Single Versus Multiple Dose Ivermectin Regimen in Onchocerciasis-infected Persons with Epilepsy Treated with Phenobarbital: A Randomized Clinical Trial in the Democratic Republic of Congo
| Autor: | Swabra Nakato, Germain Abhafule, Robert Colebunders, Joseph Nelson Siewe Fodjo, Deogratias Wonya’Rossi, Richard Lokonda, An Hotterbeekx, Steven Haesendonckx, Steven Abrams, Alfred Dusabimana, Francoise Nyisi, Michel Mandro, Deby Mukendi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
life_sciences_other Pediatrics medicine.medical_specialty 030231 tropical medicine lcsh:Medicine Multiple dose Article law.invention ivermectin 03 medical and health sciences Epilepsy 0302 clinical medicine Ivermectin Randomized controlled trial law Internal medicine parasitic diseases medicine Immunology and Allergy Onchocerca Molecular Biology Biology seizures General Immunology and Microbiology biology business.industry lcsh:R onchocerciasis trial biology.organism_classification medicine.disease 3. Good health Clinical trial Regimen Infectious Diseases epilepsy Phenobarbital business Onchocerciasis 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Pathogens Volume 9 Issue 3 Pathogens, Vol 9, Iss 3, p 205 (2020) |
| ISSN: | 2076-0817 |
| Popis: | Background: There is anecdotal evidence that ivermectin may decrease seizure frequency in Onchocerca volvulus-infected persons with epilepsy (PWE). Methods: In October 2017, a 12-month clinical trial was initiated in rural Democratic Republic of Congo. PWE with onchocerciasis-associated epilepsy experiencing &ge 2 seizures/month were randomly allocated to receive, over a one-year period, ivermectin once or thrice (group 1), while other onchocerciasis-infected PWE (OIPWE) were randomized to ivermectin twice or thrice (group 2). All participants also received anti-epileptic drugs. Data was analyzed using multiple logistic regression. Results: We enrolled 197 participants. In an intent-to-treat analysis (data from group 1 and 2 combined), seizure freedom was more likely among OIPWE treated with ivermectin thrice (OR: 5.087, 95% CI: 1.378&ndash 19.749 p = 0.018) and twice (OR: 2.471, 95% CI: 0.944&ndash 6.769 p = 0.075) than in those treated once. Similarly, > 50% seizure reduction was more likely among those treated with ivermectin twice (OR: 4.469, 95% CI: 1.250&ndash 16.620) and thrice (OR: 2.693, 95% CI: 1.077&ndash 6.998). Absence of microfilariae during the last 4 months increased the odds of seizure freedom (p = 0.027). Conclusions: Increasing the number of ivermectin treatments was found to suppress both microfilarial density and seizure frequency in OIPWE, suggesting that O. volvulus infection plays an etiological role in causing seizures. |
| Databáze: | OpenAIRE |
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