Association between blood Loa loa microfilarial density and proteinuria levels in a rural area of the Republic of Congo (the MorLo project): a population-based cross-sectional study.

Autor:	Campillo JT; TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement, Montpellier, France. Electronic address: jeremy.campillo@ird.fr., Hemilembolo MC; TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement, Montpellier, France; 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; TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement, Montpellier, France., Lebredonchel E; Département de Biochimie, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique des Hôpitaux de Paris, Paris, France., Dupasquier V; Department of Cardiology, Montpellier University Hospital, Montpellier, France., Boullé C; TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement, Montpellier, France; Department of Infectious and Tropical Diseases, Montpellier University Hospital, Montpellier, France., Rancé LG; Department of Anesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France., Boussinesq M; TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement, Montpellier, 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., Chesnais CB; TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement, Montpellier, France.
Jazyk:	angličtina
Zdroj:	The Lancet. Microbe [Lancet Microbe] 2023 Sep; Vol. 4 (9), pp. e704-e710. Date of Electronic Publication: 2023 Jul 19.
DOI:	10.1016/S2666-5247(23)00142-8
Abstrakt:	Background: Case reports have hypothesised that proteinuria, sometimes with glomerulopathy or nephrotic syndromes, might be associated with loiasis. To our knowledge, no study has been done to assess this association. We aimed to investigate the association between Loa loa microfilariae burden and proteinuria. Methods: We did a cross-sectional study between May 16, 2022, and June 11, 2022, to assess the relationship between Loa loa microfilaraemia densities and proteinuria in a rural area of the Republic of Congo. We included all consenting adults living in the target area at study commencement who had L loa microfilarial densities greater than 500 microfilariae per mL during previous screening for a clinical trial in 2019. This study is part of the MorLo project, and used the project's study population of individuals aged 18 years or older who were living near Sibiti. For each microfilaraemic individual, two individuals without L loa microfilarial densities matched on age, sex, and place of residence were included. The association between proteinuria (assessed by dipstick) and L loa microfilarial densities, age, and sex was assessed using an unconstrained ordinal regression model since the parallel-lines assumption was violated for microfilarial densities. Findings: 991 participants were included, of whom 342 (35%) were L loa microfilaraemic. The prevalence of microfilaraemia was 38% (122 of 325) among individuals with trace proteinuria (<300 mg/24 h), 51% (45 of 89) among individuals with light proteinuria (300 mg to 1 g/24 h), and 71% (15 of 21) among individuals with high proteinuria (>1 g/24 h). Individuals with high proteinuria had significantly higher L loa microfilarial densities (p<0·0001): mean microfilariae per mL were 1595 (SD 4960) among individuals with no proteinuria, 2691 (7982) for those with trace proteinuria, 3833 (9878) for those with light proteinuria, and 13 541 (20 118) for those with high proteinuria. Individuals with 5000-14 999 microfilariae per mL and individuals with 15 000 microfilariae per mL or greater were, respectively, 5·39 and 20·49 times more likely to have a high proteinuria than individuals with no microfilaraemia. Interpretation: The risk of proteinuria increases with L loa microfilaraemia. Further studies are needed to identify renal disorders (eg, tubulopathies, glomerulopathies, or nephrotic syndromes) responsible for loiasis-related proteinuria. Funding: European Research Council, MorLo project. Translation: For the French translation of the abstract see Supplementary Materials section. Competing Interests: Declaration of interests CB is the recipient of a grant from the Bettencourt-Schueller Foundation (CCU-AH-INSERM-Bettencourt). All other authors declare no competing interests. (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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