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-
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.
-
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: 529–534.
-
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: 495–507.
-
4.
Kamgno J, Boussinesq M, 2001. Hyperendemic loaiasis in the Tikar plain, shrub savanna region of Cameroon [in French]. Bull Soc Pathol Exot 94: 342–346.
-
5.
Padgett J, Jacobsen K, 2008. Loiasis: African eye worm. Trans R Soc Trop Med Hyg 102: 983–989.
-
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: 1056–1061.
-
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: 1142–1148.
-
8.
Boussinesq M, 2006. Loiasis. Ann Trop Med Parasitol 100: 715–731.
-
9.
Boussinesq M, Gardon J, 1997. Prevalences of Loa loa microfilaraemia throughout the area endemic for the infection. Ann Trop Med Parasitol 91: 573–589.
-
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: 279–284.
-
12.
Nutman T, Reese W, Poindexter R, Ottesen E, 1988. Immunological correlates of the hyperresponsive syndrome of loiasis. J Infect Dis 157: 544–550.
-
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: 1318–1325.
-
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: 18–22.
-
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: 379–385.
-
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: 777–785.
-
19.
Kamgno J, Boussinesq M, 2002. Effect of a single dose (600 mg) of albendazole on Loa loa microfilaraemia. Parasite 9: 59–63.
-
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.
-
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.
-
22.
Tabi T et al. 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: 211–215.
-
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: 707–715.
-
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.
-
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.
-
26.
Postels D, Birbeck G, 2013. Cerebral malaria. Handb Clin Neurol 114: 91–102.
-
27.
Khan YA, Mian UH, Ghanchi NK, Zubairi ABS, Beg MA, 2017. Neurological involvement associated with Plasmodium vivax malaria from Pakistan. Trop Doct 48: 52–54.
-
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: 103–119.
-
29.
Kivits M, 1952. Four cases of fatal encephalitis with invasion of the cerebrospinal fluid by microfilaria loa. Ann Soc Belg Med Trop 32: 235–242.
-
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: 546–551.
-
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: 275–277.
-
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: 458–460.
-
33.
Kamgno J et al. 2017. A test-and-not-treat strategy for onchocerciasis in Loa loa-endemic areas. N Engl J Med 377: 2044–2052.
-
34.
D’Ambrosio MV et al. 2015. Point-of-care quantification of blood-borne filarial parasites with a mobile phone microscope. Sci Transl Med 7: 286re4.
-
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: 108–116.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1155 | 1050 | 633 |
| Full Text Views | 1101 | 8 | 2 |
| PDF Downloads | 224 | 7 | 2 |
Case Report: Probable Case of Spontaneous Encephalopathy Due to Loiasis and Dramatic Reduction of Loa loa Microfilariaemia with Prolonged Repeated Courses of Albendazole
Divine B. Arrey-Agbor
Divine B. Arrey-Agbor
Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon;
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Hugues C. Nana-Djeunga
Hugues C. Nana-Djeunga
Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon;
Department of Animal Biology and Physiology, Parasitology and Ecology Laboratory, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon;
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Department of Animal Biology and Physiology, Parasitology and Ecology Laboratory, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon;
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Aude E. Mogoung-Wafo
Aude E. Mogoung-Wafo
Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon;
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Mirabelle Mafo
Mirabelle Mafo
Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon;
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Christian Danwe
Christian Danwe
Yaoundé Military Hospital, Yaoundé, Cameroon;
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Joseph Kamgno
Joseph Kamgno
Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon;
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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Loiasis is a vector-borne parasitic disease caused by the filarial nematode Loa loa and transmitted by the tabanid vectors from the genus Chrysops. Loa loa 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 L. loa microfilariaemia. Different regimens have been used to lower L. loa 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 L. loa 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 L. loa, but might necessitate a longer course.
Author Notes
Authors’ addresses: Divine B. Arrey-Agbor, Clinical and SAEs Surveillance Service, Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaounde, Cameroon, E-mail: bedivine2001@yahoo.fr. Hugues C. Nana-Djeunga, Epidemiology and Biostatistics Service, Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaounde, Cameroon, and Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaounde, Cameroon, E-mail: nanadjeunga@crfilmt.org. Aude E. Mogoung-Wafo and Mirabelle Mafo, Laboratory Service, Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaounde, Cameroon, E-mails: audewafo@yahoo.fr and mirabellemafo@yahoo.fr. Christian Danwe, Department of Resuscitation, Military Hospital, Yaoundé, Cameroon, E-mail: danwecris@yahoo.fr. Joseph Kamgno, Epidemiology and Biostatistics Service, Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaounde, Cameroon, and Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon, E-mail: kamgno@crfilmt.org.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
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.
-
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: 529–534.
-
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: 495–507.
-
4.
Kamgno J, Boussinesq M, 2001. Hyperendemic loaiasis in the Tikar plain, shrub savanna region of Cameroon [in French]. Bull Soc Pathol Exot 94: 342–346.
-
5.
Padgett J, Jacobsen K, 2008. Loiasis: African eye worm. Trans R Soc Trop Med Hyg 102: 983–989.
-
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: 1056–1061.
-
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: 1142–1148.
-
8.
Boussinesq M, 2006. Loiasis. Ann Trop Med Parasitol 100: 715–731.
-
9.
Boussinesq M, Gardon J, 1997. Prevalences of Loa loa microfilaraemia throughout the area endemic for the infection. Ann Trop Med Parasitol 91: 573–589.
-
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: 279–284.
-
12.
Nutman T, Reese W, Poindexter R, Ottesen E, 1988. Immunological correlates of the hyperresponsive syndrome of loiasis. J Infect Dis 157: 544–550.
-
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: 1318–1325.
-
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: 18–22.
-
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: 379–385.
-
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: 777–785.
-
19.
Kamgno J, Boussinesq M, 2002. Effect of a single dose (600 mg) of albendazole on Loa loa microfilaraemia. Parasite 9: 59–63.
-
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.
-
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.
-
22.
Tabi T et al. 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: 211–215.
-
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: 707–715.
-
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.
-
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.
-
26.
Postels D, Birbeck G, 2013. Cerebral malaria. Handb Clin Neurol 114: 91–102.
-
27.
Khan YA, Mian UH, Ghanchi NK, Zubairi ABS, Beg MA, 2017. Neurological involvement associated with Plasmodium vivax malaria from Pakistan. Trop Doct 48: 52–54.
-
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: 103–119.
-
29.
Kivits M, 1952. Four cases of fatal encephalitis with invasion of the cerebrospinal fluid by microfilaria loa. Ann Soc Belg Med Trop 32: 235–242.
-
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: 546–551.
-
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: 275–277.
-
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: 458–460.
-
33.
Kamgno J et al. 2017. A test-and-not-treat strategy for onchocerciasis in Loa loa-endemic areas. N Engl J Med 377: 2044–2052.
-
34.
D’Ambrosio MV et al. 2015. Point-of-care quantification of blood-borne filarial parasites with a mobile phone microscope. Sci Transl Med 7: 286re4.
-
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: 108–116.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1155 | 1050 | 633 |
| Full Text Views | 1101 | 8 | 2 |
| PDF Downloads | 224 | 7 | 2 |