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Onchocerca volvulus microfilariae in the anterior chambers of the eye and ocular adverse events after a single dose of 8 mg moxidectin or 150 µg/kg ivermectin: results of a randomized double-blind Phase 3 trial in the Democratic Republic of the Congo, Ghana and Liberia.
Parasit Vectors
March 2024
UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (WHO/TDR), World Health Organization, Geneva, Switzerland.
Article Synopsis
- The study examined the safety and effectiveness of moxidectin versus ivermectin in treating Onchocerca volvulus infections, particularly focusing on microfilariae levels and ocular adverse reactions in patients with high microfilarial counts.
- Data were collected from 1,463 participants, and results showed that both treatments had similar impacts on ocular microfilariae levels (mfAC) and resulted in Mazzotti reactions in about 10-12% of participants, with factors like gender and pre-treatment mfAC influencing the severity of reactions.
- The findings suggest that while both treatments are effective, women and those with higher mfAC levels may be at increased risk for more severe ocular reactions post
Can mass drug administration of moxidectin accelerate onchocerciasis elimination in Africa?
Philos Trans R Soc Lond B Biol Sci
October 2023
London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London W2 1PG, UK.
Epidemiological and modelling studies suggest that elimination of transmission (EoT) throughout Africa may not be achievable with annual mass drug administration (MDA) of ivermectin alone, particularly in areas of high endemicity and vector density. Single-dose Phase II and III clinical trials demonstrated moxidectin's superiority over ivermectin for prolonged clearance of microfilariae. We used the stochastic, individual-based EPIONCHO-IBM model to compare the probabilities of reaching EoT between ivermectin and moxidectin MDA for a range of endemicity levels (30 to 70% baseline microfilarial prevalence), treatment frequencies (annual and biannual) and therapeutic coverage/adherence values (65 and 80% of total population, with, respectively, 5 and 1% of systematic non-adherence).
View Article and Find Full Text PDFIs the neglected tropical disease mass drug administration campaign approach an effective strategy to deliver universal health coverage? A case study of the Liberia neglected tropical disease programme.
Int Health
May 2024
Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Background: Access to affordable, quality healthcare is the key element of universal health coverage (UHC). This study examines the effectiveness of the neglected tropical disease (NTD) mass drug administration (MDA) campaign approach as a means to deliver UHC, using the example of the Liberia national programme.
Methods: We first mapped the location of 3195 communities from the 2019 national MDA treatment data reporting record of Liberia.
How well do coverage surveys and programmatically reported mass drug administration coverage match? Results from 214 mass drug administration campaigns in 15 countries, 2008-2017.
BMJ Glob Health
May 2023
SCI Foundation, London, UK.
Introduction: Delivering preventive chemotherapy through mass drug administration (MDA) is a central approach in controlling or eliminating several neglected tropical diseases (NTDs). Treatment coverage, a primary indicator of MDA performance, can be measured through routinely reported programmatic data or population-based coverage evaluation surveys. Reported coverage is often the easiest and least expensive way to estimate coverage; however, it is prone to inaccuracies due to errors in data compilation and imprecise denominators, and in some cases measures treatments offered as opposed to treatments swallowed.
View Article and Find Full Text PDFA syndemic born of war: Combining intersectionality and structural violence to explore the biosocial interactions of neglected tropical diseases, disability and mental distress in Liberia.
PLOS Glob Public Health
June 2022
Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
The intersections between NTDs, disability, and mental ill-health are increasingly recognised globally. Chronic morbidity resultant from many NTDs, particularly those affecting the skin-including lymphatic filariasis (LF), leprosy, Buruli ulcer (BU) and onchocerciasis-is well known and largely documented from a medicalised perspective. However less is known about the complex biosocial interaction shaping interconnected morbidities.
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