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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Long term impact of large scale community-directed delivery of doxycycline for the treatment of onchocerciasis
Parasites and Vectors, Volume 5, No. 1, Article 53, Year 2012
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Description
Background: Anti-Wolbachia treatment with doxycycline is effective in sterilising and killing adult Onchocerca volvulus nematodes, proving superior to ivermectin and of great potential as an alternative approach for the treatment and control of onchocerciasis, particularly in areas of Loa loa co-endemicity. Nevertheless, the length of the required treatment poses potential logistical problems and risk of poor compliance, raising a barrier to the use of doxycycline in Mass Drug Administration (MDA) strategies. In 2007 and 2008 a feasibility trial of community-directed treatment with doxycycline was carried out in two health districts in Cameroon, co-endemic for O. volvulus and L. loa. With 17,519 eligible subjects, the therapeutic coverage was 73.8% with 97.5% compliance, encouraging the feasibility of using doxycycline community-directed delivery in restricted populations of this size. The current study evaluated the effectiveness of this community-directed delivery of doxycycline four years after delivery. Findings. Infection with O. volvulus was evaluated by skin biopsy and nodule palpation. Of the 507 subjects recruited, 375 had completed the treatment with doxycycline followed by one or two rounds of annual ivermectin MDA and 132 received one or two rounds of annual ivermectin MDA alone. Statistically significant lower microfilarial prevalence (17.0% [doxycycline plus ivermectin group], 27.0% [ivermectin only group], p = 0.014) and load (p = 0.012) were found in people that had received doxycycline followed by ivermectin compared to those who received ivermectin only. Conclusions: This study demonstrates the long-term effectiveness of doxycycline treatment delivered with a community-directed strategy even when evaluated four years after delivery in an area of ongoing transmission. This finding shows that a multi-week course of treatment is not a barrier to community-delivery of MDA in restricted populations of this size and supports its implementation to compliment existing control strategies for onchocerciasis, where needed. © 2012 Tamarozzi et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Tamarozzi, Francesca
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Tendongfor, Nicholas
Cameroon, Buea
University of Buea
Cameroon, Yaounde
Research Foundation for Tropical Diseases and Environment
Enyong, Peter Ayuk I.
Cameroon, Yaounde
Research Foundation for Tropical Diseases and Environment
Cameroon
Tropical Medicine Research Station
Esum, Mathias Eyong
Cameroon, Yaounde
Research Foundation for Tropical Diseases and Environment
Faragher, Brian E.
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Wanji, Samuel
Cameroon, Buea
University of Buea
Cameroon, Yaounde
Research Foundation for Tropical Diseases and Environment
Taylor, Mark John
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Statistics
Citations: 42
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1186/1756-3305-5-53
e-ISSN:
17563305
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Cameroon