectin. At the end of two weeks treatment, this finding was reversed, that is, cure rate in ivermectin group was 100%. For cost-effectiveness analysis, treatment regimens were formulated hypothetically for comparison from Markov population tree for decision analysis. It was found that BB and ivermectin each consecutively for two weeks were most cost effective regimens giving complete cure in four weeks, while ivermectin was the fastest regimen giving the same results in two weeks. Conclusion: Benzyl benzoate as first line intervention and ivermectin in the remaining gave best cost-effective results in the study patients of scabies. PMID:20177574

  7. Inhibition of Plasmodium Liver Infection by Ivermectin.

    PubMed

    Mendes, António M; Albuquerque, Inês S; Machado, Marta; Pissarra, Joana; Meireles, Patrícia; Prudêncio, Miguel

    2017-02-01

    Avermectins are powerful endectocides with an established potential to reduce the incidence of vector-borne diseases. Here, we show that several avermectins inhibit the hepatic stage of Plasmodium infection in vitro Notably, ivermectin potently inhibits liver infection in vivo by impairing parasite development inside hepatocytes. This impairment has a clear impact on the ensuing blood stage parasitemia, reducing disease severity and enhancing host survival. Ivermectin has been proposed as a tool to control malaria transmission because of its effects on the mosquito vector. Our study extends the effect of ivermectin to the early stages of mammalian host infection and supports the inclusion of this multipurpose drug in malaria control strategies. Copyright © 2017 Mendes et al.

  8. Inhibition of Plasmodium Liver Infection by Ivermectin

    PubMed Central

    Mendes, António M.; Albuquerque, Inês S.; Machado, Marta; Pissarra, Joana; Meireles, Patrícia

    2016-01-01

    ABSTRACT Avermectins are powerful endectocides with an established potential to reduce the incidence of vector-borne diseases. Here, we show that several avermectins inhibit the hepatic stage of Plasmodium infection in vitro. Notably, ivermectin potently inhibits liver infection in vivo by impairing parasite development inside hepatocytes. This impairment has a clear impact on the ensuing blood stage parasitemia, reducing disease severity and enhancing host survival. Ivermectin has been proposed as a tool to control malaria transmission because of its effects on the mosquito vector. Our study extends the effect of ivermectin to the early stages of mammalian host infection and supports the inclusion of this multipurpose drug in malaria control strategies. PMID:27895022

  9. Chemotherapy of onchocerciasis with high doses of diethylcarbamazine or a single dose of ivermectin: microfilaria levels and side effects.

    PubMed

    Albiez, E J; Newland, H S; White, A T; Kaiser, A; Greene, B M; Taylor, H R; Büttner, D W

    1988-03-01

    Fifty adult male subjects with moderate to heavy onchocerciasis from the Liberian rain forest were selected for a double-blind placebo-controlled chemotherapy study. The effects of high doses of diethylcarbamazine (DEC) - 30 mg/kg/d - over one week preceded by a one week initial treatment with normal oral doses of DEC or DEC lotion were compared with a single dose of ivermectin (150 micrograms/kg) and placebo. During the initial treatment DEC tablets or lotion caused distinctly more frequent and severe reactions than did invermectin. The reactions to ivermectin did not differ from those of the placebo patients. High doses of DEC caused, in about half of the patients, headache, dizziness, nausea or vomiting. DEC markedly increased the number of corneal microfilariae and of corneal opacities compared to ivermectin. All changes resolved with a return to pretreatment findings two months after treatment. The three treatment groups showed no differences at the ten months follow-up. In all treated patients skin microfilaria counts fell almost to zero by the end of the two week therapy. In the ivermectin group microfilaria counts remained significantly lower than in the DEC patients at the two and ten months examinations. In summary, ivermectin was much better tolerated than DEC and had a longer lasting effect on the microfilariae in the skin. Since high doses of DEC were less effective and caused more frequent and severe side effects, this approach cannot be recommended for treatment of onchocerciasis.

  10. Ivermectin 400 micrograms/kg: long-term suppression of microfilariae in Bancroftian filariasis.

    PubMed

    Moulia-Pelat, J P; Glaziou, P; Nguyen, L N; Chanteau, S; Plichart, R; Beylier, I; Martin, P M; Cartel, J L

    1994-01-01

    Forty-three Wuchereria bancrofti carriers were given 4 successive semi-annual single doses of ivermectin 100 micrograms/kg (IVER 100). The geometric mean microfilaremia (mf) recurrence percentages, compared to the pre-initial treatment mf level, were 35%, 21%, 17% and 17% at 6, 12, 18 and 24 months respectively. However, the recurrence of mf 6 months after the fourth treatment remained high in 15 individuals, considered as 'bad responders'. At month 24, the subjects were randomly allocated into 2 groups: the first group was treated with a fifth dose of IVER 100 and the second with a first, single dose of 400 micrograms/kg of ivermectin (IVER 400). At month 30, the mf recurrence percentage was significantly higher in patients treated with IVER 100 than in those receiving IVER 400 (61% vs. 8%, P < 0.05). In the IVER 100 group, 6 of the 8 'bad responders' remained 'bad responders', whereas only 2 of 7 did so in the IVER 400 group. Only 3 additional patients in the IVER 100 group became consistently amicrofilaraemic, whereas 9 did so in the IVER 400 group. Two 'good responders' in the IVER 100 group became 'bad responders'. A single dose of 400 micrograms/kg of ivermectin has been demonstrated to be efficient for the treatment of carriers refractory to repeated doses of 100 micrograms/kg and to result in better long-term mf suppression. These results suggest a possible effect of 400 micrograms/kg of ivermectin on macrofilaria.

  11. Persistence of the activity of topical ivermectin against biting lice (Bovicola bovis).

    PubMed

    Clymer, B; Newcomb, K M; Ryan, W G; Soll, M D

    1998-08-15

    To assess the persistence of the activity of topical ivermectin against a natural challenge with biting lice (Bovicola bovis), 90 mixed-breed cattle that had been treated to remove lice, were blocked by bodyweight within sex and randomly allocated to three treatments: untreated control, doramectin at 200 micrograms/kg by subcutaneous injection, and ivermectin at 500 micrograms/kg by topical application. Forty-five pens were blocked into three groups of 15, and the blocks of pens were randomly allocated to three 14-day challenge periods starting 21, 28 and 35 days after treatment. There were five pens per treatment for each challenge period, and one B bovis-infested donor calf was introduced into each pen containing two principal calves at the start of the challenge period for that block of pens. The calves were examined thoroughly for B bovis seven, 14 and 21 days after the introduction of the donors. There were no significant differences between the control and doramectin groups for the numbers of animals infested, or the geometric mean louse counts at the final examination for any of the challenge periods. At the final examination for each challenge period, the louse counts of the cattle treated with topical ivermectin were all zero, and significantly (P < 0.05) fewer cattle treated with topical ivermectin were infested than either the controls or cattle treated with doramectin.

  12. Effectiveness Evaluation of Levamisole, Albendazole, Ivermectin, and Vernonia amygdalina in West African Dwarf Goats

    PubMed Central

    Adediran, Oyeduntan A.; Uwalaka, Emmanuel C.

    2015-01-01

    Anthelmintic drug resistance has led to the search for alternatives in controlling helminth infections. Fifty West African Dwarf goats without history of anthelmintic treatment were divided equally into five groups. Group A was treated with ivermectin injection subcutaneously, group B with levamisole subcutaneously, group C with albendazole orally, and group D with aqueous extract of Vernonia amygdalina and group E was untreated control. Faecal samples were collected before treatment from each animal and larval culture was carried out. Faecal egg count reduction (FECR) test was carried out for each group and the data analysed using FECR version 4 to calculate percent reduction in faecal egg count. Predominant helminth infections from larval culture were Haemonchus contortus (70%), Trichostrongylus spp. (61%), and Oesophagostomum spp. (56%). Mixed infection was present in all the animals. From the FECR test Vernonia amygdalina extract was more effective against helminths (100%), compared to ivermectin 96%, levamisole 96%, and albendazole 99%. The lower 95% confidence limit was 89 for ivermectin and levamisole and 91 for albendazole. There is low resistance to ivermectin and levamisole and susceptibility to albendazole while V. amygdalina has great potentials that could be explored for the treatment of helminth diseases in goats. PMID:26579232

  13. The relative plasma availabilities of ivermectin in reindeer (Rangifer tarandus tarandus) following subcutaneous and two different oral formulation applications.

    PubMed

    Oksanen, Antti; Åsbakk, Kjetil; Raekallio, Marja; Nieminen, Mauri

    2014-11-25

    Overwintering (breeding) reindeer (Rangifer tarandus tarandus) are commonly treated with ivermectin against parasitic infestations once yearly in autumn-winter roundups. The only preparations registered to reindeer are those for subcutaneous injection. However, also oral extra-label ivermectin administration is used. Twenty-six, 8-month-old reindeer calves were randomly allocated into three groups. Group 1 (n = 9) received oral ivermectin mixture (Ivomec® vet mixt. 0.8 mg/ml, oral ovine liquid drench formulation), Group 2 (n = 9) oral ivermectin paste (Ivomec® vet 18.7 mg/g equine paste), and Group 3 (n = 8) subcutaneous injection of ivermectin (Ivomec® 10 mg/ml vet inj.), each group at a dose of 200 μg/kg body weight. Blood samples were collected at treatment and at days 1, 2, 3, 6, 9 and 16 post treatment. Plasma concentrations of ivermectin were determined by high-pressure liquid chromatography (HPLC) with fluorescence detection. The peak plasma concentration (Cmax) was reached by 2 days after each treatment. The Cmax and Area Under Curve (AUC) differed significantly between the groups: Cmax was 30.2 ± 3.9, 14.9 ± 5.7 and 63.1 ± 13.1 ng/ml, and AUC∞ was 2881 ± 462, 1299 ± 342 and 6718 ± 1620 ng*h/ml for groups 1, 2 and 3, respectively (mean ± standard deviation). The differences in plasma concentrations of ivermectin are concomitant with earlier observed differences in antiparasitic efficacy, which discounts the use of the equine paste in reindeer in favour of the oral ovine liquid drench formulation, or preferably, the reindeer-registered subcutaneous injection formulation.

  14. Elimination of an Infestation of Rat Fur Mites (Radfordia ensifera) from a Colony of Long Evans Rats, Using the Micro-dot Technique for Topical Administration of 1% Ivermectin.

    PubMed

    Kondo, Sylvia; Taylor, Andrew; Chun, Stewart

    1998-01-01

    Micro-dot delivery of 1% ivermectin was used in an effort to eliminate an infestation of rat fur mites (Radfordia ensifera) from a conventionally housed colony of Long Evans rats. The colony was used for breeding as well as for behavioral testing. A micropipette was used to apply a 1% solution of ivermectin (2 mg/kg of body weight) to the skin on the dorsal aspect of the shoulder. Three treatments were applied at approximately 2-week intervals. All rats in the colony were treated. However, to avoid toxicity to neonates, nursing females and their pups (control group) received mineral oil in lieu of ivermectin until after weaning, at which time they also were treated with ivermectin. During the treatment phase, skin scrapings were used to detect mites. Control rats remained positive for fur mites when treated with mineral oil. After 3 applications of ivermectin, all rats were found to be free of mites. During the posttreatment phase, skin scrapings, dorsal tape tests, and a washing method were performed on euthanatized rats to detect mites. Rats tested up to 129 days (18 weeks) after ivermectin treatment were still free of mites. In a breeding colony composed of rats of various sizes and ages, micropipette delivery of ivermectin allowed for accurate dosing to eliminate fur mites, while preventing inadvertent toxicosis. We did not detect obvious adverse effects on the breeding program or on the behavioral studies in which these rats were subsequently used, nor did we detect morbidity or mortality associated with ivermectin administration.

  15. Effect of single-dose ivermectin therapy on human Onchocerca volvulus infection with onchocercal ocular involvement.

    PubMed Central

    Newland, H S; White, A T; Greene, B M; D'Anna, S A; Keyvan-Larijani, E; Aziz, M A; Williams, P N; Taylor, H R

    1988-01-01

    Ivermectin has shown promise as a potentially safe and effective microfilaricidal drug for the treatment of onchocerciasis. Several limited studies have shown it to have fewer side effects, especially ocular complications, than the currently available drug, diethylcarbamazine. The detailed ocular findings in 200 moderately to heavily infected Liberians who were enrolled in a safety and dose-finding study are presented. They received either 0, 100, 150, or 200 micrograms/kg of ivermectin and were followed up for 12 months. In clinical studies so far carried out ivermectin in a dose of 100, 150, or 200 micrograms/kg has not been associated with any major adverse reactions nor were there any sight-threatening effects even in the presence of severe ocular disease. Each of these doses significantly reduced the ocular microfilaria load for at least 12 months when compared with either the placebo (p less than 0.05) or pretreatment values (p less than 0.001). However, the 100 and 150 micrograms/kg doses caused fewer minor side effects than the higher dose. These results confirm that ivermectin in a single oral dose may be a safe and effective microfilaricidal drug for the treatment of onchocerciasis and that it appears to be free of major ocular side effects. Images PMID:3046657

  16. Effect of single-dose ivermectin therapy on human Onchocerca volvulus infection with onchocercal ocular involvement.

    PubMed

    Newland, H S; White, A T; Greene, B M; D'Anna, S A; Keyvan-Larijani, E; Aziz, M A; Williams, P N; Taylor, H R

    1988-08-01

    Ivermectin has shown promise as a potentially safe and effective microfilaricidal drug for the treatment of onchocerciasis. Several limited studies have shown it to have fewer side effects, especially ocular complications, than the currently available drug, diethylcarbamazine. The detailed ocular findings in 200 moderately to heavily infected Liberians who were enrolled in a safety and dose-finding study are presented. They received either 0, 100, 150, or 200 micrograms/kg of ivermectin and were followed up for 12 months. In clinical studies so far carried out ivermectin in a dose of 100, 150, or 200 micrograms/kg has not been associated with any major adverse reactions nor were there any sight-threatening effects even in the presence of severe ocular disease. Each of these doses significantly reduced the ocular microfilaria load for at least 12 months when compared with either the placebo (p less than 0.05) or pretreatment values (p less than 0.001). However, the 100 and 150 micrograms/kg doses caused fewer minor side effects than the higher dose. These results confirm that ivermectin in a single oral dose may be a safe and effective microfilaricidal drug for the treatment of onchocerciasis and that it appears to be free of major ocular side effects.

  17. Dermal safety study with imidacloprid/moxidectin topical solution in the ivermectin-sensitive collie.

    PubMed

    Paul, A J; Hutchens, D E; Firkins, L D; Borgstrom, M

    2004-05-26

    A study was conducted to determine the safety of the dermal application of 10% imidacloprid/2.5% moxidectin topical solution in ivermectin-sensitive collies. Each milliliter of this solution contains 100mg of imidacloprid and 25mg of moxidectin. A total of 21 collies were prescreened for ivermectin-sensitivity and heartworm negative status prior to selection for the study. Animals were assigned based on the maximum ivermectin-sensitivity score demonstrated during the prestudy screening. Treatment groups included a 3x and 5x test article group, and a 3x and 5x mineral oil control group. The 3x and 5x doses were administered at three and five times, respectively, the 1x dose based on the animal's body weight. On day 0, 3 of the 21 dogs were treated with dermal applications of a preliminary dose of 3x test article to screen for unexpected signs of toxicity with the remaining 18 dogs being treated with 3x mineral oil to blind for the volume of liquid applied. After no signs of toxicity were observed, these same three dogs were treated with 3x of test article and 2x mineral oil on days 28 and 56. The remaining 18 animals were equally allocated to either a 5x test article group or a 5x control group and were each treated on days 28, 56, and 84. Personnel performing observations were blinded to treatment. Observations were made for clinical signs of ivermectin sensitivity twice daily during non-dosing days. On treatment days, dogs were observed hourly for the first 4h post-treatment and at 6, 8, 12, 18 and 24h. Signs of toxicosis were not observed in any of the dogs throughout the observation period. This study demonstrated the safety of imidacloprid/moxidectin, when administered to collies testing positive for ivermectin sensitivity at dosages up to five times the maximum recommended dose.

  18. Efficacy of two avermectins, doramectin and ivermectin against Argulus siamensis infestation in Indian major carp, Labeo rohita.

    PubMed

    Hemaprasanth, K P; Kar, Banya; Garnayak, S K; Mohanty, J; Jena, J K; Sahoo, P K

    2012-11-23

    The efficacy of two avermectins, doramectin and ivermectin via oral and parenteral routes and their prophylactic effects against Argulus siamensis infestation in Indian major carp, Labeo rohita was studied. Doramectin and ivermectin were fed once to L. rohita sub-adults naturally infested with A. siamensis parasites at graded levels of 1000, 750 and 500 μg/kg body weight and 500, 300 and 200 μg/kg body weight, respectively. The mean time of clearance of parasites was 24 ± 0.149 h for 1000 and 24 ± 0.210 h for 750 μg of doramectin/kg body weight fish, however, the dose of 1,000 μg resulted in adverse reactions and mortality in fish. A single dose of 500μg/kg body weight of ivermectin also cleared the infestation in 24 ± 0.258 h. In second experiment, L. rohita naturally infested with A. siamensis were administered with doramectin and ivermectin intramuscularly as single dose of 200, 150 and 100 μg/kg body weight. Both doramectin and ivermectin at 200 μg/kg body weight cleared the infestation in 4 ± 0.149 and 4 ± 0.258 h respectively, however, those resulted in adverse reactions viz., black pigmentation, lethargy and poor appetite in fish. The mean time of clearance of parasites from fish was 6 ± 0.210 and 12 ± 0.314 h for doramectin and ivermectin, respectively, when given at a lower dose of 150 μg/kg body weight. The prophylactic effects of both drugs were also evaluated by challenging naïve rohu with metanaupliar larvae of A. siamensis after feeding the fish single dose of the doramectin and ivermectin at 750 and 500 μg/kg body weight, respectively. The effects of both the drugs were found to last for 17-18 days. The effects of bath treatment with doramectin and ivermectin at different concentrations on adult A. siamensis and metanaupliar larvae of A. siamensis were also evaluated. The results suggested that ivermectin could act more rapidly compared to doramectin. However, detailed studies on the toxicity and pharmacokinetics of doramectin and

  19. Efficacy and Safety of Single and Double Doses of Ivermectin versus 7-Day High Dose Albendazole for Chronic Strongyloidiasis

    PubMed Central

    Suputtamongkol, Yupin; Premasathian, Nalinee; Bhumimuang, Kid; Waywa, Duangdao; Nilganuwong, Surasak; Karuphong, Ekkapun; Anekthananon, Thanomsak; Wanachiwanawin, Darawan; Silpasakorn, Saowaluk

    2011-01-01

    Background Strongyloidiasis, caused by an intestinal helminth Strongyloides stercoralis, is common throughout the tropics. It remains an important health problem due to autoinfection, which may result in hyperinfection and disseminated infection in immunosuppressed patients, especially patients receiving chemotherapy or corticosteroid treatment. Ivermectin and albendazole are effective against strongyloidiasis. However, the efficacy and the most effective dosing regimen are to be determined. Methods A prospective, randomized, open study was conducted in which a 7-day course of oral albendazole 800 mg daily was compared with a single dose (200 microgram/kilogram body weight), or double doses, given 2 weeks apart, of ivermectin in Thai patients with chronic strongyloidiasis. Patients were followed-up with 2 weeks after initiation of treatment, then 1 month, 3 months, 6 months, 9 months, and 1 year after treatment. Combination of direct microscopic examination of fecal smear, formol-ether concentration method, and modified Koga agar plate culture were used to detect strongyloides larvae in two consecutive fecal samples in each follow-up visit. The primary endpoint was clearance of strongyloides larvae from feces after treatment and at one year follow-up. Results Ninety patients were included in the analysis (30, 31 and 29 patients in albendazole, single dose, and double doses ivermectin group, respectively). All except one patient in this study had at least one concomitant disease. Diabetes mellitus, systemic lupus erythrematosus, nephrotic syndrome, hematologic malignancy, solid tumor and human immunodeficiency virus infection were common concomitant diseases in these patients. The median (range) duration of follow-up were 19 (2–76) weeks in albendazole group, 39 (2–74) weeks in single dose ivermectin group, and 26 (2–74) weeks in double doses ivermectin group. Parasitological cure rate were 63.3%, 96.8% and 93.1% in albendazole, single dose oral ivermectin

  20. Field effects of faecal residues from ivermectin slow-release boluses on the attractiveness of cattle dung to dung beetles.

    PubMed

    Errouissi, F; Lumaret, J-P

    2010-12-01

    A 2-year study was performed in two sites in southern France to assess the effect of ivermectin residues on the attractiveness of cattle dung to colonizing insects. Insect captures were compared between pitfall traps baited with dung from untreated cattle and dung from cattle that had been treated with a slow-release (SR) bolus of ivermectin. Cattle dung was collected at different times after treatment (4, 14, 42, 70 and 98 days). Excretion showed a plateau, with levels ranging between 0.688 µg and 1.123 µg ivermectin per gram of wet dung. Faecal residues affected insect captures at both sites. Effects were independent of the time dung was collected after treatment, except for one result subsequent to a severe drought during the baiting period. Ivermectin-contaminated dung showed a significant attractive effect, with increased captures regardless of the guild to which beetles belonged. This study demonstrates the attractiveness of ivermectin residues over a long period after the treatment of animals. It draws attention to the danger of widespread use of this endectocide-based SR bolus, which is attributable to the preferential attraction of insects to treated dung, which potentially puts at risk the survival of their offspring.

  1. Impact of 10 years of diethylcarbamazine and ivermectin mass administration on infection and transmission of lymphatic filariasis.

    PubMed

    Ramaiah, K D; Das, P K; Vanamail, P; Pani, S P

    2007-06-01

    The potential of repeated mass administration of diethylcarbamazine (DEC) and ivermectin to eliminate lymphatic filariasis has been examined in a study implemented in 10 villages with a population of 18415 in south India. During ten rounds of mass drug administration, 49-84% of the eligible population received treatment in different villages. Ten rounds of mass administration of DEC alone reduced the microfilaria (mf) prevalence and intensity by 93% and 97%, respectively, and the vector infection and infectivity rates by 91% and 89%, respectively. The corresponding figures with nine rounds of administration of ivermectin alone were 83%, 90%, 89% and 79%. Out of five villages in each treatment arm, the mf rate declined to ivermectin arm. No mosquitoes with infective-stage larvae were found in three of five villages in the DEC arm and two of five villages in the ivermectin arm. None of the children (n=130) were found to be positive for mf in either treatment arm. None of the 40 sampled children were found to be positive for circulating filarial antigenaemia in villages with lower endemicity in the DEC arm. The results suggest that ten rounds of DEC mass administration have the potential to interrupt transmission of infection in the majority of communities. The outcome was relatively less remarkable with ivermectin.

  2. Behavioral effects of ivermectin in a freshwater oligochaete, Lumbriculus variegatus.

    PubMed

    Ding, J; Drewes, C D; Hsu, W H

    2001-07-01

    Ivermectin is a potent antiparasitic drug against nematode and arthropod parasites. In this study, we examined the lethal and sublethal effects of ivermectin in a freshwater oligochaete, Lumbriculus variegatus. The median lethal concentration (LC50) at 72 h after ivermectin exposure was 560 nM. Sublethal endpoints focused on several stimulus-evoked locomotor behaviors: escape reflexes controlled by giant interneuron pathways, swimming and reversal, and crawling. Swimming, reversal, and crawling are controlled by nongiant interneuron pathways. Ivermectin inhibited swimming, reversal, crawling frequency, and crawling speed in a time- and concentration-dependent manner with a mean inhibitory concentration (IC50) at 3 h of 1.1, 16, 91, and 51 nM, respectively. Ivermectin at 0.3 nM also significantly decreased the frequency of helical swimming waves. Picrotoxin, a Cl- channel blocker, antagonized the ivermectin-induced decrease in swimming frequency, crawling frequency, and crawling speed. There were no adverse effects on escape reflex 3 h after exposure to 300 nM ivermectin. Electrophysiological recordings showed that ivermectin had no effects on the conduction velocity of giant fiber systems. The results indicated that locomotor behaviors controlled by nongiant locomotor pathways were more sensitive to ivermectin than pathways controlled by giant interneurons and that Cl- channels may be involved in mediating ivermectin's inhibitory effects.

  3. Ivermectin: A Reflection on Simplicity (Nobel Lecture).

    PubMed

    Campbell, William C

    2016-08-22

    Parasitic diseases including river blindness and lymphatic filariasis affect hundreds of millions of people annually. The discovery of the drug ivermectin has provided humankind with a powerful new means to combat these severe diseases. To a very large extent the drug was brought about by "simple" science. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Ivermectin: a long-acting microfilaricidal agent.

    PubMed

    Ette, E I; Thomas, W O; Achumba, J I

    1990-04-01

    Ivermectin is a macrocyclic lactone (fermentation) product and actinomycete (Streptomyces avermitilis) that possesses an unusually broad spectrum of potent activity against several species of nematodes, arachnids, and insects that parasitize domestic animals. From clinical trials in humans it has been found to be microfilaricidal, killing microfilariae of Onchocerca volvulus (the parasite causing onchocerciasis), and interrupting its transmission by the black fly vector. Dermal microfilariae density in patients are reduced to near zero levels for 6-12 months after a single oral dose of ivermectin 0.15-0.2 mg/kg. Its precise mechanism of action is unknown. It has a time to maximum concentration of 2.7-4.3 h, and an elimination half-life of 28 +/- 10 h. When compared with an oral solution the tablet dosage form has a relative bioavailability of approximately 60 percent. Not much is known about its metabolism in humans, and the unchanged drug is not detected in the urine. Controlled clinical trials have shown ivermectin to be associated with milder side effects than diethylcarbamazine, the current drug of choice for onchocerciasis therapy. It does not cause the severe Mazzoti-type (anaphylactoid) reactions that are associated with diethylcarbamazine use. Ivermectin is effective, safer, and more tolerable than diethylcarbamazine. It should, therefore, replace diethylcarbamazine as the drug of choice for onchocerciasis therapy.

  5. [Comparative efficacy of annual and semi-annual doses of ivermectin or diethylcarbamazine for the prevention of lymphatic filariasis].

    PubMed

    Cartel, J L; Spiegel, A; Nguyen, L; Moulia-Pelat, J P; Martin, P M; Roux, J F

    1992-01-01

    A double blind randomized trial was performed on 58 healthy Polynesian Wuchereria bancrofti carriers, they were randomly allocated to treatments with repeated annual or semi-annual doses of ivermectin 100 mcg/kg or diethylcarbamazine (DEC) 3 mg/kg, or with repeated annual doses of DEC 6 mg/kg. After the 12-month treatment, the clearance of microfilaremia was complete in 7 of the 23 carriers treated with ivermectin and in 3 of the 35 treated with DEC. Nine months after that treatment, the lowest mean microfilaremia was observed in the carriers treated with 3 successive semi-annual doses of DEC 3 mg/kg. Adverse reactions were comparable in carriers treated with ivermectin and in those treated with DEC, and did not interfere with daily activities of treated subjects.

  6. Community-directed interventions are practical and effective in low-resource communities: experience of ivermectin treatment for onchocerciasis control in Cameroon and Uganda, 2004-2010.

    PubMed

    Katabarwa, Moses N; Habomugisha, Peace; Eyamba, Albert; Byamukama, Edson; Nwane, Philippe; Arinaitwe, Alex; Musigire, Julius; Tushemereirwe, Ruth; Khainza, Annet

    2016-03-01

    The community-directed intervention (CDI) approach has improved treatment coverage in onchocerciasis-affected communities. However, there is still a lot to learn. This study assessed its performance and highlighted the lessons learnt so far. Representative samples of households were selected from Cameroon and Uganda program areas through multi-stage random sampling. An adult male and female from every selected household were interviewed separately on their involvement in CDI activities every year between 2004 and 2010. Community health workers (CHWs) were interviewed and treatment records reviewed to determine whether 90% treatment coverage was attained within 2 weeks. Records related to training of CHWs and their supervisors were analyzed. Decision making decreased for community leaders and health workers, while it increased for community members. The proportion of CHWs attaining 90% treatment coverage within 2 weeks improved as their demand for monetary incentives, and number of persons they served, reduced. The number of CHWs supervised by a community supervisor remained low, but increased for the health workers. The cost of training a CHW and a community supervisor reduced to about US$1 and US$4.8, respectively. The CDI approach was effective, culturally appropriate and probably less costly in delivering health services in low-resource communities. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Over 25 Years of Clinical Experience With Ivermectin: An Overview of Safety for an Increasing Number of Indications.

    PubMed

    Kircik, Leon H; Del Rosso, James Q; Layton, Alison M; Schauber, Jürgen

    2016-03-01

    Although the broad-spectrum anti-parasitic effects of the avermectin derivative ivermectin are well documented, its anti-inflammatory activity has only recently been demonstrated. For over 25 years, ivermectin has been used to treat parasitic infections in mammals, with a good safety profile that may be attributed to its high affinity to invertebrate neuronal ion channels and its inability to cross the blood-brain barrier in humans and other mammals. Numerous studies report low rates of adverse events, as an oral treatment for parasitic infections, scabies and head lice. Ivermectin has been used off-label to treat diseases associated with Demodex mites, such as blepharitis and demodicidosis. New evidence has linked Demodex mites to rosacea, a chronic inflammatory disease. Ivermectin has recently received FDA and EU approval for the treatment of adult patients with inflammatory lesions of rosacea, a disease in which this agent has been shown to be well tolerated. After more than 25 years of use, ivermectin continues to provide a high margin of safety for a growing number of indications based on its anti-parasitic and anti-inflammatory activities.

  8. Ivermectin. A review of its antifilarial activity, pharmacokinetic properties and clinical efficacy in onchocerciasis.

    PubMed

    Goa, K L; McTavish, D; Clissold, S P

    1991-10-01

    Ivermectin, a derivative of avermectin B, is an orally effective microfilaricidal agent. It is the current drug of choice for treating patients infected with the nematode Onchocerca volvulus, which is a major cause of blindness in inhabitants of some tropical areas. Ivermectin is administered orally as a single dose of 150 micrograms/kg given annually. Skin and ocular microfilarial counts are dramatically reduced after the first dose, with some evidence for a resulting decrease in transmission of infection by the blackfly vector. With the exception of rare serious reactions such as severe systemic postural hypotension, ivermectin is generally well tolerated. The drug has the clear advantages of ease of administration and better tolerability compared with diethylcarbamazine and suramin, agents previously used to treat onchocerciasis. Thus, ivermectin is suitable for inclusion in mass treatment programmes and is the best therapeutic option presently available to combat onchocerciasis. As such it provides hope for many thousands of people at risk of becoming blind, and represents a major contribution to tropical medicine.

  9. Genome-wide analysis of ivermectin response by Onchocerca volvulus reveals that genetic drift and soft selective sweeps contribute to loss of drug sensitivity.

    PubMed

    Doyle, Stephen R; Bourguinat, Catherine; Nana-Djeunga, Hugues C; Kengne-Ouafo, Jonas A; Pion, Sébastien D S; Bopda, Jean; Kamgno, Joseph; Wanji, Samuel; Che, Hua; Kuesel, Annette C; Walker, Martin; Basáñez, Maria-Gloria; Boakye, Daniel A; Osei-Atweneboana, Mike Y; Boussinesq, Michel; Prichard, Roger K; Grant, Warwick N

    2017-07-01

    Treatment of onchocerciasis using mass ivermectin administration has reduced morbidity and transmission throughout Africa and Central/South America. Mass drug administration is likely to exert selection pressure on parasites, and phenotypic and genetic changes in several Onchocerca volvulus populations from Cameroon and Ghana-exposed to more than a decade of regular ivermectin treatment-have raised concern that sub-optimal responses to ivermectin's anti-fecundity effect are becoming more frequent and may spread. Pooled next generation sequencing (Pool-seq) was used to characterise genetic diversity within and between 108 adult female worms differing in ivermectin treatment history and response. Genome-wide analyses revealed genetic variation that significantly differentiated good responder (GR) and sub-optimal responder (SOR) parasites. These variants were not randomly distributed but clustered in ~31 quantitative trait loci (QTLs), with little overlap in putative QTL position and gene content between the two countries. Published candidate ivermectin SOR genes were largely absent in these regions; QTLs differentiating GR and SOR worms were enriched for genes in molecular pathways associated with neurotransmission, development, and stress responses. Finally, single worm genotyping demonstrated that geographic isolation and genetic change over time (in the presence of drug exposure) had a significantly greater role in shaping genetic diversity than the evolution of SOR. This study is one of the first genome-wide association analyses in a parasitic nematode, and provides insight into the genomics of ivermectin response and population structure of O. volvulus. We argue that ivermectin response is a polygenically-determined quantitative trait (QT) whereby identical or related molecular pathways but not necessarily individual genes are likely to determine the extent of ivermectin response in different parasite populations. Furthermore, we propose that genetic drift

  10. Ivermectin, an unconventional agonist of the glycine receptor chloride channel.

    PubMed

    Shan, Q; Haddrill, J L; Lynch, J W

    2001-04-20

    The effects of the antihelmintic, ivermectin, were investigated in recombinantly expressed human alpha(1) homomeric and alpha(1)beta heteromeric glycine receptors (GlyRs). At low (0.03 microm) concentrations ivermectin potentiated the response to sub-saturating glycine concentrations, and at higher (> or =0.03 microm) concentrations it irreversibly activated both alpha(1) homomeric and alpha(1)beta heteromeric GlyRs. Relative to glycine-gated currents, ivermectin-gated currents exhibited a dramatically reduced sensitivity to inhibition by strychnine, picrotoxin, and zinc. The insensitivity to strychnine could not be explained by ivermectin preventing the access of strychnine to its binding site. Furthermore, the elimination of a known glycine- and strychnine-binding site by site-directed mutagenesis had little effect on ivermectin sensitivity, demonstrating that the ivermectin- and glycine-binding sites were not identical. Ivermectin strongly and irreversibly activated a fast-desensitizing mutant GlyR after it had been completely desensitized by a saturating concentration of glycine. Finally, a mutation known to impair dramatically the glycine signal transduction mechanism had little effect on the apparent affinity or efficacy of ivermectin. Together, these findings indicate that ivermectin activates the GlyR by a novel mechanism.

  11. A persistent problem with scabies in and outside a nursing home in Amsterdam: indications for resistance to lindane and ivermectin.

    PubMed

    van den Hoek, J A; van de Weerd, J A; Baayen, T D; Molenaar, P M; Sonder, G J; van Ouwerkerk, I M; de Vries, H J

    2008-11-27

    An ongoing outbreak of scabies in and outside a nursing home in Amsterdam is described. Despite standard treatment with lindane and ivermectin, many recurrences were observed which suggested resistance to these drugs. After treatment with 5% permethrine, the patients were finally cured.

  12. Cost-Effectiveness of Ivermectin 1% Cream in Adults with Papulopustular Rosacea in the United States.

    PubMed

    Taieb, Alain; Stein Gold, Linda; Feldman, Steven R; Dansk, Viktor; Bertranou, Evelina

    2016-06-01

    Papulopustular rosacea is a chronic skin disease involving central facial erythema in combination with papules and pustules. Papulopustular rosacea is treated with topical, systemic, or a combination of topical and systemic therapies. Currently approved topical therapies include azelaic acid gel/cream/foam twice daily (BID) and metronidazole cream/gel/lotion BID. Ivermectin 1% cream once daily (QD) is a new topical agent for the treatment of papulopustular rosacea that has been approved for the management of inflammatory lesions of rosacea and offers an alternative to current treatments. To evaluate the cost-effectiveness of ivermectin 1% cream QD compared with current topical treatments in order to understand the cost of adding ivermectin as a treatment option that would bring additional clinical benefit for adults with papulopustular rosacea in the United States. The cost-effectiveness of ivermectin 1% cream QD was compared with metronidazole 0.75% cream BID and azelaic acid 15% gel BID for adults in the United States with moderate-to-severe papulopustular rosacea using a Markov cohort state transition structure with 2 mutually exclusive health states (rosacea and no rosacea) and 5 phases. Patients could succeed or fail to respond to treatment and experience a relapse after treatment success. The model took a health care payer perspective (direct medical costs of topical and/or systemic therapy plus health care costs for physician and specialist visits) and used a 3-year time horizon. The model was run for a cohort of 1,000 patients. Costs (2014 U.S. dollars) and benefits (disease-free days and quality-adjusted life-years [QALYs]) were discounted at a rate of 3% per annum. Cost-effectiveness was determined by the incremental cost-effectiveness ratio (ICER) and measured in terms of incremental cost per QALY gained (estimated from health state utilities for patients with and without rosacea). Univariate and probabilistic sensitivity analyses (PSA) were conducted to

  13. Therapeutic Potential of Myrrh and Ivermectin against Experimental Trichinella spiralis Infection in Mice

    PubMed Central

    El-Sabaa, Abdel-Aleem A.

    2013-01-01

    Trichinosis is a parasitic zoonosis caused by the nematode Trichinella spiralis. Anthelmintics are used to eliminate intestinal adults as well as tissue-migrating and encysted larvae. This study aimed to investigate the effects of ivermectin and myrrh obtained from the aloe-gum resin of Commiphora molmol on experimental trichinosis. Ninety albino mice were orally infected with 300 T. spiralis larvae. Drugs were tested against adult worms at day 0 and day 5 and against encysted larvae on day 15 and day 35 post-infection (PI). Mature worms and encysted larvae were counted in addition to histopathological examination of muscle specimens. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total protein, albumin, globulin, urea, and creatinine values were estimated. Significant reductions in mean worm numbers were detected in ivermectin treated mice at day 0 and day 5 PI achieving efficacies of 98.5% and 80.0%, while efficacies of myrrh in treated mice were 80.7% and 51.5%, respectively. At days 15 and 35 post-infection, ivermectin induced significant reduction in encysted larval counts achieving efficacies of 76.5% and 54.0%, respectively, while myrrh efficacies were 76.6% and 35.0%, respectively. AST, ALT, urea, and creatinine levels were reduced, while total proteins were increased in response to both treatments compared to their values in the infected non-treated mice. Ivermectin use for controlling T. spiralis could be continued. Myrrh was effective and could be a promising drug against the Egyptian strains of T. spiralis with results nearly comparable to ivermectin. PMID:23864740

  14. A Randomized, Single-Ascending-Dose, Ivermectin-Controlled, Double-Blind Study of Moxidectin in Onchocerca volvulus Infection

    PubMed Central

    Opoku, Nicholas O.; Attah, Simon K.; Lazdins-Helds, Janis; Kuesel, Annette C.

    2014-01-01

    Background Control of onchocerciasis as a public health problem in Africa relies on annual mass ivermectin distribution. New tools are needed to achieve elimination of infection. This study determined in a small number of Onchocerca volvulus infected individuals whether moxidectin, a veterinary anthelminthic, is safe enough to administer it in a future large study to further characterize moxidectin's safety and efficacy. Effects on the parasite were also assessed. Methodology/Principal Findings Men and women from a forest area in South-eastern Ghana without ivermectin mass distribution received a single oral dose of 2 mg (N = 44), 4 mg (N = 45) or 8 mg (N = 38) moxidectin or 150 µg/kg ivermectin (N = 45) with 18 months follow up. All ivermectin and 97%–100% of moxidectin treated participants had Mazzotti reactions. Statistically significantly higher percentages of participants treated with 8 mg moxidectin than participants treated with ivermectin experienced pruritus (87% vs. 56%), rash (63% vs. 42%), increased pulse rate (61% vs. 36%) and decreased mean arterial pressure upon 2 minutes standing still after ≥5 minutes supine relative to pre-treatment (61% vs. 27%). These reactions resolved without treatment. In the 8 mg moxidectin and ivermectin arms, the mean±SD number of microfilariae/mg skin were 22.9±21.1 and 21.2±16.4 pre-treatment and 0.0±0.0 and 1.1±4.2 at nadir reached 1 and 3 months after treatment, respectively. At 6 months, values were 0.0±0.0 and 1.6±4.5, at 12 months 0.4±0.9 and 3.4±4.4 and at 18 months 1.8±3.3 and 4.0±4.8, respectively, in the 8 mg moxidectin and ivermectin arm. The reduction from pre-treatment values was significantly higher after 8 mg moxidectin than after ivermectin treatment throughout follow up (p<0.01). Conclusions/Significance The 8 mg dose of moxidectin was safe enough to initiate the large study. Provided its results confirm those from this study, availability of moxidectin to control

  15. A randomized, single-ascending-dose, ivermectin-controlled, double-blind study of moxidectin in Onchocerca volvulus infection.

    PubMed

    Awadzi, Kwablah; Opoku, Nicholas O; Attah, Simon K; Lazdins-Helds, Janis; Kuesel, Annette C

    2014-06-01

    Control of onchocerciasis as a public health problem in Africa relies on annual mass ivermectin distribution. New tools are needed to achieve elimination of infection. This study determined in a small number of Onchocerca volvulus infected individuals whether moxidectin, a veterinary anthelminthic, is safe enough to administer it in a future large study to further characterize moxidectin's safety and efficacy. Effects on the parasite were also assessed. Men and women from a forest area in South-eastern Ghana without ivermectin mass distribution received a single oral dose of 2 mg (N = 44), 4 mg (N = 45) or 8 mg (N = 38) moxidectin or 150 µg/kg ivermectin (N = 45) with 18 months follow up. All ivermectin and 97%-100% of moxidectin treated participants had Mazzotti reactions. Statistically significantly higher percentages of participants treated with 8 mg moxidectin than participants treated with ivermectin experienced pruritus (87% vs. 56%), rash (63% vs. 42%), increased pulse rate (61% vs. 36%) and decreased mean arterial pressure upon 2 minutes standing still after ≥5 minutes supine relative to pre-treatment (61% vs. 27%). These reactions resolved without treatment. In the 8 mg moxidectin and ivermectin arms, the mean±SD number of microfilariae/mg skin were 22.9±21.1 and 21.2±16.4 pre-treatment and 0.0±0.0 and 1.1±4.2 at nadir reached 1 and 3 months after treatment, respectively. At 6 months, values were 0.0±0.0 and 1.6±4.5, at 12 months 0.4±0.9 and 3.4±4.4 and at 18 months 1.8±3.3 and 4.0±4.8, respectively, in the 8 mg moxidectin and ivermectin arm. The reduction from pre-treatment values was significantly higher after 8 mg moxidectin than after ivermectin treatment throughout follow up (p<0.01). The 8 mg dose of moxidectin was safe enough to initiate the large study. Provided its results confirm those from this study, availability of moxidectin to control programmes could help them achieve onchocerciasis elimination objectives

  16. Genome-wide analysis of ivermectin response by Onchocerca volvulus reveals that genetic drift and soft selective sweeps contribute to loss of drug sensitivity

    PubMed Central

    Nana-Djeunga, Hugues C.; Kengne-Ouafo, Jonas A.; Pion, Sébastien D. S.; Bopda, Jean; Kamgno, Joseph; Wanji, Samuel; Che, Hua; Kuesel, Annette C.; Walker, Martin; Basáñez, Maria-Gloria; Boakye, Daniel A.; Osei-Atweneboana, Mike Y.; Boussinesq, Michel; Prichard, Roger K.; Grant, Warwick N.

    2017-01-01

    Background Treatment of onchocerciasis using mass ivermectin administration has reduced morbidity and transmission throughout Africa and Central/South America. Mass drug administration is likely to exert selection pressure on parasites, and phenotypic and genetic changes in several Onchocerca volvulus populations from Cameroon and Ghana—exposed to more than a decade of regular ivermectin treatment—have raised concern that sub-optimal responses to ivermectin's anti-fecundity effect are becoming more frequent and may spread. Methodology/Principal findings Pooled next generation sequencing (Pool-seq) was used to characterise genetic diversity within and between 108 adult female worms differing in ivermectin treatment history and response. Genome-wide analyses revealed genetic variation that significantly differentiated good responder (GR) and sub-optimal responder (SOR) parasites. These variants were not randomly distributed but clustered in ~31 quantitative trait loci (QTLs), with little overlap in putative QTL position and gene content between the two countries. Published candidate ivermectin SOR genes were largely absent in these regions; QTLs differentiating GR and SOR worms were enriched for genes in molecular pathways associated with neurotransmission, development, and stress responses. Finally, single worm genotyping demonstrated that geographic isolation and genetic change over time (in the presence of drug exposure) had a significantly greater role in shaping genetic diversity than the evolution of SOR. Conclusions/Significance This study is one of the first genome-wide association analyses in a parasitic nematode, and provides insight into the genomics of ivermectin response and population structure of O. volvulus. We argue that ivermectin response is a polygenically-determined quantitative trait (QT) whereby identical or related molecular pathways but not necessarily individual genes are likely to determine the extent of ivermectin response in different

  17. 21 CFR 870.2060 - Transducer signal amplifier and conditioner.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Transducer signal amplifier and conditioner. 870.2060 Section 870.2060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Transducer signal amplifier and conditioner. (a) Identification. A transducer signal amplifier...

  18. 21 CFR 870.2060 - Transducer signal amplifier and conditioner.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Transducer signal amplifier and conditioner. 870.2060 Section 870.2060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Transducer signal amplifier and conditioner. (a) Identification. A transducer signal amplifier...

  19. 21 CFR 870.2050 - Biopotential amplifier and signal conditioner.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Biopotential amplifier and signal conditioner. 870.2050 Section 870.2050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Biopotential amplifier and signal conditioner. (a) Identification. A biopotential amplifier and...

  20. 21 CFR 870.2050 - Biopotential amplifier and signal conditioner.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Biopotential amplifier and signal conditioner. 870.2050 Section 870.2050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Biopotential amplifier and signal conditioner. (a) Identification. A biopotential amplifier and...

  1. 21 CFR 870.2050 - Biopotential amplifier and signal conditioner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Biopotential amplifier and signal conditioner. 870.2050 Section 870.2050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Biopotential amplifier and signal conditioner. (a) Identification. A biopotential amplifier and...

  2. 21 CFR 870.2060 - Transducer signal amplifier and conditioner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Transducer signal amplifier and conditioner. 870.2060 Section 870.2060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Transducer signal amplifier and conditioner. (a) Identification. A transducer signal amplifier...

  3. 21 CFR 870.2050 - Biopotential amplifier and signal conditioner.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Biopotential amplifier and signal conditioner. 870.2050 Section 870.2050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Biopotential amplifier and signal conditioner. (a) Identification. A biopotential amplifier and...

  4. 21 CFR 870.2050 - Biopotential amplifier and signal conditioner.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Biopotential amplifier and signal conditioner. 870.2050 Section 870.2050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Biopotential amplifier and signal conditioner. (a) Identification. A biopotential amplifier and...

  5. 21 CFR 870.2060 - Transducer signal amplifier and conditioner.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Transducer signal amplifier and conditioner. 870.2060 Section 870.2060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Transducer signal amplifier and conditioner. (a) Identification. A transducer signal amplifier...

  6. 21 CFR 870.2060 - Transducer signal amplifier and conditioner.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Transducer signal amplifier and conditioner. 870.2060 Section 870.2060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Transducer signal amplifier and conditioner. (a) Identification. A transducer signal amplifier...

  7. 10 CFR 429.15 - Room air conditioners.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Room air conditioners. 429.15 Section 429.15 Energy... COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.15 Room air conditioners. (a) Sampling plan for selection of units for testing. (1) The requirements of § 429.11 are applicable to room air...

  8. [Lymphatic filariasis transmission assessment survey in schools three years after stopping mass drug treatment with albendazole and ivermectin in the 7 endemic districts in Togo].

    PubMed

    Dorkenoo, A M; Sodahlon, Y K; Bronzan, R N; Yakpa, K; Sossou, E; Ouro-Medeli, A; Teko, M; Seim, A; Mathieu, E

    2015-08-01

    The aim of this study is to verify the level of transmission of lymphatic filariasis three years after stopping mass drug treatment in the 7 endemic districts in Togo. The survey was conducted in 2012 in Togo's 7 endemic districts grouped into four evaluation units (EU) using the WHO-recommended transmission assessment survey (TAS) protocol. Children aged 6-7 years were screened for Wuchereria bancofti antigen using the immunochromatographic card (ICT) method. A cluster sampling method was used to select eligible children in schools as the net primary-school enrolment ratio is greater than or equal to 75% in each of the four EUs. The number of children and schools to be selected in each EU, the randomization list for the selection of these children and the critical cut-off number of positive cases not to exceed were automatically generated using the Survey Sample Builder (SSB) tool, (NTD Support Center, Atlanta, Ga, USA). For confirmation, positive cases were subsequently tested for microfilaremia using nocturnal thick blood smear and for filarial antigen using Og4C3 antigen ELISA (TropBio ELISA Kit®, Townsville, Queensland, Australia). An EU is considered to have passed the test successfully (it is assumed that transmission can no longer be sustained), when the number of positive cases is below the critical cut-off number set by the SSB, which is roughly equivalent to 2% prevalence. Of the 1 706 children surveyed in Kpendjal-Tone's EU, 1 549 in Binah-Doufelgou's EU, 1 550 in Kozah's EU and the 1 575 in Amou-Haho's EU, 8 (0.46%), 1 (0.08%), 0 (0.00%) and 4 (0.25%) ICT positive cases respectively were detected. The number of positive ICT tests was well below 18, the critical cut number for each of the 4 EUs. All 13 ICT positive cases tested negative for nocturnal microfilaremia and Og4C3 ELISA. We conclude that all four EU passed the TAS with success, and the transmission of Wuchereria bancrofti is no longer likely to be sustained in the 7 endemic districts in Togo

  9. Interruption of Infection Transmission in the Onchocerciasis Focus of Ecuador Leading to the Cessation of Ivermectin Distribution

    PubMed Central

    Lovato, Raquel; Guevara, Angel; Guderian, Ronald; Proaño, Roberto; Unnasch, Thomas; Criollo, Hipatia; Hassan, Hassan K.; Mackenzie, Charles D.

    2014-01-01

    Introduction: A clinically significant endemic focus of onchocerciasis existing in Esmeraldas Province, coastal Ecuador has been under an ivermectin mass drug administration program since 1991. The main transmitting vector in this area is the voracious blackfly, Simulium exiguum. This paper describes the assessments made that support the decision to cease mass treatment. Methodology and Principle Findings: Thirty-five rounds of ivermectin treatment occurred between 1991–2009 with 29 of these carrying >85% coverage. Following the guidelines set by WHO for ceasing ivermectin distribution the impact on parasite transmission was measured in the two vector species by an O-150 PCR technique standard for assessing for the presence of Onchocerca volvulus. Up to seven collection sites in three major river systems were tested on four occasions between 1995 and 2008. The infectivity rates of 65.0 (CI 39–101) and 72.7 (CI 42–116) in 1995 dropped to zero at all seven collection sites by 2008. Assessment for the presence of antibodies against O. volvulus was made in 2001, 2006, 2007 and 2008 using standard ELISA assays for detecting anti-Ov16 antibodies. None of total of 1810 children aged 1–15 years (between 82 and 98% of children present in the surveyed villages) tested in the above years were found to be carrying antibodies to this antigen. These findings were the basis for the cessation of mass drug treatment with ivermectin in 2009. Significance: This fulfillment of the criteria for cessation of mass distribution of ivermectin in the only known endemic zone of onchocerciasis in Ecuador moves the country into the surveillance phase of official verification for national elimination of transmission of infection. These findings indicate that ivermectin given twice a year with greater than 85% of the community can move a program to the final stages of verification of transmission interruption. PMID:24853587

  10. Seventeen Years of Annual Distribution of Ivermectin Has Not Interrupted Onchocerciasis Transmission in North Region, Cameroon

    PubMed Central

    Katabarwa, Moses N.; Eyamba, Albert; Nwane, Philippe; Enyong, Peter; Yaya, Souleymanou; Baldiagaï, Jean; Madi, Théodore Kambaba; Yougouda, Abdoulaye; Andze, Gervais Ondobo; Richards, Frank O.

    2011-01-01

    We studied onchocerciasis transmission and impact on ocular morbidity in three health districts in North Region, Cameroon, where annual mass ivermectin treatment has been provided for 12–17 years. The studies, which took place from 2008 to 2010, consisted of skin snips for microfilariae (mf), palpation examinations for nodules, slit lamp examinations for mf in the eye, and Simulium vector dissections for larval infection rates. Adults had mf and nodule rates of 4.8% and 13.5%, respectively, and 5.5% had mf in the anterior chamber of the eye. Strong evidence of ongoing transmission was found in one health district, where despite 17 years of annual treatments, the annual transmission potential was 543 L3/person per year; additionally, children under 10 years of age had a 2.6% mf prevalence. Halting ivermectin treatments in North Cameroon now might risk recrudescence of transmission and ocular disease. PMID:22144441

  11. Comparative efficacy of pour-on eprinomectin and ivermectin against Sarcoptes scabiei in buffaloes.

    PubMed

    Nazir, T; Katoch, R; Yadav, Anish; Godara, R

    2016-06-01

    The efficacy of eprinomectin and ivermectin pour-on was evaluated against Sarcoptes scabiei in naturally infested buffaloes. Eighteen animals were allocated into three groups (A, B and C) of six animals each. Animals in group A were treated with eprinomectin (pour-on) @ 0.5 mg/kg; group B with ivermectin (pour-on) @ 0.2 mg/kg while group C served as untreated controls. Skin scrapings were examined on days 0, 7, 14, 21, 28 and 42 post-treatment (PT). Skin scrapings were found free for mites on day 21 PT, with marked clinical improvement in the lesions after day 28 of treatment. Untreated control group continued to show severe progressive lesions throughout the study period. No clinical side-effects of the tested drugs were observed after treatment. This preliminary report on the efficacy of eprinomectin (pour-on) against S. scabiei in buffaloes is encouraging and results could be of considerable importance.

  12. Seventeen years of annual distribution of ivermectin has not interrupted onchocerciasis transmission in North Region, Cameroon.

    PubMed

    Katabarwa, Moses N; Eyamba, Albert; Nwane, Philippe; Enyong, Peter; Yaya, Souleymanou; Baldiagaï, Jean; Madi, Théodore Kambaba; Yougouda, Abdoulaye; Andze, Gervais Ondobo; Richards, Frank O

    2011-12-01

    We studied onchocerciasis transmission and impact on ocular morbidity in three health districts in North Region, Cameroon, where annual mass ivermectin treatment has been provided for 12-17 years. The studies, which took place from 2008 to 2010, consisted of skin snips for microfilariae (mf), palpation examinations for nodules, slit lamp examinations for mf in the eye, and Simulium vector dissections for larval infection rates. Adults had mf and nodule rates of 4.8% and 13.5%, respectively, and 5.5% had mf in the anterior chamber of the eye. Strong evidence of ongoing transmission was found in one health district, where despite 17 years of annual treatments, the annual transmission potential was 543 L3/person per year; additionally, children under 10 years of age had a 2.6% mf prevalence. Halting ivermectin treatments in North Cameroon now might risk recrudescence of transmission and ocular disease.

  13. Antimicrobial and antifungal effects of tissue conditioners containing a photocatalyst.

    PubMed

    Uchimaru, Masayuki; Sakai, Takako; Moroi, Ryoji; Shiota, Susumu; Shibata, Yukie; Deguchi, Mikito; Sakai, Hidetaka; Yamashita, Yoshihisa; Terada, Yoshihiro

    2011-01-01

    This study examined the antimicrobial/antifungal ability of a tissue conditioner containing a photocatalyst for Escherichia coli, Streptococcus mutans, Staphylococcus aureus and Candida albicans. The photocatalyst was mixed with tissue conditioners powders at concentrations of 0, 10, 15, and 20 wt%. Tissue conditioners powders containing a photocatalyst were mixed with liquid to make test specimens. Test specimens inoculated by each microorganism were irradiated by ultraviolet light for 0-, 2- and 4 hours. The antimicrobial/antifungal effects were evaluated by the CFU technique. The CFU values of each microorganism for tissue conditioners containing a photocatalyst showed significant decrease following UV-irradiation. The improvement in antimicrobial/antifungal effects was concomitant with the increase of the mixing ratio and the irradiation time. Therefore, the results indicated that tissue conditioners containing a photocatalyst might have photocatalytic ability.

  14. A controlled prospective trial of the prophylactic effect of a single dose of ivermectin against Onchocerca volvulus.

    PubMed

    Boussinesq, M; Chippaux, J P

    2001-09-01

    A clinical trial was conducted in Cameroon in order to evaluate in humans the possible effect of a single dose of ivermectin (150 micrograms per kg) on the pre-adult stages of Onchocerca volvulus. The incidence of the skin microfilariae was measured in two groups of patients who initially had negative biopsies, and who were subsequently treated, immediately after the seasonal peak of transmission of O. volvulus, either with a combination of ivermectin + ferrous sulphate, or with ferrous sulphate alone. One year after the treatment, i.e. 14 months after the start of the transmission period, the proportion of patients with positive skin biopsies, and their mean microfilarial loads, did not differ significantly between the two groups. Thus a single dose of ivermectin does not seem to have any perceptible prophylactic effect against O. volvulus.

  15. Cell module and fuel conditioner development

    NASA Technical Reports Server (NTRS)

    Hoover, D. Q., Jr.

    1981-01-01

    The test results of and post test analysis of Stack 559 are reported. The design features and construction status of Stacks 560, 561, 562 and 563 are described. The measurements of cell materials compressibility are rationalized and summarized and an explanation of their uses is given. Preliminary results of a manifold material/coating survey are given. The results of shift converter catalyst performance tests and reforming catalyst aging tests are reported. State points for full load and part load operation of the fuel conditioning subsystem tabulated. Work on the data base for the fuel conditioner ancillary subsystems is summarized.

  16. Onchocerca volvulus-specific antibody and cytokine responses in onchocerciasis patients after 16 years of repeated ivermectin therapy

    PubMed Central

    Mai, C S; Hamm, D M; Banla, M; Agossou, A; Schulz-Key, H; Heuschkel, C; Soboslay, P T

    2007-01-01

    The recommended control option against onchocerciasis is repeated ivermectin treatment, which will need to be implemented for decades, and it remains unknown how repeated ivermectin therapy might affect immunity against Onchocerca volvulus in the long term. O. volvulus-specific antibody reactivity and cellular cytokine production were investigated in onchocerciasis patients receiving ivermectin (150 µg/kg) annually for 16 years. In treated patients, the T helper type 2 (Th2) cytokine interleukin (IL)-5 and T regulatory IL-10 in response to O. volvulus antigen (OvAg) and bacteria-derived Streptolysin O (SL-O) diminished to levels found in infection-free endemic controls; also, cellular release of Th1-type interferon (IFN)-γ at 16 years post initial ivermectin treatment (p.i.t.) approached control levels. In ivermectin-treated onchocerciasis patients, IL-5 production in responses to the mitogen phytohaemagglutinin (PHA) decreased, but IL-10 in response PHA increased, and neither attained the cytokine production levels of endemic controls. At 16 years p.i.t., O. volvulus-specific IgG1 and IgG4 subclass reactivity still persisted at higher levels in onchocerciasis patients than in O. volvulus exposed but microfilariae-free endemic controls. In addition, cytokine responses remained depressed in onchocerciasis patients infected concurrently with Mansonella perstans and Necator americanus or Entamoeba histolytica/dispar. Thus, long-term ivermectin therapy of onchocerciasis may not suffice to re-establish fully a balanced Th1 and Th2 immune responsiveness in O. volvulus microfilariae-negative individuals. Such deficient reconstitution of immune competence may be due to an as yet continuing and uncontrolled reinfection with O. volvulus, but parasite co-infections can also bias and may prevent the development of such immunity. PMID:17302900

  17. Haemonchus contortus resistance to ivermectin and netobimin in Brazilian sheep.

    PubMed

    Vieira, L S; Berne, M E; Cavalcante, A C; Costa, C A

    1992-12-01

    Suffolk, Texel, Hampshire Down and Ile de France sheep from the municipalities of Porto Amazonas, Piraquara and Araucaria in the State of Paraná, and Bagé in the State of Rio Grande do Sul were brought to Sobral, State of Ceará, to be used in a cross-breeding project. On arrival they had clinical signs of nematode parasitosis, and one Suffolk female died. The animals were treated orally with ivermectin (0.2 mg kg-1) and fifteen days later with netobimin (20.0 mg kg-1). Neither drug reduced the egg counts (measured in eggs per gram, EPG) significantly, and this suggested that the nematodes in the sheep were resistant to the anthelmintics used. Haemonchus contortus was the species involved. The egg counts were reduced after oral treatment with trichlorfon (100.0 mg kg-1). Haemonchus contortus larvae obtained from these animals before trichlorfon treatment and passaged through two nematode-free sheep were used in a further experiment. Twenty 6- to 9-month-old nematode-free lambs were infected with the H. contortus larvae (10,000 per animal) and after the infection was confirmed, were randomly divided into four groups of five animals. Group I was orally treated with ivermectin at 0.2 mg kg-1, Group II with oral netobimin at 20.0 mg kg-1, Group III with oral trichlorfon at 100.0 mg kg-1 and Group IV was a non-treated control. Egg counts and faecal cultures were taken before dosing on the day of treatment and seven days later when all animals were necropsied and the nematodes were collected from the abomasa and counted.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Efficacy of pyrantel pamoate and ivermectin paste formulations against naturally acquired Oxyuris equi infections in horses.

    PubMed

    Reinemeyer, Craig R; Prado, Julio C; Nichols, Eric C; Marchiondo, Alan A

    2010-07-15

    In recent years, numerous veterinary practitioners have reported anecdotal episodes in which anthelmintic treatment did not appear to deliver the expected efficacy against equine pinworms (Oxyuris equi). Anthelmintic resistance has not been demonstrated formally in equine pinworms, so a clinical study was designed to evaluate the efficacy of paste formulations of pyrantel pamoate or ivermectin against naturally acquired infections with O. equi. Twenty-one horses (>4 months to 15 years of age) with patent, naturally acquired pinworm infections were blocked by source of origin and allocated randomly to one of three treatment groups: horses (n=7) assigned to Group 1 were treated orally with pyrantel pamoate paste at a dosage of 13.2 mg/kg (2x label dosage), Group 2 horses (n=7) were untreated controls, and horses (n=7) assigned to Group 3 were treated orally with ivermectin paste at a dosage of 200 microg/kg. Fourteen days after treatment, horses were euthanatized, necropsied, and large intestinal contents were processed for recovery of adult pinworms. In addition, duplicate 1% aliquots of intestinal contents from the cecum, ventral colon, dorsal colon, and small colon were collected, preserved, and examined for recovery and enumeration of fourth-stage larval O. equi. Anthelmintic efficacy against pinworms was evaluated by comparing the post-treatment worm counts of Groups 1 and 3 to those of control animals. Mean numbers of O. equi adults recovered postmortem were significantly decreased by both pyrantel pamoate (P=0.0366) and ivermectin (P=0.0137) treatment, with respective efficacies of 91.2% and 96.0%. In addition, both products demonstrated >99% efficacy against fourth-stage O. equi larvae. The current study demonstrated acceptable adulticidal and larvicidal efficacy of both pyrantel pamoate and ivermectin paste formulations against O. equi and did not support the existence of macrocyclic lactone or pyrimidine resistance in the pinworm populations evaluated.

  19. Comparing therapeutic efficacy between ivermectin, selamectin, and moxidectin in canaries during natural infection with Dermanyssus gallinae.

    PubMed

    Todisco, Gianluca; Paoletti, Barbara; Giammarino, Angelo; Manera, Maurizio; Sparagano, Olivier A E; Iorio, Raffaella; Giannella, Benedetta; Robbe, Domenico

    2008-12-01

    The aim of this study was to compare the efficacy of three spot-on drugs on canaries during Dermanyssus gallinae natural infections and during the breeding season. Three groups of canary couples (seven couples each) were included: group A was treated with ivermectin, B with selamectin, and C with moxidectin. All the drugs were administered topically infrascapularly. The parasitic charge was estimated before the treatment (t(0)) and after 8 (t(1)), 16 (t(2)), 24 (t(3)), and 32 (t(4)) days following the initial treatment. No significant differences were detected among the three tested drugs for the five repeats for each of the four mite stages (egg, larva, nymphs, and fed and