Skip to main content
PMC home page
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1997;75(3):229–236.

Impact of annual dosing with ivermectin on progression of onchocercal visual field loss.

S N Cousens 1, A Cassels-Brown 1, I Murdoch 1, O E Babalola 1, D Jatau 1, N D Alexander 1, J E Evans 1, P Danboyi 1, A Abiose 1, B R Jones 1
PMCID: PMC2486957  PMID: 9277010

Abstract

Reported are the results of a randomized, double-masked, placebo-controlled trial of annual ivermectin dosing in 34 rural communities, Kaduna State, northern Nigeria, where guinea savanna onchocerciasis is mesoendemic. A total of 939 individuals underwent Friedmann field analysis at the first examination and saw at least 19 spots in at least one eye. Of these, 636 (68%) completed a subsequent Friedmann field analysis 2-3 years later. The adjusted incidence rate ratio for the ivermectin group versus the placebo group was 0.64 (95% confidence interval (CI): 0.42-0.98). There was some evidence that the impact of ivermectin was greatest among those who had received one dose of ivermectin. The majority of the deteriorations occurred in eyes that gave evidence of optic atrophy at the first examination. An analysis restricted to individuals with optic atrophy at baseline indicated a reduction of 45% in the incidence of visual field deterioration in the ivermectin group (95% CI: 8-67%). Previous findings have shown that ivermectin has an impact on the incidence of optic atrophy. Our results indicate, for the first time, that ivermectin has a substantial impact on the progression of visual field loss among those with pre-existing optic atrophy.

Full text

PDF
229

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abiose A., Jones B. R., Cousens S. N., Murdoch I., Cassels-Brown A., Babalola O. E., Alexander N. D., Nuhu I., Evans J., Ibrahim U. F. Reduction in incidence of optic nerve disease with annual ivermectin to control onchocerciasis. Lancet. 1993 Jan 16;341(8838):130–134. doi: 10.1016/0140-6736(93)90002-x. [DOI] [PubMed] [Google Scholar]
  2. Abiose A., Murdoch I., Babalola O., Cousens S., Liman I., Onyema J., Evans J., Gregory W., Jones B. Distribution and aetiology of blindness and visual impairment in mesoendemic onchocercal communities, Kaduna State, Nigeria. Kaduna Collaboration for Research on Onchocerciasis. Br J Ophthalmol. 1994 Jan;78(1):8–13. doi: 10.1136/bjo.78.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Alley E. S., Plaisier A. P., Boatin B. A., Dadzie K. Y., Remme J., Zerbo G., Samba E. M. The impact of five years of annual ivermectin treatment on skin microfilarial loads in the onchocerciasis focus of Asubende, Ghana. Trans R Soc Trop Med Hyg. 1994 Sep-Oct;88(5):581–584. doi: 10.1016/0035-9203(94)90172-4. [DOI] [PubMed] [Google Scholar]
  4. Dadzie K. Y., Remme J., Alley E. S., de Sole G. Changes in ocular onchocerciasis four and twelve months after community-based treatment with ivermectin in a holoendemic onchocerciasis focus. Trans R Soc Trop Med Hyg. 1990 Jan-Feb;84(1):103–108. doi: 10.1016/0035-9203(90)90395-u. [DOI] [PubMed] [Google Scholar]
  5. Flanagan J. G., Wild J. M., Barnes D. A., Gilmartin B. A., Good P. A., Crews S. J. The qualitative comparative analysis of the visual field using computer assisted, semi-automated and manual instrumentation: III. Clinical analysis. Doc Ophthalmol. 1984 Dec 15;58(4):341–350. doi: 10.1007/BF00679798. [DOI] [PubMed] [Google Scholar]
  6. Greene B. M., Dukuly Z. D., Muñoz B., White A. T., Pacqué M., Taylor H. R. A comparison of 6-, 12-, and 24-monthly dosing with ivermectin for treatment of onchocerciasis. J Infect Dis. 1991 Feb;163(2):376–380. doi: 10.1093/infdis/163.2.376. [DOI] [PubMed] [Google Scholar]
  7. Lariviere M., Vingtain P., Aziz M., Beauvais B., Weimann D., Derouin F., Ginoux J., Schulz-Key H., Gaxotte P., Basset D. Double-blind study of ivermectin and diethylcarbamazine in African onchocerciasis patients with ocular involvement. Lancet. 1985 Jul 27;2(8448):174–177. doi: 10.1016/s0140-6736(85)91496-5. [DOI] [PubMed] [Google Scholar]
  8. Luty A. J., Downham M. D., Whitworth J. A., Morgan D., McNicholas A., Taylor D. W. Immunological studies on onchocerciasis in Sierra Leone. 1. Pretreatment baseline data. Trop Med Parasitol. 1990 Dec;41(4):371–375. [PubMed] [Google Scholar]
  9. Taylor H. R., Greene B. M. The status of ivermectin in the treatment of human onchocerciasis. Am J Trop Med Hyg. 1989 Oct;41(4):460–466. doi: 10.4269/ajtmh.1989.41.460. [DOI] [PubMed] [Google Scholar]
  10. Whitworth J. A., Gilbert C. E., Mabey D. M., Maude G. H., Morgan D., Taylor D. W. Effects of repeated doses of ivermectin on ocular onchocerciasis: community-based trial in Sierra Leone. Lancet. 1991 Nov 2;338(8775):1100–1103. doi: 10.1016/0140-6736(91)91963-u. [DOI] [PubMed] [Google Scholar]
  11. Wild J. M., Flanagan J. G., Barnes D. A., Gilmartin B. A., Good P. A., Crews S. J. The qualitative comparative analysis of the visual field using computer assisted, semi-automated and manual instrumentation: II. Statistical analysis. Doc Ophthalmol. 1984 Dec 15;58(4):325–340. doi: 10.1007/BF00679797. [DOI] [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES