Table 1.

The types of reactions seen in the treatment of onchocerciasis with oral diethylcarbamazine, ivermectin* and others

EXPECTED ("ACCEPTABLE") REACTIONS

• "Classical Mazzotti reactions"

Pruritus

Papular dermal response

Dermal edema

Headache

Nausea

Lethargy

EXCESSIVE ("UNACCEPTABLE") REACTIONS

• Excessive forms of the normally expected Mazzotti reactions

Temporal association with treatment

Lethargy

Papular, pruritic, and edematous dermal responses

Severe headache

Bone ache

Inability to work

Prostration (e.g. Sowda patients)

• Major neurological changes

Coma

Epilepsy

• Specific (non-Mazzotti) dermal responses

Drug-related allergic responses (dermal plaques etc.)

• Other responses

Unsubstantiated reports (bleeding, etc.)

* Ivermectin produces reactions significantly less in severity and duration.