Asunto(s)
Papio , Síndrome de Inmunodeficiencia Adquirida del Simio/inmunología , África , Animales , Anticuerpos Antivirales/sangre , Recuento de Linfocito CD4 , Enfermedad Crónica , Femenino , Recuento de Linfocitos , Síndrome de Inmunodeficiencia Adquirida del Simio/virología , Virus de la Inmunodeficiencia de los Simios/inmunología , Virus de la Inmunodeficiencia de los Simios/fisiología , Factores de Tiempo , Carga ViralRESUMEN
The major objective of this study was to evaluate the usefulness of IgG4 ELISA and Western blot analysis, using a crude extract of Onchocerca volvulus adult worms as antigens, for diagnosing onchocerciasis in a Gabonese paediatric population with mixed filarial infections. The subjects had loaisis, streptocercosis or mansonellosis in addition to onchocerciasis. Control sera from loaisis or mansonellosis subjects residing outside the endemic zone were used to provide the cut-off point for positive results. The IgG4 ELISA had a specificity of 96% but a lower sensitivity of 78.7%. It detected 25 onchocerciasis cases out of 65 individuals who were negative on parasitological examination. Furthermore, the ELISA provided a more accurate picture of onchocerciasis transmission in a village with very low skin microfilarial load. A 27.5-kD antigen was identified on Western blots as a marker of onchocerciasis. The paediatric population provided a reliable window for assessing the parasitologic and serologic parameters in the three villages with disparate levels of onchocerciasis transmission.
Asunto(s)
Inmunoglobulina G/sangre , Inmunoglobulina G/clasificación , Onchocerca volvulus/inmunología , Oncocercosis/inmunología , Oncocercosis/transmisión , Adolescente , Animales , Antígenos Helmínticos/análisis , Biomarcadores/análisis , Western Blotting , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Estudios de Evaluación como Asunto , Femenino , Gabón/epidemiología , Humanos , Inmunoglobulina G/análisis , Onchocerca volvulus/química , Oncocercosis/diagnóstico , Prevalencia , Sensibilidad y Especificidad , Piel/parasitologíaAsunto(s)
Ivermectina/uso terapéutico , Loiasis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Animales , Niño , Preescolar , Humanos , Ivermectina/administración & dosificación , Loa/efectos de los fármacos , Loiasis/parasitología , Microfilarias/efectos de los fármacos , Persona de Mediana EdadRESUMEN
A study was carried out in southeastern Gabon to evaluate the tolerance and efficacy of single high doses of ivermectin in 31 Loa loa-infected subjects with low-to-moderate parasitemia (7-7,700 microfilaria/ml). The first group of 16 subjects received 300 micrograms/kg of ivermectin and, seven days later, a second group of 15 received 400 micrograms/kg. Complete clinical and biological monitoring was carried out during the first 10 days post-treatment and again after one and three months. All subjects continued with their usual activities during the study. The clinical tolerance of treatment was very good, and except in one case, only mild adverse reactions were observed, with pruritus being the most common symptom. There were no significant changes in blood or urine function test results or in hematologic results, except for a pronounced eosinophil reaction. The 400 micrograms/kg dose of ivermectin equaled or surpassed in tolerance that of 300 micrograms/kg dose. After treatment, L. loa microfilaremia decreased rapidly to less than 9% of the pretreatment value by day 10. This decrease was enhanced with the 400 micrograms/kg dose, although differences between the two groups diminished slightly with time. At 100 days post-treatment, the microfilaremia was still at less than 10% of the initial values in the two groups, which may indicate an effect of ivermectin on the adult worms.
