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-
1.
Zoure HGM, Wanji S, Noma M, Amazigo UV, Diggle PJ, Tekle AH, Remme JHF, 2011. The geographic distribution of Loa loa in Africa: results of large-scale implementation of the rapid assessment procedure for loiasis (RAPLOA). PLoS Negl Trop Dis 5: e1210.
-
2.
Metzger WG, Mordmuller B, 2014. Loa loa—does it deserve to be neglected? Lancet Infect Dis 14: 353–357.
-
3.
Boussinesq M, 2006. Loiasis. Ann Trop Med Parasitol 100: 715–731.
-
4.
Lipner EM, Law MA, Barnett E, Keystone JS, von Sonnenburg F, Loutan L, Prevots DR, Klion AD, Nutman TB; GeoSentinel Surveillance Network, 2007. Filariasis in travelers presenting to the GeoSentinel Surveillance Network. PLoS Negl Trop Dis 1: e88.
-
5.
Churchill DR, Morris C, Fakoya A, Wright SG, Davidson RN, 1996. Clinical and laboratory features of patients with loiasis (Loa loa filariasis) in the UK. J Infect 33: 103–109.
-
6.
Gantois N, Rapp C, Gautret P, Ficko C, Savini H, Larreche S, Saidi R, Crevon L, Simon F, 2013. Imported loiasis in France: a retrospective analysis of 47 cases. Travel Med Infect Dis 11: 366–373.
-
7.
Klion AD, Massougbodji A, Sadeler BC, Ottesen EA, Nutman TB, 1991. Loiasis in endemic and nonendemic populations: immunologically mediated differences in clinical presentation. J Infect Dis 163: 1318–1325.
-
8.
Gobbi F, Postiglione C, Angheben A, Marocco S, Monteiro G, Buonfrate D, Mascarello M, Gobbo M, Boussinesq M, Bisoffi Z, 2014. Imported loiasis in Italy: an analysis of 100 cases. Travel Med Infect Dis 12: 713–717.
-
9.
Nutman TB, Reese W, Poindexter RW, Ottesen EA, 1988. Immunologic correlates of the hyperresponsive syndrome of loiasis. J Infect Dis 157: 544–550.
-
10.
Wahl G, Georges A, 1995. Current knowledge on the epidemiology, diagnosis, immunology, and treatment of loiasis. Trop Med Parasitol 46: 287–291.
-
11.
Gardon J, Gardon-Wendel N, Ngangue D, Kamgno J, Chippaux J-P, Boussinesq M, 1997. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet 350: 18–22.
-
12.
Carme B, Boulesteix J, Boutes H, Puruehnce M, 1991. Five cases of encephalitis during treatment of loiasis with diethylcarbamazine. Am J Trop Med Hyg 44: 684–690.
-
13.
Padgett JJ, Jacobsen KH, 2008. Loiasis: African eye worm. Trans R Soc Trop Med Hyg 102: 983–989.
-
14.
Boussinesq M, 2012. Loiasis: new epidemiologic insights and proposed treatment strategy. J Travel Med 19: 140–143.
-
15.
Takougang I, Meli J, Lamlenn S, Tatah PN, Ntep M, 2007. Loiasis—a neglected and under-estimated affliction: endemicity, morbidity and perceptions in eastern Cameroon. Ann Trop Med Parasitol 101: 151–160.
-
16.
Ali S, Fisher M, Juckett G, 2008. The African eye worm: a case report and review. J Travel Med 15: 50–52.
-
17.
Nutman TB, Miller KD, Mulligan M, Ottesen EA, 1986. Loa loa infection in temporary residents of endemic regions: recognition of a hyperresponsive syndrome with characteristic clinical manifestations. J Infect Dis 154: 10–18.
-
18.
Klion AD, Ottesen EA, Nutman TB, 1994. Effectiveness of diethylcarbamazine in treating loiasis acquired by expatriate visitors to endemic regions: long-term follow-up. J Infect Dis 169: 604–610.
-
19.
Antinori S, Schifanella L, Million M, Galimberti L, Ferraris L, Mandia L, Trabucchi G, Cacioppo V, Monaco G, Tosoni A, Brouqui P, Gismondo MR, Giuliani G, Corbellino M, 2012. Imported Loa loa filariasis: three cases and a review of cases reported in non-endemic countries in the past 25 years. Int J Infect Dis 16: e649–e662.
-
20.
Ghys C, Morissens M, Rozen L, Karmali R, Theunissen C, 2012. Loiasis with pleural and peritoneal involvement. J Travel Med 19: 186–188.
-
21.
Boussinesq M, Gardon J, Gardon-Wendel N, Kamgno J, Ngoumou P, Chippaux J-P, 1998. Three probable cases of Loa loa encephalopathy following ivermectin treatment for onchocerciasis. Am J Trop Med Hyg 58: 461–469.
-
22.
Twum-Danso N, 2003. Loa loa encephalopathy temporally related to ivermectin administration reported from onchocerciasis mass treatment programs from 1989 to 2001: implications for the future. Filaria J 2: S7.
-
23.
Kamgno J, Pion SD, Tejiokem MC, Twum-Danso NA, Thylefors B, Boussinesq M, 2007. Randomized, controlled, double-blind trial with ivermectin on Loa loa microfilaraemia: efficacy of a low dose (approximately 25 microg/kg) versus current standard dose (150 microg/kg). Trans R Soc Trop Med Hyg 101: 777–785.
-
24.
Boussinesq M, Gardon J, Gardon-Wendel N, Chippaux J, 2003. Clinical picture, epidemiology, and outcome of Loa-associated adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon. Filaria J 2: S4.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 339 | 289 | 24 |
| Full Text Views | 440 | 17 | 0 |
| PDF Downloads | 115 | 9 | 0 |
Clinical Features of Imported Loiasis: A Case Series from the Hospital for Tropical Diseases, London
Makoto Saito
Makoto Saito
Hospital for Tropical Diseases, London, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom
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Margaret Armstrong
Margaret Armstrong
Hospital for Tropical Diseases, London, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom
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Samuel Boadi
Samuel Boadi
Hospital for Tropical Diseases, London, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom
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Patricia Lowe
Patricia Lowe
Hospital for Tropical Diseases, London, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom
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Peter L. Chiodini
Peter L. Chiodini
Hospital for Tropical Diseases, London, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom
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Tom Doherty
Tom Doherty
Hospital for Tropical Diseases, London, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom
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We retrospectively analyzed the background, clinical features, and treatment response of 50 cases of imported loiasis who presented between 2000 and 2014 to the Hospital for Tropical Diseases (HTD), London, United Kingdom. Of them, 29 were migrants from, and 21 were visitors to, countries where the disease is endemic. Clinical features differed between these groups. Migrants experienced fewer Calabar swellings (odds ratio [OR] = 0.12), more eye worm (OR = 3.4), more microfilaremia (OR = 3.5), lower filarial antibody levels, and lower eosinophil counts (P < 0.05 for all tests). Among 46 patients who were started on treatment at HTD, 33 (72%) received diethylcarbamazine (DEC) monotherapy as first-line treatment, and among 26 patients who were followed up after treatment, seven (27%) needed a second course of treatment. There were 46 courses of treatment with DEC, and 20 (43%) of them had reactions. All patients with microfilaremia > 3,000 microfilariae/mL and all those with an elevated C-reactive protein (CRP) (≥ 5 mg/L) before treatment had reactions (P = 0.10 and P = 0.01, respectively). These data suggest that monotherapy with DEC may not be the optimal treatment for patients with loiasis, particularly for those with a high microfilarial load.
Author Notes
Financial support: Makoto Saito is supported by GlaxoSmithKline International Scholarship Charitable Trust Fund. Margaret Armstrong is supported by the Special Trustees of the Hospital for Tropical Diseases. Peter L. Chiodini is supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre.
Authors' addresses: Makoto Saito, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mail: makosaitou-tky@umin.ac.jp. Margaret Armstrong, Samuel Boadi, Patricia Lowe, Peter L. Chiodini, and Tom Doherty, Hospital for Tropical Diseases, London, United Kingdom, E-mails: margaret.armstrong@uclh.nhs.uk, samuel.boadi@uclh.nhs.uk, patricia.lowe@uclh.nhs.uk, peter.chiodini@uclh.nhs.uk, and tom.doherty1957@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Zoure HGM, Wanji S, Noma M, Amazigo UV, Diggle PJ, Tekle AH, Remme JHF, 2011. The geographic distribution of Loa loa in Africa: results of large-scale implementation of the rapid assessment procedure for loiasis (RAPLOA). PLoS Negl Trop Dis 5: e1210.
-
2.
Metzger WG, Mordmuller B, 2014. Loa loa—does it deserve to be neglected? Lancet Infect Dis 14: 353–357.
-
3.
Boussinesq M, 2006. Loiasis. Ann Trop Med Parasitol 100: 715–731.
-
4.
Lipner EM, Law MA, Barnett E, Keystone JS, von Sonnenburg F, Loutan L, Prevots DR, Klion AD, Nutman TB; GeoSentinel Surveillance Network, 2007. Filariasis in travelers presenting to the GeoSentinel Surveillance Network. PLoS Negl Trop Dis 1: e88.
-
5.
Churchill DR, Morris C, Fakoya A, Wright SG, Davidson RN, 1996. Clinical and laboratory features of patients with loiasis (Loa loa filariasis) in the UK. J Infect 33: 103–109.
-
6.
Gantois N, Rapp C, Gautret P, Ficko C, Savini H, Larreche S, Saidi R, Crevon L, Simon F, 2013. Imported loiasis in France: a retrospective analysis of 47 cases. Travel Med Infect Dis 11: 366–373.
-
7.
Klion AD, Massougbodji A, Sadeler BC, Ottesen EA, Nutman TB, 1991. Loiasis in endemic and nonendemic populations: immunologically mediated differences in clinical presentation. J Infect Dis 163: 1318–1325.
-
8.
Gobbi F, Postiglione C, Angheben A, Marocco S, Monteiro G, Buonfrate D, Mascarello M, Gobbo M, Boussinesq M, Bisoffi Z, 2014. Imported loiasis in Italy: an analysis of 100 cases. Travel Med Infect Dis 12: 713–717.
-
9.
Nutman TB, Reese W, Poindexter RW, Ottesen EA, 1988. Immunologic correlates of the hyperresponsive syndrome of loiasis. J Infect Dis 157: 544–550.
-
10.
Wahl G, Georges A, 1995. Current knowledge on the epidemiology, diagnosis, immunology, and treatment of loiasis. Trop Med Parasitol 46: 287–291.
-
11.
Gardon J, Gardon-Wendel N, Ngangue D, Kamgno J, Chippaux J-P, Boussinesq M, 1997. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet 350: 18–22.
-
12.
Carme B, Boulesteix J, Boutes H, Puruehnce M, 1991. Five cases of encephalitis during treatment of loiasis with diethylcarbamazine. Am J Trop Med Hyg 44: 684–690.
-
13.
Padgett JJ, Jacobsen KH, 2008. Loiasis: African eye worm. Trans R Soc Trop Med Hyg 102: 983–989.
-
14.
Boussinesq M, 2012. Loiasis: new epidemiologic insights and proposed treatment strategy. J Travel Med 19: 140–143.
-
15.
Takougang I, Meli J, Lamlenn S, Tatah PN, Ntep M, 2007. Loiasis—a neglected and under-estimated affliction: endemicity, morbidity and perceptions in eastern Cameroon. Ann Trop Med Parasitol 101: 151–160.
-
16.
Ali S, Fisher M, Juckett G, 2008. The African eye worm: a case report and review. J Travel Med 15: 50–52.
-
17.
Nutman TB, Miller KD, Mulligan M, Ottesen EA, 1986. Loa loa infection in temporary residents of endemic regions: recognition of a hyperresponsive syndrome with characteristic clinical manifestations. J Infect Dis 154: 10–18.
-
18.
Klion AD, Ottesen EA, Nutman TB, 1994. Effectiveness of diethylcarbamazine in treating loiasis acquired by expatriate visitors to endemic regions: long-term follow-up. J Infect Dis 169: 604–610.
-
19.
Antinori S, Schifanella L, Million M, Galimberti L, Ferraris L, Mandia L, Trabucchi G, Cacioppo V, Monaco G, Tosoni A, Brouqui P, Gismondo MR, Giuliani G, Corbellino M, 2012. Imported Loa loa filariasis: three cases and a review of cases reported in non-endemic countries in the past 25 years. Int J Infect Dis 16: e649–e662.
-
20.
Ghys C, Morissens M, Rozen L, Karmali R, Theunissen C, 2012. Loiasis with pleural and peritoneal involvement. J Travel Med 19: 186–188.
-
21.
Boussinesq M, Gardon J, Gardon-Wendel N, Kamgno J, Ngoumou P, Chippaux J-P, 1998. Three probable cases of Loa loa encephalopathy following ivermectin treatment for onchocerciasis. Am J Trop Med Hyg 58: 461–469.
-
22.
Twum-Danso N, 2003. Loa loa encephalopathy temporally related to ivermectin administration reported from onchocerciasis mass treatment programs from 1989 to 2001: implications for the future. Filaria J 2: S7.
-
23.
Kamgno J, Pion SD, Tejiokem MC, Twum-Danso NA, Thylefors B, Boussinesq M, 2007. Randomized, controlled, double-blind trial with ivermectin on Loa loa microfilaraemia: efficacy of a low dose (approximately 25 microg/kg) versus current standard dose (150 microg/kg). Trans R Soc Trop Med Hyg 101: 777–785.
-
24.
Boussinesq M, Gardon J, Gardon-Wendel N, Chippaux J, 2003. Clinical picture, epidemiology, and outcome of Loa-associated adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon. Filaria J 2: S4.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 339 | 289 | 24 |
| Full Text Views | 440 | 17 | 0 |
| PDF Downloads | 115 | 9 | 0 |