In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 16, No. 4 ( 2022-4-27), p. e0010079-
Abstract:
Our study in CDTI-naïve areas in Nord Kivu and Ituri (Democratic Republic of the Congo, DRC), Lofa County (Liberia) and Nkwanta district (Ghana) showed that a single 8 mg moxidectin dose reduced skin microfilariae density (microfilariae/mg skin, SmfD) better and for longer than a single 150μg/kg ivermectin dose. We now analysed efficacy by study area and pre-treatment SmfD (intensity of infection, IoI). Methodology/Principal findings Four and three IoI categories were defined for across-study and by-study area analyses, respectively. We used a general linear model to analyse SmfD 1, 6, 12 and 18 months post-treatment, a logistic model to determine the odds of undetectable SmfD from month 1 to month 6 (UD1-6), month 12 (UD1-12) and month 18 (UD1-18), and descriptive statistics to quantitate inter-interindividual response differences. Twelve months post-treatment, treatment differences (difference in adjusted geometric mean SmfD after moxidectin and ivermectin in percentage of the adjusted geometric mean SmfD after ivermectin treatment) were 92.9%, 90.1%, 86.8% and 84.5% in Nord Kivu, Ituri, Lofa and Nkwanta, and 74.1%, 84.2%, 90.0% and 95.4% for participants with SmfD 10–20, ≥20- 〈 50, ≥50- 〈 80, ≥80, respectively. Ivermectin’s efficacy was lower in Ituri and Nkwanta than Nord Kivu and Lofa (p≤0.002) and moxidectin’s efficacy lower in Nkwanta than Nord Kivu, Ituri and Lofa (p 〈 0.006). Odds ratios for UD1-6, UD1-12 or UD1-18 after moxidectin versus ivermectin treatment exceeded 7.0. Suboptimal response (SmfD 12 months post-treatment 〉 40% of pre-treatment SmfD) occurred in 0%, 0.3%, 1.6% and 3.9% of moxidectin and 12.1%, 23.7%, 10.8% and 28.0% of ivermectin treated participants in Nord Kivu, Ituri, Lofa and Nkwanta, respectively. Conclusions/Significance The benefit of moxidectin vs ivermectin treatment increased with pre-treatment IoI. The possibility that parasite populations in different areas have different drug susceptibility without prior ivermectin selection pressure needs to be considered and further investigated. Clinical Trial Registration Registered on 14 November 2008 in Clinicaltrials.gov (ID: NCT00790998 ).
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0010079
DOI:
10.1371/journal.pntd.0010079.g001
DOI:
10.1371/journal.pntd.0010079.g002
DOI:
10.1371/journal.pntd.0010079.g003
DOI:
10.1371/journal.pntd.0010079.g004
DOI:
10.1371/journal.pntd.0010079.g005
DOI:
10.1371/journal.pntd.0010079.g006
DOI:
10.1371/journal.pntd.0010079.g007
DOI:
10.1371/journal.pntd.0010079.g008
DOI:
10.1371/journal.pntd.0010079.g009
DOI:
10.1371/journal.pntd.0010079.t001
DOI:
10.1371/journal.pntd.0010079.t002
DOI:
10.1371/journal.pntd.0010079.t003
DOI:
10.1371/journal.pntd.0010079.t004
DOI:
10.1371/journal.pntd.0010079.t005
DOI:
10.1371/journal.pntd.0010079.t006
DOI:
10.1371/journal.pntd.0010079.t007
DOI:
10.1371/journal.pntd.0010079.s001
DOI:
10.1371/journal.pntd.0010079.s002
DOI:
10.1371/journal.pntd.0010079.s003
DOI:
10.1371/journal.pntd.0010079.r001
DOI:
10.1371/journal.pntd.0010079.r002
DOI:
10.1371/journal.pntd.0010079.r003
DOI:
10.1371/journal.pntd.0010079.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2429704-5
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