The effects of ivermectin on onchocercal skin disease and severe itching: Results of a multicentre trial

W. R. Brieger, A. K. Awedoba, C. I. Eneanya, M. Hagan, K. F. Ogbuagu, D. O. Okello, O. O. Ososanya, E. B.L. Ovuga, M. Noma, O. O. Kale, G. M. Burnham, J. H.F. Remme

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE. To determine the effects of ivermectin in annual, 3-monthly and 6-monthly doses on onchocercal skin disease (OSD) and severe itching. METHOD. A multicentre, double-blind placebo controlled trial was conducted among 4072 residents of rural communities in Ghana, Nigeria and Uganda. Baseline clinical examination categorized reactive skill lesions as acute papular onchodermatitis, chronic papular onchodermatitis and lichenified onchodermatitis. Presence and severity of itching was determined by open- ended and probing questions. Clinical examination and interview took place at baseline and each of 5 subsequent 3-monthly follow-up visits. RESULTS. While prevalence and severity of reactive lesions decreased for all 4 arms, those receiving ivermectin maintained a greater decrease in prevalence and severity over time. The difference between ivermectin and placebo groups was significant for prevalence at 9 months and for severity at 3 months. Differences between placebo and ivermectin groups were much more pronounced for itching. From 6 months onward, the prevalence of severe itching was reduced by 40-50% among those receiving ivermectin compared to the trend in the placebo group. CONCLUSION. this is an important effect on disease burden as severe itching is for the affected people the most troubling complication of onchocerciasis. The difference among regimens was not significant, and the recommended regimen of annual treatment for the control of ocular onchocerciasis appears also the most appropriate for onchocerciasis control in areas where the skin manifestations predominate. The final determination of the effect on skin lesions requires a longer period of study.

Original languageEnglish (US)
Pages (from-to)951-961
Number of pages11
JournalTropical Medicine and International Health
Volume3
Issue number12
DOIs
StatePublished - 1998
Externally publishedYes

Keywords

  • Itching
  • Ivermectin
  • Onchocerciasis
  • Onchodermatitis

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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