Association between altered cognition and Loa loa microfilaremia: First evidence from a cross-sectional study in a rural area of the Republic of Congo.

Autor: Checkouri T; AP-HP, Service des Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France., Missamou F; Programme National de Lutte contre l'Onchocercose, Direction de l'Épidémiologie et de la Lutte contre la Maladie, Ministère de la Santé et de la Population, Brazzaville, Republic of the Congo., Pion SDS; UMI 233 TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM Unité, Montpellier, France., Bikita P; Programme National de Lutte contre l'Onchocercose, Direction de l'Épidémiologie et de la Lutte contre la Maladie, Ministère de la Santé et de la Population, Brazzaville, Republic of the Congo., Hemilembolo MC; Programme National de Lutte contre l'Onchocercose, Direction de l'Épidémiologie et de la Lutte contre la Maladie, Ministère de la Santé et de la Population, Brazzaville, Republic of the Congo.; UMI 233 TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM Unité, Montpellier, France., Boussinesq M; UMI 233 TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM Unité, Montpellier, France., Chesnais CB; UMI 233 TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM Unité, Montpellier, France., Campillo JT; UMI 233 TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM Unité, Montpellier, France.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2023 Jun 20; Vol. 17 (6), pp. e0011430. Date of Electronic Publication: 2023 Jun 20 (Print Publication: 2023).
DOI: 10.1371/journal.pntd.0011430
Abstrakt: Background: Individuals with high Loa loa microfilarial densities are at risk of developing severe encephalopathy after administration of antiparasitic drugs. Apart from this finding, loiasis is considered benign with no effect on brain function. However, recent epidemiological data suggest an increased mortality and morbidity in L. loa infected individuals, underscoring the importance of studies on the possible neurological morbidity associated with loiasis.
Methodology: Using MoCA tests and neurological ultrasounds, we conducted a cross-sectional study to assess cognitive alteration in a population living in a rural area endemic for loiasis in the Republic of Congo. Fifty individuals with high microfilarial densities (MFD) were matched on sex, age and residency with 50 individuals with low MFD and 50 amicrofilaremic subjects. Analyses focused on individuals with MoCA scores indicating an altered cognition (i.e. < 23/30) and on the total MoCA score according to Loa loa MFD, sociodemographic characteristics and neurological ultrasound results.
Principal Findings: MoCA scores were very low in the studied population (mean of 15.6/30). Individuals with more than 15,000 microfilariae per milliliter of blood (mean predicted score:14.0/30) are more than twenty times more likely to have an altered cognition, compared to individuals with no microfilaremia (mean predicted score: 16.3/30). Years of schooling were strongly associated with better MoCA results. Extracranial and intracranial atheroma were not associated with L. loa MFD.
Conclusion/significance: Loaisis microfilaremia is probably involved in cognitive impairment, especially when the MFD are high. These results highlight the urgent need to better understand loaisis-induced morbidity. Further studies investigating neurological morbidity of loiasis are needed.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Checkouri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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