Behavioural and clinical predictors for Loiasis
Standard
Behavioural and clinical predictors for Loiasis. / Mischlinger, Johannes; Veletzky, Luzia; Tazemda-Kuitsouc, Gildas B; Pitzinger, Paul; Matsegui, Pierre B; Gmeiner, Markus; Lagler, Heimo; Gebru, Tamirat; Held, Jana; Mordmüller, Benjamin; Ramharter, Michael.
in: J GLOB HEALTH, Jahrgang 8, Nr. 1, 06.2018, S. 010413.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Behavioural and clinical predictors for Loiasis
AU - Mischlinger, Johannes
AU - Veletzky, Luzia
AU - Tazemda-Kuitsouc, Gildas B
AU - Pitzinger, Paul
AU - Matsegui, Pierre B
AU - Gmeiner, Markus
AU - Lagler, Heimo
AU - Gebru, Tamirat
AU - Held, Jana
AU - Mordmüller, Benjamin
AU - Ramharter, Michael
PY - 2018/6
Y1 - 2018/6
N2 - Background: Loiasis is a vector-borne disease in Central and West Africa. While there is still uncertainty to what extent loiasis is responsible for population morbidity, individuals having both loiasis and onchocerciasis have a high risk of fatal encephalopathy when treatment (ie, ivermectin) for onchocerciasis is given. Therefore it is current policy that communities of high loiasis-burden are excluded from mass drug administration programmes of ivermectin. To address this treatment gap we present diagnostic scores, based on clinical and behavioural predictors that may help to rapidly identify sub-groups with loiasis within high-burden communities.Methods: A cross-sectional survey was performed in the province of la Ngounie, Gabon between December 2015 and Februrary 2016 and 947 participants of all ages were recruited. Clinical parameters and behavioural exposure factors were ascertained by questionnaire-based interviews. Parasitological analysis of blood samples was performed for L. loa detection. Diagnostic scores consisting of clinical and behavioural factors were modelled to predict loiasis in sub-groups residing in endemic regions.Results: Increasing sylvan exposure was identified as important risk factor for loiasis with adjusted odds ratios of 5.1 (95% confidence interval CI 2.6-9.9) for occasional forest exposure, 11.1 (95% CI 5.4-22.6) for frequent forest exposure and 25.7 (95% CI 12.5-52.9) for intensive forest exposure. Individuals with loiasis were 7.7 (95% CI 5.4-11.0) times more likely to report recurrent pruritus than those without loiasis. Reporting of regular daily exposure to the deep rain forest and recurrent pruritus was 9-fold (positive likelihood ratio 9.18; 95% CI: 6.39-13.18) more prevalent in individuals with loiasis than in controls. Concordantly, the absence of regular weekly forest exposure was associated with extremely low disease-likelihood (negative likelihood ratio 0.09; 95% CI 0.05-0.16).Conclusions: These composite scores may serve as a simple tool to rapidly identify both those most and those least at risk of disease and may simplify loiasis control activities as well as screening procedures for studies on loiasis. Further, they may aid policy-makers to tailor the delivery of ivermectin mass drug administration for onchocerciasis control programmes more effectively and safely in regions of high loiasis-burden.
AB - Background: Loiasis is a vector-borne disease in Central and West Africa. While there is still uncertainty to what extent loiasis is responsible for population morbidity, individuals having both loiasis and onchocerciasis have a high risk of fatal encephalopathy when treatment (ie, ivermectin) for onchocerciasis is given. Therefore it is current policy that communities of high loiasis-burden are excluded from mass drug administration programmes of ivermectin. To address this treatment gap we present diagnostic scores, based on clinical and behavioural predictors that may help to rapidly identify sub-groups with loiasis within high-burden communities.Methods: A cross-sectional survey was performed in the province of la Ngounie, Gabon between December 2015 and Februrary 2016 and 947 participants of all ages were recruited. Clinical parameters and behavioural exposure factors were ascertained by questionnaire-based interviews. Parasitological analysis of blood samples was performed for L. loa detection. Diagnostic scores consisting of clinical and behavioural factors were modelled to predict loiasis in sub-groups residing in endemic regions.Results: Increasing sylvan exposure was identified as important risk factor for loiasis with adjusted odds ratios of 5.1 (95% confidence interval CI 2.6-9.9) for occasional forest exposure, 11.1 (95% CI 5.4-22.6) for frequent forest exposure and 25.7 (95% CI 12.5-52.9) for intensive forest exposure. Individuals with loiasis were 7.7 (95% CI 5.4-11.0) times more likely to report recurrent pruritus than those without loiasis. Reporting of regular daily exposure to the deep rain forest and recurrent pruritus was 9-fold (positive likelihood ratio 9.18; 95% CI: 6.39-13.18) more prevalent in individuals with loiasis than in controls. Concordantly, the absence of regular weekly forest exposure was associated with extremely low disease-likelihood (negative likelihood ratio 0.09; 95% CI 0.05-0.16).Conclusions: These composite scores may serve as a simple tool to rapidly identify both those most and those least at risk of disease and may simplify loiasis control activities as well as screening procedures for studies on loiasis. Further, they may aid policy-makers to tailor the delivery of ivermectin mass drug administration for onchocerciasis control programmes more effectively and safely in regions of high loiasis-burden.
KW - Adolescent
KW - Adult
KW - Aged
KW - Animals
KW - Child
KW - Child, Preschool
KW - Cross-Sectional Studies
KW - Environmental Exposure
KW - Female
KW - Gabon
KW - Humans
KW - Loa
KW - Loiasis
KW - Male
KW - Middle Aged
KW - Rainforest
KW - Risk Assessment
KW - Risk Factors
KW - Rural Population
KW - Surveys and Questionnaires
KW - Young Adult
KW - Journal Article
U2 - 10.7189/jogh.08.010413
DO - 10.7189/jogh.08.010413
M3 - SCORING: Journal article
C2 - 29497506
VL - 8
SP - 010413
JO - J GLOB HEALTH
JF - J GLOB HEALTH
SN - 2047-2978
IS - 1
ER -