1921
Volume 99, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Loiasis is a vector-borne parasitic disease caused by the filarial nematode and transmitted by the tabanid vectors from the genus . infection is associated with clinical manifestations such as pruritus, migratory transient edema, passage of adult worm in the bulbar conjunctiva, retinal damage, glomerular damage, albuminuria, pleural effusion, hydrocele, and endomyocardial fibrosis. Data reporting the occurrence of spontaneous encephalopathy associated with loiasis are very scanty. Severe adverse events occurring post-ivermectin administered in the framework of the fight against onchocerciasis and/or lymphatic filariasis in loiasis co-endemic areas have been closely associated with very high microfilariaemia. Different regimens have been used to lower microfilariaemia before definitive treatment, and many discrepancies have been reported. We report the case of a patient who was admitted to a health facility and hospitalized for 34 days for altered consciousness, blurred vision, headache, and chills. After other potential diagnoses were eliminated, the patient was confirmed with encephalopathy due to loiasis and referred to the Centre for Research on Filariasis and other Tropical Diseases (CRFilMT). On admission at CRFilMT, the patient was harboring 28,700 microfilariae per milliliter of blood (mf/mL), and after four 21-day courses of 400 mg daily albendazole, the microfilariaemia lowered to 5,060 mf/mL. The patient was then treated with ivermectin 3 mg and a total clearance of microfilariae was observed, with satisfactory clinical evolution and no adverse event. This case study further confirmed that albendazole is effective against , but might necessitate a longer course.

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References

  1. Zoure HG, Wanji S, Noma M, Amazigo UV, Diggle PJ, Tekle AH, Remme JH, , 2011. The geographic distribution of Loa loa in Africa: results of large-scale implementation of the rapid assessment procedure for loiasis (RAPLOA). PLoS Negl Trop Dis 5: e1210. [Google Scholar]
  2. Noireau F, Carme B, Apembet JD, Gouteux JP, , 1989. Loa loa and Mansonella perstans filariasis in the Chaillu mountains, Congo: parasitological prevalence. Trans R Soc Trop Med Hyg 83: 529534. [Google Scholar]
  3. Boussinesq M, Gardon J, Kamgno J, Pion SD, Gardon-Wendel N, Chippaux JP, , 2001. Relationships between the prevalence and intensity of Loa loa infection in the Central province of Cameroon. Ann Trop Med Parasitol 95: 495507. [Google Scholar]
  4. Kamgno J, Boussinesq M, , 2001. Hyperendemic loaiasis in the Tikar plain, shrub savanna region of Cameroon [in French]. Bull Soc Pathol Exot 94: 342346. [Google Scholar]
  5. Padgett J, Jacobsen K, , 2008. Loiasis: African eye worm. Trans R Soc Trop Med Hyg 102: 983989. [Google Scholar]
  6. Kamgno J, Pion SD, Mackenzie CD, Thylefors B, Boussinesq M, , 2009. Loa loa microfilarial periodicity in ivermectin-treated patients: comparison between those developing and those free of serious adverse events. Am J Trop Med Hyg 81: 10561061. [Google Scholar]
  7. Bakajika DK, Noigo MM, Lotsima JP, Masikini GA, Fischer K, Lloyd MM, Weil GJ, Fischer PU, , 2014. Filarial antigenemia and Loa loa night blood microfilaremia in an area without bancroftian filariasis in the Democratic Republic of Congo. Am J Trop Med Hyg 91: 11421148. [Google Scholar]
  8. Boussinesq M, , 2006. Loiasis. Ann Trop Med Parasitol 100: 715731. [Google Scholar]
  9. Boussinesq M, Gardon J, , 1997. Prevalences of Loa loa microfilaraemia throughout the area endemic for the infection. Ann Trop Med Parasitol 91: 573589. [Google Scholar]
  10. Kamgno J, Nana-Djeunga H, Kouam-Kenmogne M, , 2016. Loiasis. Gyapong J, Boatin B, eds. Neglected Tropical Diseases in Sub-Saharan Africa. Cham, Switzerland: Springer, 421.
  11. Pinder M, , 1988. Loa loa—a neglected filaria. Parasitol Today 4: 279284. [Google Scholar]
  12. Nutman T, Reese W, Poindexter R, Ottesen E, , 1988. Immunological correlates of the hyperresponsive syndrome of loiasis. J Infect Dis 157: 544550. [Google Scholar]
  13. Klion A, Massougbodji A, Sadeler B, Ottesen E, Nutman T, , 1991. Loiasis in endemic and nonendemic populations: immunologically mediated differences in clinical presentation. J Infect Dis 163: 13181325. [Google Scholar]
  14. Gardon J, Gardon-Wendel N, Demanga N, Kamgno J, Chippaux JP, Boussinesq M, , 1997. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet 350: 1822. [Google Scholar]
  15. American Psychiatric Association, 2000. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.
  16. Akue JP, , 2011. Encephalitis due to Loa loa. Takachev S, ed. Non-Flavivirus Encephalitis. Rijeka, Croatia: Intech, 341–360.
  17. Kamgno J, Djomo P, Pion S, Thylefors B, Boussinesq M, , 2010. A controlled trial to assess the effect of quinine, chloroquine, amodiaquine, and artesunate on Loa loa microfilaremia. Am J Trop Med Hyg 82: 379385. [Google Scholar]
  18. Kamgno J, Pion S, Tejiokem M, Twum-Danso N, Thylefors B, Boussinesq M, , 2007. Randomized, controlled, double-blind trial with ivermectin on Loa loa microfilaraemia: efficacy of a low dose (similar to 25 µg/kg) versus current standard dose (150 µg/kg). Trans R Soc Trop Med Hyg 101: 777785. [Google Scholar]
  19. Kamgno J, Boussinesq M, , 2002. Effect of a single dose (600 mg) of albendazole on Loa loa microfilaraemia. Parasite 9: 5963. [Google Scholar]
  20. Kamgno J, Nguipdop-Djomo P, Gounoue R, Tejiokem M, Kuesel AC, , 2016. Effect of two or six doses 800 mg of albendazole every two months on Loa loa microfilaraemia: a double blind, randomized, placebo-controlled trial. PLoS Negl Trop Dis 10: e0004492. [Google Scholar]
  21. Klion A, Massougbodjia A, Horton R, Ekone S, Lanmasso T, Ahouisson L, Nutman T, , 1992. Albendazole in human loiasis: results of a double-blind, placebo-controlled trial. J Infect Dis 168: 5. [Google Scholar]
  22. Tabi T, 2004. Human loiasis in a Cameroonian village: a double-blind, placebo-controlled, crossover clinical trial of a three-day albendazole regimen. Am J Trop Med Hyg 71: 211215. [Google Scholar]
  23. Tsague-Dongmo L, Kamgno J, Pion S, Moyou-Somo R, Boussinesq M, , 2002. Effects of a 3-day regimen of albendazole (800 mg daily) on Loa loa microfilaraemia. Ann Trop Med Parasitol 96: 707715. [Google Scholar]
  24. Fobi G, Gardon J, Santiago M, Demanga N, Gardon-Wendel N, Boussinesq M, , 2000. Ocular findings after ivermectin treatment of patients with high Loa loa microfilaremia. Ophthalmic Epidemiol 7: 13. [Google Scholar]
  25. Lukiana T, Mandina M, Situakibanza NH, Mbula MM, Lepira BF, Odio WT, Kamgno J, Boussinesq M, , 2006. A possible case of spontaneous Loa loa encephalopathy associated with a glomerulopathy. Filaria J 5: 6. [Google Scholar]
  26. Postels D, Birbeck G, , 2013. Cerebral malaria. Handb Clin Neurol 114: 91102. [Google Scholar]
  27. Khan YA, Mian UH, Ghanchi NK, Zubairi ABS, Beg MA, , 2017. Neurological involvement associated with Plasmodium vivax malaria from Pakistan. Trop Doct 48: 5254. [Google Scholar]
  28. Van Bogaert L, Dubois A, Janssens PG, Radermecker J, Tverdy G, Wanson M, , 1955. Encephalitis in Loa-loa filariasis. J Neurol Neurosurg Psychiatry 18: 103119. [Google Scholar]
  29. Kivits M, , 1952. Four cases of fatal encephalitis with invasion of the cerebrospinal fluid by microfilaria loa. Ann Soc Belg Med Trop 32: 235242. [Google Scholar]
  30. Kamgno J, Boussinesq M, Labrousse F, Nkegoum B, Thylefors BI, Mackenzie CD, , 2008. Encephalopathy after ivermectin treatment in a patient infected with Loa loa and Plasmodium spp. Am J Trop Med Hyg 78: 546551. [Google Scholar]
  31. Kamgno J, Gardon J, Boussinesq M, , 2000. Analysis of the prevention of post-ivermectin Loa loa encephalopathy by administration of initial low dose. Med Trop (Mars) 60: 275277. [Google Scholar]
  32. Kombila M, Duong T, Ferrer A, Perret J, Marion M, Nguiri C, Gaxotte P, Manfoumbi M, Richard-Lenoble D, , 1998. Short- and long-term action of multiple doses of ivermectin on loiasis microfilaremia. Am J Trop Med Hyg 58: 458460. [Google Scholar]
  33. Kamgno J, 2017. A test-and-not-treat strategy for onchocerciasis in Loa loa-endemic areas. N Engl J Med 377: 20442052. [Google Scholar]
  34. D’Ambrosio MV, 2015. Point-of-care quantification of blood-borne filarial parasites with a mobile phone microscope. Sci Transl Med 7: 286re4. [Google Scholar]
  35. Chesnais CB, Takougang I, Paguele M, Pion SD, Boussinesq M, , 2017. Excess mortality associated with loiasis: a retrospective population-based cohort study. Lancet Infect Dis 17: 108116. [Google Scholar]
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  • Received : 21 Aug 2017
  • Accepted : 15 Mar 2018
  • Published online : 07 May 2018

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